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心率对普瑞特罗在犬冠状动脉狭窄时对局部心肌血流及功能影响的作用

Influence of heart rate on the effects of prenalterol on regional myocardial blood flow and function during coronary stenosis in dogs.

作者信息

Berdeaux A, Bonhenry C, Duhazé P, Giudicelli J F, Thuillez C

出版信息

Br J Pharmacol. 1984 Sep;83(1):203-10. doi: 10.1111/j.1476-5381.1984.tb10136.x.

Abstract

The effects of prenalterol, a selective beta 1-adrenoceptor agonist with potent cardiac positive inotropic properties have been investigated on regional myocardial blood flow (RMBF) (microspheres) and contractile function (ultrasonic crystals) during partial circumflex coronary artery stenosis in 8 open-chest anaesthetized dogs. Prenalterol was investigated at two intravenous doses: 5 micrograms kg-1, which increased myocardial contractility (dP/dt max: +29%) more than heart rate (+12%, up to 150 beats min-1) and 20 micrograms kg-1 which induced almost similar increases in contractility (+35%) and heart rate (+31% up to 175 beats min-1). The induced modifications of regional flow and function were then compared to those produced in another series of 6 dogs by atrial pacing at 150 and 175 beats min-1 respectively. Prenalterol significantly increased RMBF and segment length (SL)-shortening in a dose-dependent manner in the nonischaemic zone. In the ischaemic zone, RMBF was maintained and SL-shortening increased with prenalterol, 5 micrograms kg-1 whereas both RMBF and contractile function were severely decreased with prenalterol, 20 micrograms kg-1. Atrial pacing had almost no effect on RMBF and SL-shortening in the nonischaemic zone. In the ischaemic zone, atrial pacing rate-dependently decreased both RMBF and SL-shortening. Thus, a significant increase in contractility, associated with little tachycardia (prenalterol, 5 micrograms kg-1), induces beneficial effects on RMBF and function in both the nonischaemic and ischaemic myocardium. In contrast, a strong tachycardia, whether accompanied by positive inotropic effects (prenalterol, 20 gig kg-') or not (atrial pacing at 175 beats min-1) induces deleterious effects on RMBF and cardiac function in the ischaemic myocardium.

摘要

在8只开胸麻醉犬的冠状动脉左旋支部分狭窄期间,研究了具有强效心脏正性肌力特性的选择性β1肾上腺素能受体激动剂普瑞特罗对局部心肌血流量(RMBF)(微球法)和收缩功能(超声晶体法)的影响。研究了普瑞特罗的两种静脉注射剂量:5微克/千克,该剂量使心肌收缩力(最大dp/dt:+29%)的增加超过心率(+12%,最高达150次/分钟);以及20微克/千克,该剂量使收缩力(+35%)和心率(+31%,最高达175次/分钟)产生几乎相似的增加。然后将区域血流和功能的诱导变化与另一组6只犬分别以150次/分钟和175次/分钟的心房起搏所产生的变化进行比较。普瑞特罗以剂量依赖方式显著增加非缺血区的RMBF和节段长度(SL)缩短。在缺血区,普瑞特罗5微克/千克可维持RMBF并增加SL缩短,而普瑞特罗20微克/千克则会使RMBF和收缩功能严重降低。心房起搏对非缺血区的RMBF和SL缩短几乎没有影响。在缺血区,心房起搏使RMBF和SL缩短均呈心率依赖性降低。因此,收缩力显著增加且伴有轻微心动过速(普瑞特罗,5微克/千克),对非缺血和缺血心肌的RMBF和功能均产生有益影响。相比之下,强烈的心动过速,无论是否伴有正性肌力作用(普瑞特罗,20微克/千克)或不伴有(175次/分钟的心房起搏),都会对缺血心肌的RMBF和心脏功能产生有害影响。

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