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从内毒素血症豚鼠分离的心室肌细胞的收缩功能障碍。

Contractile dysfunction of ventricular myocytes isolated from endotoxemic guinea pigs.

作者信息

Rubin L J, Keller R S, Parker J L, Adams H R

机构信息

Department of Veterinary Biomedical Science, College of Veterinary Medicine, University of Missouri, Columbia 65211, USA.

出版信息

Shock. 1994 Aug;2(2):113-20. doi: 10.1097/00024382-199408000-00006.

Abstract

Mechanisms responsible for the decline in cardiac function following sepsis or endotoxemia are unclear but may result from indirect effects of cardiodynamic readjustments to diminishing venous return or to direct effects of endogenous factors on myocardial function. We examined contractile properties of ventricular myocytes isolated from endotoxemic guinea pig hearts to 1) verify and characterize inotropic dysfunction in the absence of immediate influences from extrinsic neurohumoral agents, and 2) assess the ability of beta-adrenergic receptor activation to modulate contractility. Myocytes were isolated by enzymatic dispersion from hearts 4 h following an intraperitoneal injection of Escherichia coli endotoxin. Contractility was assessed using a computer-driven image analysis system. Inotropic responsiveness of endotoxemic myocytes to changes in frequency of stimulation (.2-2.0 Hz) or increases in extracellular calcium ([Ca2+]o, 1.8-8.0 mM) was significantly less than control myocytes, even with maximally effective frequencies or [Ca2+]o. These data demonstrate that the endotoxin-induced dysfunction is intrinsic to ex vivo cardiac myocytes and independent of immediate influence from extracardiac factors by 4 h in vivo exposure to endotoxemia. Inotropic responsiveness to beta-adrenergic receptor activation remained intact in endotoxemic myocytes; maximally effective concentrations (> 10 nM) reversed the endotoxin-induced contractile dysfunction. These data confirm that E. coli endotoxemia incorporates intrinsic contractile dysfunction of myocardial cells, while sparing their ability to respond to inotropic mechanisms activated by beta-adrenoceptor agonists.

摘要

脓毒症或内毒素血症后心脏功能下降的机制尚不清楚,但可能是由于心脏动力学对静脉回流减少的调整产生的间接影响,或内源性因素对心肌功能的直接影响所致。我们检测了从内毒素血症豚鼠心脏分离的心室肌细胞的收缩特性,以1)在无外在神经体液因子即时影响的情况下,验证并表征心肌收缩功能障碍,以及2)评估β-肾上腺素能受体激活调节收缩力的能力。在腹腔注射大肠杆菌内毒素4小时后,通过酶分散法从心脏分离肌细胞。使用计算机驱动的图像分析系统评估收缩力。内毒素血症肌细胞对刺激频率变化(0.2 - 2.0 Hz)或细胞外钙浓度升高([Ca2+]o,1.8 - 8.0 mM)的收缩反应性明显低于对照肌细胞,即使在最大有效频率或[Ca2+]o时也是如此。这些数据表明,内毒素诱导的功能障碍是离体心肌细胞固有的,且在体内暴露于内毒素血症4小时后不受心外因素的即时影响。内毒素血症肌细胞对β-肾上腺素能受体激活的收缩反应性保持完整;最大有效浓度(> 10 nM)可逆转内毒素诱导的收缩功能障碍。这些数据证实,大肠杆菌内毒素血症伴有心肌细胞固有的收缩功能障碍,同时保留了它们对β-肾上腺素能受体激动剂激活的收缩机制的反应能力。

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