Martins J B
Department of Internal Medicine, Veterans Administration Medical Center, Iowa City, Iowa.
Am J Physiol. 1988 Sep;255(3 Pt 2):H577-86. doi: 10.1152/ajpheart.1988.255.3.H577.
We studied the timing of the electrophysiological effects of sympathetic supersensitivity with chronically implanted electrodes in the anterior and posterior left ventricular free wall in 10 dogs. We produced denervation of the anterior wall in six dogs by application of phenol surrounding the anterior electrode. Drug infusions that were performed under pentobarbital sodium anesthesia included norepinephrine, isoproterenol, and methoxamine. In four controls there was no difference in response of the two sites. Presynaptic supersensitivity was manifest as early as 2 days and as late as 64 days by a parallel left shift (greater than or equal to 8.3 ms) in the norepinephrine dose to effective refractory period shortening response curve in the anterior compared with posterior left ventricle, P less than 0.01. The isoproterenol dose-response curve was also shifted to the left by 5.6 ms (P less than 0.01) but was manifest only after 10 days and only until 28 days from the denervation procedure. Local repolarization in the denervated areas shortened more than the innervated areas with both drugs. The methoxamine dose-response curve was flat, and the anterior-denervated area was not different than the posterior-innervated area. We conclude that recovery properties in ventricular muscle demonstrate evidence of supersensitivity, which is neurotransmitter and beta- but not alpha-receptor specific.
我们用长期植入电极记录10只犬左心室前壁和后壁的交感神经超敏反应的电生理效应的发生时间。我们通过在前电极周围应用苯酚使6只犬的前壁去神经支配。在戊巴比妥钠麻醉下进行的药物输注包括去甲肾上腺素、异丙肾上腺素和甲氧明。在4只对照犬中,两个部位的反应没有差异。与左心室后壁相比,左心室前壁去神经支配后,去甲肾上腺素剂量与有效不应期缩短反应曲线平行左移(大于或等于8.3毫秒),最早在2天出现,最晚在64天出现,提示突触前超敏反应,P<0.01。异丙肾上腺素剂量反应曲线也左移5.6毫秒(P<0.01),但仅在去神经支配术后10天出现,且仅持续至28天。两种药物作用下,去神经支配区域的局部复极化比神经支配区域缩短更明显。甲氧明剂量反应曲线呈平坦状,去神经支配的前壁区域与神经支配的后壁区域无差异。我们得出结论,心室肌的恢复特性显示出超敏反应的证据,这是神经递质特异性的,且是β受体而非α受体特异性的。