Browning D J, Guarnieri T, Strauss H C
J Clin Invest. 1981 Oct;68(4):942-56. doi: 10.1172/jci110349.
The relationship between the positive inotropic and toxic effects of cardiac glycosides and their effects on intracellular ionic composition is incompletely defined. We measured intracellular potassium activity (alpha ik), extracellular potassium activity (alpha ek), resting potential, action potential duration, and contractile force at 32 degrees C in paired papillary muscles from feline right ventricles exposed to ouabain. Muscles used for electrophysiological measurements were quiescent except for isolated stimulation to confirm impalement and record action potential duration. Muscles used for contractile force measurements were quiescent except for 4-min periods when force was measured at a cycle length of 1,400 ms. Muscle length was adjusted to achieve 50% of maximal tension at this cycle length before each experiment. In four experiments, alpha ik and contractile force were measured in the same muscle. Alpha iK was measured with single and double-barrel K-sensitive electrodes. At 10 nM ouabain, action potential duration is prolonged. Among the concentrations tested, the threshold for a clear positive inotropic effect is 0.1 microM ouabain. The threshold for decrease in alpha iK, increase in alpha eK, and decrease in membrane potential is 1 microM, at which concentration toxic signs develop, including arrhythmias, aftercontractions, and alteration in the staircase response of contractile force to repetitive stimulation. Ouabain need not change alpha iK to effect positive inotropy in ventricular muscle, a relationship different from that reported between [K]i (intracellular potassium concentration) and positive inotropy. Higher ouabain concentrations, which others have shown to clearly inhibit active Na and K transport, are shown to upset intracellular potassium activity homeostasis and to consistently produce toxicity.
强心苷的正性肌力作用、毒性作用与其对细胞内离子组成的影响之间的关系尚未完全明确。我们在32℃下,对暴露于哇巴因的猫右心室成对乳头肌测量了细胞内钾活性(αik)、细胞外钾活性(αek)、静息电位、动作电位持续时间和收缩力。用于电生理测量的肌肉处于静息状态,仅进行孤立刺激以确认刺入并记录动作电位持续时间。用于测量收缩力的肌肉也处于静息状态,仅在以1400毫秒的心动周期长度测量力的4分钟期间除外。在每次实验前,将肌肉长度调整至在此心动周期长度下达到最大张力的50%。在四个实验中,在同一块肌肉中测量了αik和收缩力。αik用单管和双管钾敏感电极进行测量。在10 nM哇巴因时,动作电位持续时间延长。在所测试的浓度中,明显的正性肌力作用阈值为0.1 μM哇巴因。αik降低、αek升高和膜电位降低的阈值为1 μM,在此浓度下会出现毒性体征,包括心律失常、后收缩以及收缩力对重复刺激的阶梯反应改变。哇巴因在心室肌中产生正性肌力作用时无需改变αik,这种关系与报道的[K]i(细胞内钾浓度)与正性肌力作用之间的关系不同。其他人已表明较高浓度的哇巴因可明显抑制钠钾主动转运,本文研究表明其会破坏细胞内钾活性稳态并持续产生毒性。