Kim Bo Hyun, Cho Kyoung Im, Kim Seong Man, Kim Nari, Han Jin, Kim Jee Yeon, Kim In Ju
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Heart Vessels. 2013 Jul;28(4):524-35. doi: 10.1007/s00380-012-0304-z. Epub 2012 Nov 11.
Ivabradine slows the heart rate (HR) by selectively inhibiting the I(f) current in the sinus node without a negative inotropic effect. We aimed to investigate the effects of ivabradine on thyroid hormone-induced left ventricular (LV) remodeling and ion channel activity in rats. Thirty Sprague-Dawley rats were randomly selected into the groups of control, injection of L-thyroxine (T4, 100 μg/kg/day), and injection of L-thyroxine with ivabradine (T4-Iva, T4 + 10 mg/kg/day). Circumferential (S circ), radial (S rad), and longitudinal (S long) strains were assessed by speckle tracking echocardiography (STE). Myocardial width and fibrosis were assessed from histological LV cross sections, and electrophysiological analysis was done by patch clamp method. In comparison with the control group, the T4 group showed significantly increased HR and LV end-systolic diameter (LVESD), reduced S circ (-16.04 ± 3.95 vs. -7.84 ± 2.98 %, p < 0.001), S rad (20.94 ± 3.81 vs. 40.57 ± 6.70 %, p < 0.001), and S long (-15.26 ± 5.15 vs. -23.83 ± 5.19 %, p < 0.001), despite the 59.5 % increase of average I Ca,L density at 0 mV (13.4 ± 1.2 pA/pF) compared to control group (8.4 ± 0.8 pA/pF). Treatment with ivabradine significantly reduced HR and LVESD, improved SRcirc, S long and SRlong in the T4 group, and the average I Ca,L density at 0 mV in T4-Iva groups (9.9 ± 1.6 pA/pF) was restored to the control level. Morphologically, the T4 group showed significantly increased cardiomyocyte width (25.3 ± 1.89 vs. 18.90 ± 1.14 μm in control, p < 0.001) and fibrosis, which were not significantly changed by ivabradine. In conclusion, selective HR reduction by ivabradine attenuates thyroid hormone-induced reduction of myocardial deformation and altered intracellular Ca(2+) handling without modification of the myocyte hypertrophy with fibrosis in rats.
伊伐布雷定通过选择性抑制窦房结的If电流来减慢心率(HR),且无负性肌力作用。我们旨在研究伊伐布雷定对甲状腺激素诱导的大鼠左心室(LV)重塑和离子通道活性的影响。将30只Sprague-Dawley大鼠随机分为对照组、注射L-甲状腺素(T4,100μg/kg/天)组和注射L-甲状腺素加伊伐布雷定(T4-Iva,T4 + 10mg/kg/天)组。通过斑点追踪超声心动图(STE)评估圆周应变(S circ)、径向应变(S rad)和纵向应变(S long)。从左心室组织学横截面评估心肌宽度和纤维化,并采用膜片钳法进行电生理分析。与对照组相比,T4组的心率和左心室收缩末期内径(LVESD)显著增加,S circ(-16.04±3.95 vs. -7.84±2.98%,p < 0.001)、S rad(20.94±3.81 vs. 40.57±6.70%,p < 0.001)和S long(-15.26±5.15 vs. -23.83±5.19%,p < 0.001)降低,尽管与对照组(8.4±0.8 pA/pF)相比,0 mV时平均L型钙电流密度增加了59.5%(13.4±1.2 pA/pF)。伊伐布雷定治疗显著降低了T4组的心率和LVESD,改善了S circ、S long和S rad,且T4-Iva组0 mV时的平均L型钙电流密度(9.9±1.6 pA/pF)恢复到了对照水平。形态学上,T4组的心肌细胞宽度(25.3±1.89 vs.对照组的18.90±1.14μm,p < 0.001)和纤维化显著增加,而伊伐布雷定对此无显著改变。总之,伊伐布雷定选择性降低心率可减轻甲状腺激素诱导的心肌变形减少和细胞内钙处理改变,而不改变大鼠心肌细胞肥大伴纤维化的情况。