Litwin S E, Raya T E, Anderson P G, Daugherty S, Goldman S
Department of Internal Medicine, Veterans Administration Medical Center, Tucson, Arizona 85723.
J Clin Invest. 1990 Aug;86(2):481-8. doi: 10.1172/JCI114734.
To provide an integrated assessment of changes in systolic and diastolic function in diabetic rats, we measured conscious hemodynamics and performed ex vivo analysis of left ventricular passive-elastic properties. Rats given streptozotocin (STZ) 65 mg/kg i.v. (n = 14) were compared with untreated age-matched controls (n = 15) and rats treated with insulin after administration of STZ (n = 11). After 7 d, diabetic rats exhibited decreases in heart rate and peak developed left ventricular (LV) pressure during aortic occlusion. After 26 d of diabetes there were significant decreases in resting LV systolic pressure, developed pressure, and maximal +dP/dt, whereas LV end-diastolic pressure increased and the time constant of LV relaxation was prolonged. The passive LV pressure-volume relationship was progressively shifted away from the pressure axis, and the overall chamber stiffness constant was decreased. However, "operating chamber stiffness" calculated at end-diastolic pressure was increased at 7 d, and unchanged at 26 d. LV cavity/wall volume and end-diastolic volume were increased after 26 d of diabetes. Myocardial stiffness was unchanged at both time intervals. All of the above abnormalities were reversed by the administration of insulin. We conclude that the hemodynamic and passive-elastic changes that occur in diabetic rats represent an early dilated cardiomyopathy which is reversible with insulin.
为了综合评估糖尿病大鼠收缩和舒张功能的变化,我们测量了清醒状态下的血流动力学,并对左心室被动弹性特性进行了离体分析。将静脉注射65 mg/kg链脲佐菌素(STZ)的大鼠(n = 14)与未治疗的年龄匹配对照大鼠(n = 15)以及注射STZ后接受胰岛素治疗的大鼠(n = 11)进行比较。7天后,糖尿病大鼠在主动脉闭塞期间心率和左心室(LV)压力峰值出现下降。糖尿病26天后,静息LV收缩压、压力峰值和最大 +dP/dt显著降低,而LV舒张末期压力升高,LV舒张时间常数延长。左心室被动压力 - 容积关系逐渐偏离压力轴,整体心室僵硬度常数降低。然而,在舒张末期压力下计算的“工作心室僵硬度”在7天时增加,在26天时保持不变。糖尿病26天后,LV腔/壁体积和舒张末期容积增加。两个时间点的心肌僵硬度均未改变。上述所有异常情况在给予胰岛素后均得到逆转。我们得出结论,糖尿病大鼠发生的血流动力学和被动弹性变化代表一种早期扩张型心肌病,胰岛素可使其逆转。