Snoeckx L H, van der Vusse G J, Coumans W A, Willemsen P H, Reneman R S
Department of Physiology, University of Limburg, Maastricht, The Netherlands.
Cardiovasc Res. 1993 May;27(5):874-81. doi: 10.1093/cvr/27.5.874.
The aim was to examine differences between the postischaemic functional and biochemical recovery of adult and aged hypertrophied hearts.
Isolated hypertrophied hearts of adult and aged spontaneously hypertensive rats (SHRadult; SHRaged) and normal hearts of age matched Wistar-Kyoto rats (WKYadult; WKYaged) were perfused in an ejecting heart preparation. Haemodynamic function was monitored before and after 45 min of ischaemia. Coronary effluent samples and tissue biopsies were taken for biochemical analysis.
After ischaemia, in SHRadult and WKYadult the maximum positive first derivative of the left ventricular pressure (dP/dtmax) was restored to 105% and 97% respectively of the preischaemic values. Left ventricular developed pressure recovered to 80% (SHRadult) and 97% (WKYadult), while cardiac output reached 71% (SHRadult) and 99% (WKYadult) of preischaemic levels. In SHRaged and WKYaged the dP/dtmax recovered to 26% and 60% respectively (both p < 0.05 compared to the preischaemic values). The left ventricular developed pressure recovered to 36% in SHRaged and to 73% in WKYaged (both p < 0.05), while cardiac output was restored to 6% in SHRaged and 38% in WKYaged (both p < 0.05). Throughout reperfusion, left ventricular end diastolic pressure remained significantly elevated in SHRaged, and was associated with a prominent subendocardial underperfusion, suggesting an impaired diastolic functional recovery. Overall haemodynamic recovery was significantly better in the WKYaged than in the SHRaged. The preischaemic total adenine nucleotides content was comparable in all groups, but creatine phosphate levels were significantly lower in both aged groups than in adult groups. In all but the WKYadult, the total adenine nucleotides were depressed upon reperfusion, while creatine phosphate normalised, except in SHRaged. SHRaged lost more lactate dehydrogenase and tended to lose more xanthine and uric acid than other groups.
The aged hypertrophied heart shows a higher vulnerability to ischaemic damage than the adult hypertrophied heart. This phenomenon is associated with subendocardial underperfusion, increased membrane damage and inadequate recovery of creatine phosphate levels.
研究成年和老年肥厚心脏缺血后功能及生化恢复的差异。
在离体心脏灌流装置中灌注成年和老年自发性高血压大鼠(成年SHR;老年SHR)的肥厚心脏以及年龄匹配的Wistar-Kyoto大鼠(成年WKY;老年WKY)的正常心脏。在缺血45分钟前后监测血流动力学功能。采集冠状动脉流出液样本和组织活检样本进行生化分析。
缺血后,成年SHR和成年WKY的左心室压力最大正向一阶导数(dP/dtmax)分别恢复至缺血前值的105%和97%。左心室舒张末压恢复至缺血前水平的80%(成年SHR)和97%(成年WKY),而心输出量达到缺血前水平的71%(成年SHR)和99%(成年WKY)。在老年SHR和老年WKY中,dP/dtmax分别恢复至26%和60%(与缺血前值相比,两者p<0.05)。老年SHR的左心室舒张末压恢复至36%,老年WKY恢复至73%(两者p<0.05),而老年SHR的心输出量恢复至6%,老年WKY恢复至38%(两者p<0.05)。在整个再灌注过程中,老年SHR的左心室舒张末压持续显著升高,并伴有明显的心内膜下灌注不足,提示舒张功能恢复受损。老年WKY的整体血流动力学恢复明显优于老年SHR。所有组缺血前的总腺嘌呤核苷酸含量相当,但两个老年组的磷酸肌酸水平均显著低于成年组。除成年WKY外,所有组再灌注时总腺嘌呤核苷酸均降低,而磷酸肌酸恢复正常,但老年SHR除外。与其他组相比,老年SHR损失更多的乳酸脱氢酶,且倾向于损失更多的黄嘌呤和尿酸。
老年肥厚心脏比成年肥厚心脏对缺血损伤更敏感。这种现象与心内膜下灌注不足、膜损伤增加以及磷酸肌酸水平恢复不充分有关。