Cook Rosalind F, Bussey Carol T, Mellor Kimberley M, Cragg Patricia A, Lamberts Regis R
Department of Physiology, Otago School of Medical Sciences, HeartOtago, University of Otago, Dunedin, New Zealand.
Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Exp Physiol. 2017 Aug 1;102(8):911-923. doi: 10.1113/EP086293. Epub 2017 Jun 9.
What is the central question of the study? The sympathetic system regulates heart rate via β-adrenoceptors; this is impaired during diabetes. However, the specific β-adrenoceptor subtype contributions in heart rate regulation in diabetes in vivo are unknown. What is the main finding and its importance? Telemetric recordings in conscious non-diabetic and type 2 diabetic rats demonstrated that the β -adrenoceptor subtype, and not the β -adrenoceptor, regulated the lower resting heart rate and increased β-adrenoceptor responsiveness in diabetes in vivo. This provides new physiological insight into the dysregulation of heart rate in type 2 diabetes, which is important for improving therapeutic strategies targeting the diabetic chronotropic incompetence. β-Adrenoceptor blockers are widely used to reduce heart rate, the strongest predictor of mortality in cardiac patients, but are less effective in diabetic patients. This study aimed to determine the specific contributions of β - and β -adrenoceptor subtypes to chronotropic responses in type 2 diabetes in vivo, which are currently unknown. Type 2 diabetic and non-diabetic rats were implanted with radiotelemeters to measure arterial blood pressure and derive heart rate in conscious conditions. Vascular access ports were implanted to inject isoprenaline (β - and β -adrenoceptor agonist, 0.1-300 μg kg ) in the presence of atenolol (β -adrenoceptor antagonist, 2000 μg kg ) or nadolol (β - and β -adrenoceptor agonist, 4000 μg kg ) to determine the chronotropic contributions of the β-adrenoceptor subtypes. Resting heart rate was reduced in diabetic rats (388 ± 62 versus 290 ± 37 beats min non-diabetic versus diabetic, P < 0.05, mean ± SD), which remained after atenolol or nadolol administration. Overall β-adrenoceptor chronotropic responsiveness was increased in diabetic rats (change in heart rate at highest dose of isoprenaline: 135 ± 66 versus 205 ± 28 beats min , non-diabetic versus diabetic, P < 0.05), a difference that diminished after β -adrenoceptor blockade with atenolol (change in heart rate at highest dose of isoprenaline: 205 ± 37 versus 195 ± 22 beats min , non-diabetic versus diabetic, P < 0.05). In conclusion, the β -adrenoceptor is the main subtype to modulate chronotropic β-adrenoceptor responses in healthy and diabetic rats. This study provides new insights into the pathological basis of dysregulation of heart rate in type 2 diabetes, which could be important for improving the current therapeutic strategies targeting diabetic chronotropic incompetence.
该研究的核心问题是什么?交感神经系统通过β-肾上腺素能受体调节心率;在糖尿病期间这一调节功能受损。然而,体内糖尿病状态下特定β-肾上腺素能受体亚型对心率调节的作用尚不清楚。主要发现及其重要性是什么?对清醒的非糖尿病和2型糖尿病大鼠进行遥测记录表明,在体内糖尿病状态下,是β-肾上腺素能受体亚型而非β-肾上腺素能受体调节了较低的静息心率并增强了β-肾上腺素能受体反应性。这为2型糖尿病患者心率失调提供了新的生理学见解,这对于改进针对糖尿病性变时性功能不全的治疗策略具有重要意义。β-肾上腺素能受体阻滞剂被广泛用于降低心率,心率是心脏病患者死亡率的最强预测指标,但在糖尿病患者中效果较差。本研究旨在确定β-和β-肾上腺素能受体亚型对2型糖尿病体内变时反应的具体作用,目前这些作用尚不清楚。给2型糖尿病和非糖尿病大鼠植入无线电遥测仪,以测量清醒状态下的动脉血压并得出心率。植入血管通路端口,在阿替洛尔(β-肾上腺素能受体拮抗剂,2000μg/kg)或纳多洛尔(β-和β-肾上腺素能受体拮抗剂,4000μg/kg)存在的情况下注射异丙肾上腺素(β-和β-肾上腺素能受体激动剂,0.1 - 300μg/kg),以确定β-肾上腺素能受体亚型的变时作用。糖尿病大鼠的静息心率降低(非糖尿病大鼠为388±62次/分钟,糖尿病大鼠为290±37次/分钟,P<0.05,平均值±标准差),在给予阿替洛尔或纳多洛尔后仍保持降低。糖尿病大鼠的总体β-肾上腺素能受体变时反应性增加(异丙肾上腺素最高剂量时的心率变化:非糖尿病大鼠为135±66次/分钟,糖尿病大鼠为205±28次/分钟,P<0.05),在用阿替洛尔进行β-肾上腺素能受体阻断后,这种差异减小(异丙肾上腺素最高剂量时的心率变化:非糖尿病大鼠为205±37次/分钟,糖尿病大鼠为195±22次/分钟,P<0.05)。总之,β-肾上腺素能受体是调节健康和糖尿病大鼠变时性β-肾上腺素能受体反应的主要亚型。本研究为2型糖尿病患者心率失调的病理基础提供了新的见解,这对于改进目前针对糖尿病性变时性功能不全的治疗策略可能具有重要意义。