Lorell B H, Barry W H
J Am Coll Cardiol. 1984 Feb;3(2 Pt 1):341-8. doi: 10.1016/s0735-1097(84)80018-2.
The calcium channel blocking agents verapamil and nifedipine have been reported to lessen abnormalities of left ventricular relaxation in patients with severe left ventricular hypertrophy or coronary artery disease. Whether these effects in human beings are related in part to a direct effect on myocardial calcium metabolism is difficult to determine because of complicating drug influences on ventricular loading via systemic arterial vasodilation, on myocardial blood supply via coronary artery vasodilation and on reflex changes in sympathetic tone. For this reason, the effects of verapamil were investigated in a cellular model of impaired relaxation using spontaneously contracting tissue cultured monolayers of chick embryo ventricular cells exposed to high external calcium ([Ca]o). Under control conditions ([Ca]o, 0.9 mM), verapamil (2 X 10(-8)M) induced a 57 +/- 8% decrease in amplitude of cell contraction monitored with a phase contrast microscope video motion detector system. Elevation of [Ca]o from 0.9 to 8.0 mM resulted in a decrease in amplitude and velocity of contraction and a decrease in velocity of relaxation associated with an upward shift in diastolic cell wall position, suggesting a failure of normal myofilament dissociation. These abnormalities were completely reversible on reperfusion with [Ca]o, 0.9 mM. On re-exposure of the cells to [Ca]o, 8.0 mM, in the presence of verapamil, there was an increase in amplitude of contraction (0.56 +/- 0.11 to 1.03 +/- 0.09 micron, p less than 0.01) and velocity of relaxation (4.97 +/- 0.89 to 9.94 +/- 0.87 micron/s, p less than 0.01) compared with exposure to [Ca]o, 8.0 mM, alone, and an attenuation of the upward shift in diastolic cell wall position.(ABSTRACT TRUNCATED AT 250 WORDS)
据报道,钙通道阻滞剂维拉帕米和硝苯地平可减轻严重左心室肥厚或冠状动脉疾病患者左心室舒张异常。由于药物通过全身动脉血管舒张对心室负荷、通过冠状动脉血管舒张对心肌供血以及对交感神经张力反射变化产生复杂影响,很难确定这些对人体的作用是否部分与对心肌钙代谢的直接影响有关。因此,在一个舒张受损的细胞模型中研究了维拉帕米的作用,该模型使用暴露于高细胞外钙([Ca]o)的鸡胚心室细胞自发收缩组织培养单层。在对照条件下([Ca]o,0.9 mM),维拉帕米(2×10⁻⁸M)通过相差显微镜视频运动检测系统监测,使细胞收缩幅度降低了57±8%。将[Ca]o从0.9 mM升高到8.0 mM导致收缩幅度和速度降低以及舒张速度降低,同时舒张期细胞壁位置上移,提示正常肌丝解离失败。在用[Ca]o 0.9 mM再灌注时,这些异常完全可逆。在维拉帕米存在的情况下,细胞再次暴露于[Ca]o 8.0 mM时,与单独暴露于[Ca]o 8.0 mM相比,收缩幅度增加(从0.56±0.11微米增加到1.03±0.09微米,p<0.01),舒张速度增加(从4.97±0.89微米/秒增加到9.94±0.87微米/秒,p<0.01),并且舒张期细胞壁位置上移减弱。(摘要截短于250字)