Department of Anesthesiology, University of Toyama, Toyama, Japan.
Br J Pharmacol. 2012 May;166(1):390-400. doi: 10.1111/j.1476-5381.2011.01769.x.
Supraventricular tachyarrhythmias, including atrial fibrillation, are occasionally observed in patients suffering from sepsis. Modulation of cardiac ion channel function and expression by sepsis may have a role in the genesis of tachyarrhythmias.
Sepsis was induced by LPS (i.p.; 300 µg·kg(-1) ) in guinea pigs. Membrane potentials and ionic currents were measured in atrial myocytes isolated from guinea pigs 10 h after LPS, using whole cell patch-clamp methods.
In atrial cells from LPS-treated animals, action potential duration (APD) was significantly shortened. It was associated with a reduced L-type Ca(2+) current and an increased delayed rectifier K(+) current. These electrophysiological changes were eliminated when N(G) -nitro-l-arginine methyl ester (l-NAME) or S-ethylisothiourea was given together with LPS. In atrial tissues from LPS-treated animals, Ca(2+) channel subunits (Ca(v) 1.2 and Ca(v) 1.3) decreased and delayed rectifier K(+) channel subunits (K(v) 11.1 and K(v) 7.1) increased. However, L-NAME treatment did not substantially reverse such changes in atrial expression in LPS-treated animals, with the exception that K(v) 11.1 subunits returned to control levels. After LPS injection, inducible NOS in atrial tissues was up-regulated, and atrial NO production clearly increased.
In atrial myocytes from guinea pigs with sepsis, APD was significantly shortened. This may reflect nitration of the ion channels which would alter channel functions, rather than changes in atrial expression of the channels. Shortening of APD could serve as one of the mechanisms underlying atrial tachyarrhythmia in sepsis.
包括房颤在内的室上性心动过速偶尔会发生在败血症患者中。败血症可能通过调节心脏离子通道功能和表达而在心动过速的发生中起作用。
在豚鼠中通过 LPS(腹腔内;300μg·kg(-1) )诱导败血症。使用全细胞膜片钳方法在 LPS 后 10 小时从豚鼠中分离的心房肌细胞中测量膜电位和离子电流。
在 LPS 处理的动物心房细胞中,动作电位时程(APD)明显缩短。这与 L 型钙电流减少和延迟整流钾电流增加有关。当与 LPS 一起给予 N(G) -硝基-l-精氨酸甲酯(l-NAME)或 S-乙基异硫脲时,这些电生理变化被消除。在 LPS 处理的动物心房组织中,钙通道亚基(Ca(v) 1.2 和 Ca(v) 1.3)减少,延迟整流钾通道亚基(K(v) 11.1 和 K(v) 7.1)增加。然而,L-NAME 治疗并没有实质性地逆转 LPS 处理动物心房表达中的这些变化,除了 K(v) 11.1 亚基恢复到对照水平。在 LPS 注射后,心房组织中的诱导型 NOS 上调,心房 NO 产生明显增加。
在败血症豚鼠的心房肌细胞中,APD 明显缩短。这可能反映了离子通道的硝化作用,从而改变了通道功能,而不是通道在心房中的表达变化。APD 的缩短可能是败血症中心房性心动过速的机制之一。