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生长激素可改善实验性心力衰竭中的心脏功能。

Growth hormone improves cardiac performance in experimental heart failure.

作者信息

Yang R, Bunting S, Gillett N, Clark R, Jin H

机构信息

Department of Cardiovascular Research, Pharmacology, and Endocrinology, Genentech, Inc, South San Francisco, CA 94080, USA.

出版信息

Circulation. 1995 Jul 15;92(2):262-7. doi: 10.1161/01.cir.92.2.262.

Abstract

BACKGROUND

Growth hormone has been shown to increase maximum isometric active force of the left ventricular papillary muscle of rats in vitro. Administration of growth hormone causes an increase in myocardial contractility in normal humans. Our preliminary study suggests that treatment with growth hormone results in increased ventricular contractility in rats with left ventricular dysfunction. In the present study, the effects of growth hormone on cardiac function, including cardiac output, stroke volume, and peripheral vascular resistance, were determined in a rat model of heart failure.

METHODS AND RESULTS

Ligation of the left coronary artery or sham operation was performed; 4 weeks after surgery, recombinant human growth hormone (2 mg/kg per day SC) or vehicle then was administered for 15 days. The animals were catheterized after 13 days of the treatment. Cardiac output, measured by a thermodilution method, and other hemodynamic parameters were measured in the conscious animals 2 days after catheterization. The infarct sizes induced by left coronary ligation were comparable between growth hormone-treated and vehicle-treated rats. Six weeks after ligation, rats treated with vehicle exhibited significant decreases in cardiac index, stroke volume index, and left ventricular maximum dP/dt and increases in left ventricular end-diastolic pressure compared with sham rats. In the ligated rats, treatment with growth hormone increased cardiac index, stroke volume index, and left ventricular maximum dP/dt (P < .05) and reduced left ventricular end-diastolic pressure and systemic vascular resistance (P < .05). In sham rats, growth hormone slightly reduced arterial pressure but did not significantly alter cardiac performance. There was no significant difference in heart rate between the experimental groups.

CONCLUSIONS

These results suggest that growth hormone treatment may improve cardiac function by both increased myocardial contractility and decreased peripheral vascular resistance in heart failure.

摘要

背景

已表明生长激素可增加大鼠离体左心室乳头肌的最大等长主动张力。生长激素给药可使正常人的心肌收缩力增强。我们的初步研究表明,生长激素治疗可使左心室功能不全大鼠的心室收缩力增强。在本研究中,在心力衰竭大鼠模型中确定了生长激素对心功能的影响,包括心输出量、每搏输出量和外周血管阻力。

方法与结果

进行左冠状动脉结扎或假手术;术后4周,然后给予重组人生长激素(每天2mg/kg皮下注射)或赋形剂,持续15天。治疗13天后对动物进行插管。在插管后2天,通过热稀释法测量清醒动物的心输出量和其他血流动力学参数。生长激素治疗组和赋形剂治疗组大鼠由左冠状动脉结扎诱导的梗死面积相当。结扎后6周,与假手术大鼠相比,接受赋形剂治疗的大鼠心指数、每搏输出量指数和左心室最大dp/dt显著降低,左心室舒张末期压力升高。在结扎大鼠中,生长激素治疗可增加心指数、每搏输出量指数和左心室最大dp/dt(P<.05),并降低左心室舒张末期压力和全身血管阻力(P<.05)。在假手术大鼠中,生长激素可轻微降低动脉压,但对心脏功能无显著影响。实验组之间的心率无显著差异。

结论

这些结果表明,生长激素治疗可能通过增强心肌收缩力和降低心力衰竭时的外周血管阻力来改善心功能。

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