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压力超负荷、左心室肥厚对β-肾上腺素能受体的影响以及对儿茶酚胺的反应性。

Effects of pressure overload, left ventricular hypertrophy on beta-adrenergic receptors, and responsiveness to catecholamines.

作者信息

Vatner D E, Homcy C J, Sit S P, Manders W T, Vatner S F

出版信息

J Clin Invest. 1984 May;73(5):1473-82. doi: 10.1172/JCI111351.

Abstract

Pressure overload left ventricular (LV) hypertrophy was produced by banding the ascending aorta of puppies and allowing them to grow to adulthood. LV free wall weight per body weight increased by 87% from a normal value of 3.23 +/- 0.19 g/kg. Hemodynamic studies of conscious dogs with LV hypertrophy and of normal, conscious dogs without LV hypertrophy showed similar base-line values for mean arterial pressure, heart rate, and LV end-diastolic pressure and diameter. LV systolic pressure was significantly greater, P less than 0.01, and LV stroke shortening was significantly lss, P less than 0.01, in the LV hypertrophy group. In both normal and LV hypertrophy groups, increasing bolus doses of norepinephrine or isoproterenol produced equivalent changes in LV dP/dt. beta-adrenergic receptor binding studies with [3H]-dihydroalprenolol ( [3H]DHA) indicated that the density of binding sites was significantly elevated, P less than 0.01, in the hypertrophied LV plasma membranes (111 +/- 8.8, n = 8), as compared with normal LV (61 +/- 5.6 fmol/mg protein, n = 11). The receptor affinity decreased, i.e., disassociation constant (KD) increased, selectively in the LV of the hypertrophy group; the KD in the normal LV was 6.8 +/- 0.7 nM compared with 10.7 +/- 1.8 nM in the hypertrophied LV. These effects were observed only in the LV of the LV hypertrophy group and not in the right ventricles from the same dogs. The plasma membrane marker, 5' -nucleotidase activity, was slightly lower per milligram protein in the LV hypertrophy group, indicating that the differences in beta-adrenergic receptor binding and affinity were not due to an increase in plasma membrane protein in the LV hypertrophy group. The EC50 for isoproterenol-stimulated adenylate cyclase activity was similar in both the right and left ventricles and in the two groups. However, maximal-stimulated adenylate cyclase was lower in the hypertrophied left ventricle. Plasma catecholamines were similar in the normal and hypertrophied groups, but myocardial norepinephrine was depressed in the dogs with LV hypertrophy (163 +/- 48 pg/mg) compared with normal dogs (835 +/- 166 pg/mg). Thus, severe, but compensated LV hypertrophy, induced by aortic banding in puppies, is characterized by essentially normal hemodynamics in adult dogs studied at rest and in response to catecholamines in the conscious state. At the cellular level, reduced affinity and increased beta-adrenergic receptor number characterized the LV hypertrophy group, while the EC50 for isoproterenol-stimulated adenylate cyclase activity was normal. By these mechanisms, adequate responsiveness to catecholamines is retained in conscious dogs with severe LV hypertrophy.

摘要

通过结扎幼犬升主动脉并使其成长至成年,制造压力超负荷左心室(LV)肥厚模型。每单位体重的左心室游离壁重量较正常的3.23±0.19g/kg增加了87%。对有意识的左心室肥厚犬和无意识的正常左心室非肥厚犬进行血流动力学研究,结果显示平均动脉压、心率、左心室舒张末期压力和直径的基线值相似。左心室肥厚组的左心室收缩压显著更高(P<0.01),左心室缩短分数显著更低(P<0.01)。在正常组和左心室肥厚组中,静脉推注递增剂量的去甲肾上腺素或异丙肾上腺素均能使左心室dP/dt产生同等变化。用[3H]-二氢阿普洛尔([3H]DHA)进行的β-肾上腺素能受体结合研究表明,与正常左心室(61±5.6fmol/mg蛋白质,n=11)相比,肥厚左心室的质膜中结合位点密度显著升高(P<0.01)(111±8.8,n=8)。肥厚组左心室中受体亲和力降低,即解离常数(KD)增加;正常左心室的KD为6.8±0.7nM,而肥厚左心室为10.7±1.8nM。这些效应仅在左心室肥厚组的左心室中观察到,同一犬的右心室未出现。左心室肥厚组每毫克蛋白质的质膜标记物5'-核苷酸酶活性略低,表明β-肾上腺素能受体结合和亲和力的差异并非由于左心室肥厚组质膜蛋白增加所致。异丙肾上腺素刺激的腺苷酸环化酶活性的EC50在右心室和左心室以及两组中均相似。然而,肥厚左心室中最大刺激的腺苷酸环化酶活性较低。正常组和肥厚组的血浆儿茶酚胺相似,但左心室肥厚犬的心肌去甲肾上腺素水平低于正常犬(163±48pg/mg),正常犬为(835±166pg/mg)。因此,幼犬主动脉结扎诱导的严重但代偿性左心室肥厚,其特征是成年犬在静息状态下以及在有意识状态下对儿茶酚胺反应时血流动力学基本正常。在细胞水平上,左心室肥厚组的特征是亲和力降低和β-肾上腺素能受体数量增加,而异丙肾上腺素刺激的腺苷酸环化酶活性的EC50正常。通过这些机制,严重左心室肥厚的有意识犬对儿茶酚胺仍保持足够的反应性。

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