Sabbah H N, Levine T B, Gheorghiade M, Kono T, Goldstein S
Henry Ford Heart and Vascular Institute, Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan 48202.
Cardiovasc Drugs Ther. 1993 Jun;7(3):349-56. doi: 10.1007/BF00880158.
The hemodynamic effects of acute intravenous administration of nitroprusside, dobutamine, enalaprilat, and digoxin was investigated in a canine model of chronic heart failure (CHF) produced by multiple sequential intracoronary microembolizations. Dobutamine (4 micrograms/kg/min) increased cardiac output (2.4 +/- 0.1 vs. 4.0 +/- 0.4 l/min; p < .001) and LV ejection fraction (LVEF; 26 +/- 1 vs. 30 +/- 4%; p < .01), and decreased systemic vascular resistance (SVR; 3620 +/- 170 vs. 2470 +/- 190 dynes sec cm-5; p < .001). Nitroprusside (3 micrograms/kg/min) acted as a venodilator; it decreased pulmonary artery wedge pressure (16 +/- 1 vs. 13 +/- 1 mmHg; p < .01) and SVR (3730 +/- 440 vs. 3210 +/- 280 dynes sec cm-5; NS) but had no effect on cardiac output. Enalaprilat (1.875 mg) produced a significant increase of cardiac output (3.0 +/- 0.5 vs. 3.8 +/- 0.5 l/min; p < .001) and LVEF (22 +/- 1 vs. 30 +/- 1%; p < .01), and decreased SVR (3280 +/- 400 vs. 2450 +/- 250 dynes sec cm-5; p < .01). Intravenous digoxin at a cumulative dose of 0.75 mg increased LVEF (23 +/- 2 vs. 31 +/- 2%; p < .01) but had no effect on SVR. These data indicate that this canine model of CHF responds to acute pharmacologic intervention in a manner comparable to that seen in patients with CHF. Accordingly, this model may be a useful tool for the preclinical evaluation of new drugs targeted toward the treatment of CHF and for investigating the mechanisms of action of drugs currently used for the treatment of this disease state.
在通过多次连续冠状动脉内微栓塞产生的慢性心力衰竭(CHF)犬模型中,研究了急性静脉注射硝普钠、多巴酚丁胺、依那普利拉和地高辛的血流动力学效应。多巴酚丁胺(4微克/千克/分钟)可增加心输出量(2.4±0.1对4.0±0.4升/分钟;p<.001)和左心室射血分数(LVEF;26±1对30±4%;p<.01),并降低全身血管阻力(SVR;3620±170对2470±190达因·秒·厘米⁻⁵;p<.001)。硝普钠(3微克/千克/分钟)起静脉扩张剂的作用;它降低了肺动脉楔压(16±1对13±1毫米汞柱;p<.01)和SVR(3730±440对3210±280达因·秒·厘米⁻⁵;无显著性差异),但对心输出量无影响。依那普利拉(1.875毫克)可显著增加心输出量(3.0±0.5对3.8±0.5升/分钟;p<.001)和LVEF(22±1对30±1%;p<.01),并降低SVR(3280±400对2450±250达因·秒·厘米⁻⁵;p<.01)。累积剂量为0.75毫克的静脉注射地高辛可增加LVEF(23±2对31±2%;p<.01),但对SVR无影响。这些数据表明,这种CHF犬模型对急性药物干预的反应方式与CHF患者相似。因此,该模型可能是一种有用的工具,用于针对CHF治疗的新药的临床前评估,以及用于研究目前用于治疗这种疾病状态的药物的作用机制。