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三碘甲状腺原氨酸可独立于β-肾上腺素能受体或环磷酸腺苷的刺激而增加心肌收缩力。

Triiodothyronine increases contractility independent of beta-adrenergic receptors or stimulation of cyclic-3',5'-adenosine monophosphate.

作者信息

Ririe D G, Butterworth J F, Royster R L, MacGregor D A, Zaloga G P

机构信息

Department of Anesthesia, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1009, USA.

出版信息

Anesthesiology. 1995 Apr;82(4):1004-12. doi: 10.1097/00000542-199504000-00025.

Abstract

BACKGROUND

Triiodothyronine regulates cardiac contractility; however, the mechanisms by which it produces its acute contractile effects remains unknown. We compared the acute effects of thyroid hormones (triiodothyronine [T3] and thyroxine [T4]) and of isoproterenol on the contractility of isolated rat hearts. In addition, we sought to determine whether the acute inotropic effects of thyroid hormones were mediated by beta-adrenergic receptors or by increased production of cyclic-3',5'-adenosine monophosphate (cAMP).

METHODS

A Langendorff heart preparation harvested from euthyroid male Sprague-Dawley rats was used. Drugs were administered through an aortic perfusion catheter. A pressure-transduced left-ventricular balloon catheter measured pressure and heart rate changes. Changes in the maximum positive rate of change in pressure (dP/dT) and maximum negative dP/dT were determined. Responses to varying doses of T3, T4, and isoproterenol were assessed in the presence and absence of beta-adrenergic receptor blockade with propranolol. cAMP production, measured by radioimmunoassay, was determined in myocardial cell suspensions after incubation with T3 or isoproterenol.

RESULTS

T3 0.74 nmol rapidly and significantly increased maximum dP/dT by 335 +/- 38 mmHg/s within 30 s after bolus injection; however, contractility was unchanged after as much as 12.9 nmol T4. The maximal increase in dP/dT after 0.8 nmol isoproterenol was comparable to that produced by T3. However, the cardiotonic actions of isoproterenol were significantly slower to develop (peaking at 60 vs. 15 s) and lasted longer than those of T3. Pretreatment with propranolol 1 mumol diminished the contractile effects of isoproterenol but had no effect on those of T3. Concentrations of isoproterenol that increase contractility also significantly increased cAMP production in isolated rat myocardial cells. However, T3 failed to increase cAMP production.

CONCLUSIONS

These results demonstrate that the acute inotropic effects of T3 are not shared by T4 and appear unrelated to beta-adrenergic receptor mechanisms or to generation of cAMP. Thus, T3 acutely stimulates cardiac contraction by mechanisms that differ from those of the more commonly used beta-adrenergic receptor agonists and phosphodiesterase inhibitors. Further studies are needed to identify the mechanisms underlying the acute contractile effects of T3 and to determine whether T3 will prove useful for increasing ventricular function in patients.

摘要

背景

三碘甲状腺原氨酸调节心脏收缩力;然而,其产生急性收缩作用的机制尚不清楚。我们比较了甲状腺激素(三碘甲状腺原氨酸 [T3] 和甲状腺素 [T4])以及异丙肾上腺素对离体大鼠心脏收缩力的急性影响。此外,我们试图确定甲状腺激素的急性正性肌力作用是由β-肾上腺素能受体介导还是由环-3',5'-腺苷单磷酸(cAMP)生成增加介导。

方法

使用从正常甲状腺功能的雄性Sprague-Dawley大鼠获取的Langendorff心脏标本。药物通过主动脉灌注导管给药。通过压力转换的左心室球囊导管测量压力和心率变化。测定压力最大正变化率(dP/dT)和最大负dP/dT的变化。在有和没有用普萘洛尔进行β-肾上腺素能受体阻断的情况下,评估对不同剂量的T3、T4和异丙肾上腺素的反应。在用T3或异丙肾上腺素孵育后,通过放射免疫测定法测定心肌细胞悬液中的cAMP生成。

结果

推注0.74 nmol T3后30秒内,最大dP/dT迅速且显著增加335±38 mmHg/s;然而,高达12.9 nmol T4后收缩力未改变。0.8 nmol异丙肾上腺素后dP/dT的最大增加与T3产生的增加相当。然而,异丙肾上腺素的强心作用发展明显较慢(分别在60秒和15秒达到峰值)且持续时间比T3长。用1 μmol普萘洛尔预处理可减弱异丙肾上腺素的收缩作用,但对T3的收缩作用无影响。增加收缩力的异丙肾上腺素浓度也显著增加了离体大鼠心肌细胞中的cAMP生成。然而,T3未能增加cAMP生成。

结论

这些结果表明,T4不具有T3的急性正性肌力作用,且似乎与β-肾上腺素能受体机制或cAMP生成无关。因此,T3通过不同于更常用的β-肾上腺素能受体激动剂和磷酸二酯酶抑制剂的机制急性刺激心脏收缩。需要进一步研究以确定T3急性收缩作用的潜在机制,并确定T3是否对增加患者心室功能有用。

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