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左心室收缩阻力与收缩速率过程之间的关系。

Relation between left ventricular systolic resistance and contractile rate processes.

作者信息

Shroff S G, Naegelen D, Clark W A

机构信息

Cardiovascular Institute, Michael Reese Hospital and Medical Center, University of Chicago Pritzker School of Medicine, Illinois 60616.

出版信息

Am J Physiol. 1990 Feb;258(2 Pt 2):H381-94. doi: 10.1152/ajpheart.1990.258.2.H381.

Abstract

To test the hypothesis that left ventricular (LV) systolic resistance is determined by the intrinsic rate processes of the contractile system, we studied 40 spontaneously hypertensive male rats (SHR). Thyroid hormone manipulation was used to alter isomyosin composition and consequently the rate processes of the contractile system. Seven groups of rats were studied: control (SHRC, n = 9); propylthiouracil (PTU) treated for 10 days (SHRP-10, n = 5), 20 days (SHRP-20, n = 5), and 30 days (SHRP-30, n = 6); and thyroxine treated for 5 days (SHRT-05, n = 5), 10 days (SHRT-10, n = 5), and 15 days (SHRT-15, n = 5). In situ (n = 40) and isolated (n = 14; 5 SHRP-30, 5 SHRC, and 4 SHRT-15) heart experiments were performed. In comparison to SHRC, we observed the following: 1) LV pump performance was not different in any of the thyroxine-treated groups, whereas with PTU, pump performance was significantly depressed in rats with greater than 80% slow myosin. 2) Normalized LV peak elastance (Emaxn) was significantly increased in the SHRP-30, whereas it was not altered after thyroxine. These observations were further confirmed in the isolated heart on the basis of peak isovolumetric stress-strain relations. 3) Thyroxine increased and PTU decreased theoretical maximum flow (Qmax; a measure of LV resistance); thus an inverse relation between Qmax and percent slow myosin was observed (r2 = 0.86). 4) The time to peak isovolumetric pressure was increased in SHRP-30 and decreased in SHRT-15. The relaxation process was significantly slower for SHRP-30 group and was unchanged for SHRT-15 group. These observations support our hypothesis that LV systolic resistance quantifies an intrinsic rate-dependent property of the myocardium and that isomyosin composition is one of its determinants. In addition, with changes in isomyosin composition toward predominantly slow myosin, the responses in Emaxn and Qmax are discordant, which may be responsible for the preservation of pump performance. This underscores the importance of quantifying both LV systolic resistance and elastance in the assessment of the functional status of the LV as a mechanical pump.

摘要

为了验证左心室(LV)收缩期阻力由收缩系统的内在速率过程决定这一假设,我们研究了40只自发性高血压雄性大鼠(SHR)。通过甲状腺激素处理来改变肌球蛋白异构体组成,进而改变收缩系统的速率过程。研究了七组大鼠:对照组(SHRC,n = 9);丙硫氧嘧啶(PTU)处理10天(SHRP - 10,n = 5)、20天(SHRP - 20,n = 5)和30天(SHRP - 30,n = 6);甲状腺素处理5天(SHRT - 05,n = 5)、10天(SHRT - 10, n = 5)和15天(SHRT - 15,n = 5)。进行了原位(n = 40)和离体(n = 14;5只SHRP - 30、5只SHRC和4只SHRT - 15)心脏实验。与SHRC相比,我们观察到以下情况:1)在任何甲状腺素处理组中,左心室泵功能均无差异,而使用PTU时,慢肌球蛋白含量超过80%的大鼠泵功能显著降低。2)SHRP - 30组的归一化左心室峰值弹性(Emaxn)显著增加,而甲状腺素处理后未改变。基于峰值等容应力 - 应变关系,这些观察结果在离体心脏中得到进一步证实。3)甲状腺素增加而PTU降低理论最大流量(Qmax;左心室阻力的一种度量);因此观察到Qmax与慢肌球蛋白百分比之间呈负相关(r2 = 0.86)。4)SHRP - 30组达到峰值等容压力的时间增加,而SHRT - 15组减少。SHRP - 30组的舒张过程明显减慢,而SHRT - 15组未改变。这些观察结果支持了我们的假设,即左心室收缩期阻力量化了心肌的一种内在速率依赖性特性,且肌球蛋白异构体组成是其决定因素之一。此外,随着肌球蛋白异构体组成向主要为慢肌球蛋白转变,Emaxn和Qmax的反应不一致,这可能是泵功能得以维持的原因。这突出了在评估左心室作为机械泵时量化左心室收缩期阻力和弹性的重要性。

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