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心脏移植后心肌儿茶酚胺含量

Myocardial catecholamine content after heart transplantation.

作者信息

Regitz V, Bossaller C, Strasser R, Schüler S, Hetzer R, Fleck E

机构信息

German Heart Institute, Berlin.

出版信息

Circulation. 1990 Aug;82(2):620-3. doi: 10.1161/01.cir.82.2.620.

Abstract

Myocardial catecholamine levels have not yet been determined in the transplanted human heart. We measured norepinephrine, epinephrine, and dopamine in endomyocardial biopsies from 19 short-term (organ age, 6.6 +/- 6 months) and five long-term (organ age, 62 +/- 2 months) heart transplant patients. Results were compared with those from 10 normal control subjects. In 17 of 19 short-term heart transplant patients, myocardial catecholamines were undetectable, indicating values below 0.1 pg/micrograms noncollagen protein, which was the detection threshold of our assay. In the remaining two patients, myocardial catecholamines (pg/microgram noncollagen protein) were norepinephrine (1.4 and 3.2), epinephrine (0.8 and 1.9), and dopamine (0.9 and 2.3), respectively. In the five long-term heart transplant patients, myocardial catecholamines were not detected. Catecholamine concentrations in 10 healthy control subjects were norepinephrine (10.3 +/- 2.9), epinephrine (0.36 +/- 0.51), and dopamine (0.52 +/- 0.40). Low myocardial norepinephrine levels (less than 20% of control values) with unexplained high levels of epinephrine and dopamine were found in single transplant patients. In most heart transplant patients, however, myocardial catecholamines were undetectable up to five years after transplantation, indicating that the adrenergic response of these hearts probably depends on variations in plasma catecholamines or cardiac beta-receptor density.

摘要

尚未测定移植的人类心脏中的心肌儿茶酚胺水平。我们测量了19名短期(器官存活时间,6.6±6个月)和5名长期(器官存活时间,62±2个月)心脏移植患者的心内膜活检组织中的去甲肾上腺素、肾上腺素和多巴胺。将结果与10名正常对照受试者的结果进行比较。在19名短期心脏移植患者中,有17名患者的心肌儿茶酚胺无法检测到,表明其值低于0.1 pg/μg非胶原蛋白,这是我们检测方法的检测阈值。在其余两名患者中,心肌儿茶酚胺(pg/μg非胶原蛋白)分别为去甲肾上腺素(1.4和3.2)、肾上腺素(0.8和1.9)和多巴胺(0.9和2.3)。在5名长期心脏移植患者中,未检测到心肌儿茶酚胺。10名健康对照受试者的儿茶酚胺浓度分别为去甲肾上腺素(10.3±2.9)、肾上腺素(0.36±0.51)和多巴胺(0.52±0.40)。在个别移植患者中发现心肌去甲肾上腺素水平较低(低于对照值的20%),同时伴有无法解释的肾上腺素和多巴胺水平升高。然而,在大多数心脏移植患者中,移植后长达五年心肌儿茶酚胺均无法检测到,这表明这些心脏的肾上腺素能反应可能取决于血浆儿茶酚胺或心脏β受体密度的变化。

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