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疑似特发性扩张型心肌病患者左心室功能与钠钾泵浓度的关系

Relation of left ventricular function and Na,K-pump concentration in suspected idiopathic dilated cardiomyopathy.

作者信息

Nørgaard A, Bagger J P, Bjerregaard P, Baandrup U, Kjeldsen K, Thomsen P E

机构信息

Department of Cardiology, Aarhus Municipal Hospital, Denmark.

出版信息

Am J Cardiol. 1988 Jun 1;61(15):1312-5. doi: 10.1016/0002-9149(88)91175-7.

Abstract

The possible relation between Na-K-pump concentration and left ventricular (LV) function was studied in 24 patients with suspected idiopathic dilated cardiomyopathy. This was done by measurement of 3H-ouabain binding to biopsies obtained during left-sided heart catheterization. In all patients light microscopy of biopsies was compatilel with dilated cardiomyopathy. Nineteen patients had impaired LV function as defined by NYHA/WHO and a Na,K-pump concentration of 331 +/- 19 pmol/g wet weight, whereas 5 patients had normal LV function and a Na,K-pump concentration of 559 +/- 62 pmol/g wet weight (p less than 0.001). The correlation between Na,K-pump concentration and ejection fraction was highly significant n = 24, r = 0.81, p less than 0.001). There was no correlation between volume fraction of collagen tissue and Na,K-pump concentration in the biopsies (n = 24, r = -0.08, p less than 0.80), indicating that the decrease in Na,K-pump concentration with dilated cardiomyopathy is not the simple outcome of increased fibrosis in the myocardium. The results indicate that the decrease in Na,K-pump concentration may be of importance for myocardial dysfunction and suggest a simple biochemical assessment of dilated cardiomyopathy by measurement of 3H-ouabain binding.

摘要

在24例疑似特发性扩张型心肌病患者中研究了钠钾泵浓度与左心室(LV)功能之间的可能关系。这是通过测量在左侧心导管检查期间获得的活检组织中3H-哇巴因的结合情况来完成的。所有患者活检组织的光学显微镜检查结果均符合扩张型心肌病。19例患者根据纽约心脏协会/世界卫生组织的定义左心室功能受损,钠钾泵浓度为331±19 pmol/g湿重,而5例患者左心室功能正常,钠钾泵浓度为559±62 pmol/g湿重(p<0.001)。钠钾泵浓度与射血分数之间的相关性非常显著(n = 24,r = 0.81,p<0.001)。活检组织中胶原组织的体积分数与钠钾泵浓度之间无相关性(n = 24,r = -0.08,p<0.80),这表明扩张型心肌病患者钠钾泵浓度的降低并非心肌纤维化增加的简单结果。结果表明,钠钾泵浓度的降低可能对心肌功能障碍具有重要意义,并提示通过测量3H-哇巴因结合情况对扩张型心肌病进行简单的生化评估。

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