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甲状腺功能亢进兔心脏的收缩效率降低及非机械能成本增加。氧耗与收缩压-容积面积或力-时间积分之间的关系。

Decreased contractile efficiency and increased nonmechanical energy cost in hyperthyroid rabbit heart. Relation between O2 consumption and systolic pressure-volume area or force-time integral.

作者信息

Goto Y, Slinker B K, LeWinter M M

机构信息

Department of Medicine, University of Vermont, Burlington 05405.

出版信息

Circ Res. 1990 Apr;66(4):999-1011. doi: 10.1161/01.res.66.4.999.

Abstract

Both systolic pressure-volume area (PVA) and force-time integral (FTI) have been used as measures of oxygen consumption per beat (VO2) in the isolated left ventricle. The reciprocal of the slope of the VO2-PVA relation has been considered to reflect the chemomechanical energy transduction efficiency of the contractile machinery (contractile efficiency), whereas its VO2 intercept consists of energy cost of excitation-contraction coupling and basal metabolism. To examine whether the increase in myosin isoform V1/V3 ratio in hyperthyroid rabbits decreases contractile efficiency and to determine overall mechanisms of higher oxygen consumption in hyperthyroid hearts, the VO2-PVA and VO2-FTI relations as well as the end-systolic pressure-volume relation were assessed in cross-circulated, isovolumically beating hearts isolated from normal, hyperthyroid, and hypothyroid rabbits. Normalized initial slopes of the rising limb of the curvilinearly fitted end-systolic pressure-volume relation (E'max, ventricular contractility index) were similar for normal and hyperthyroid groups. However, the slopes and VO2 intercepts of the VO2-PVA and VO2-FTI relations were greater in hyperthyroid hearts than in normal hearts. Accordingly, in the hyperthyroid hearts, the contractile efficiency (27 +/- 6%) was lower and left ventricular VO2 for excitation-contraction coupling (0.028 +/- 0.004 ml O2/beat/100 g) was higher than in normal hearts (40 +/- 4% and 0.021 +/- 0.005 ml O2/beat/100 g, respectively). This decreased contractile efficiency in the hyperthyroid hearts was attributable to myosin isoform alteration rather than to increased beta-adrenoceptors because isoproterenol did not affect the slope of the VO2-PVA relation in all groups. In contrast, the slope of the VO2-FTI relation was significantly increased by isoproterenol in all groups. Neither the VO2-PVA nor the VO2-FTI relations in hypothyroid hearts were different from those in normal hearts except for significantly lower VO2 for basal metabolism. We conclude that in hyperthyroid rabbits, the left ventricle has decreased contractile efficiency and increased energy cost of excitation-contraction coupling and that the decreased contractile efficiency in hyperthyroid hearts is probably due to the increased V1/V3 ratio of the myosin isoform component. In addition, this study demonstrates that the VO2-PVA and VO2-FTI relations dissociate depending on the intervention, even in the same isovolumic contraction mode.

摘要

收缩压-容积面积(PVA)和力-时间积分(FTI)都已被用作离体左心室每搏氧耗量(VO₂)的测量指标。VO₂-PVA关系曲线斜率的倒数被认为反映了收缩机制的化学机械能转换效率(收缩效率),而其VO₂截距则包括兴奋-收缩偶联的能量消耗和基础代谢。为了研究甲状腺功能亢进兔肌球蛋白同工型V1/V3比值的增加是否会降低收缩效率,并确定甲状腺功能亢进心脏中氧耗量增加的总体机制,我们对从正常、甲状腺功能亢进和甲状腺功能减退兔分离出的交叉循环、等容搏动心脏的VO₂-PVA和VO₂-FTI关系以及收缩末期压力-容积关系进行了评估。正常组和甲状腺功能亢进组的收缩末期压力-容积关系曲线(E'max,心室收缩性指数)上升支的归一化初始斜率相似。然而,甲状腺功能亢进心脏的VO₂-PVA和VO₂-FTI关系曲线的斜率和VO₂截距均高于正常心脏。因此,在甲状腺功能亢进心脏中,收缩效率(27±6%)低于正常心脏,兴奋-收缩偶联的左心室VO₂(0.028±0.004 ml O₂/搏/100 g)高于正常心脏(分别为40±4%和0.021±0.005 ml O₂/搏/100 g)。甲状腺功能亢进心脏中收缩效率的降低归因于肌球蛋白同工型改变,而非β-肾上腺素能受体增加,因为异丙肾上腺素在所有组中均未影响VO₂-PVA关系曲线的斜率。相反,异丙肾上腺素在所有组中均显著增加了VO₂-FTI关系曲线的斜率。除基础代谢的VO₂显著降低外,甲状腺功能减退心脏的VO₂-PVA和VO₂-FTI关系与正常心脏无差异。我们得出结论,在甲状腺功能亢进兔中,左心室收缩效率降低,兴奋-收缩偶联的能量消耗增加,甲状腺功能亢进心脏中收缩效率的降低可能是由于肌球蛋白同工型成分的V1/V3比值增加所致。此外,本研究表明,即使在相同的等容收缩模式下,VO₂-PVA和VO₂-FTI关系也会因干预措施的不同而出现分离。

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