Ogilvie R I, Zborowska-Sluis D
Clinical Pharmacology Service, Toronto Hospital (Western Division), University of Toronto, Ontario, Canada.
J Cardiovasc Pharmacol. 1995 Sep;26(3):407-13. doi: 10.1097/00005344-199509000-00010.
The effect of L-arginine, 250 mg/kg over 10 min, on hemodynamics and venous function was studied in nine splenectomized dogs under light pentobarbital anesthesia before and after 17 +/- 1 days of rapid right ventricular pacing (RRVP) at 250 beats/min. Chronic RRVP induced mild congestive heart failure with increased mean circulatory filling (Pmcf), right atrial (Pra) and pulmonary capillary wedge pressures (Ppcw), and reduced cardiac output (CO). During the development of heart failure, total vascular compliance assessed from Pmcf-blood volume relationships during circulatory arrest was unchanged, but total vascular capacitance was markedly reduced, with an increase in stressed and reduction in unstressed blood volumes. At baseline but not after RRVP, L-arginine increased CO and reduced pulmonary vascular resistance. There were no significant changes in Pra, Ppcw, or total peripheral resistance. L-Arginine failed to alter total vascular compliance and capacitance or central blood volume in the baseline or failure state. These results do not support the hypothesis that increased Pmcf and reduced total vascular capacitance in the early stages of pacing-induced heart failure are caused by reduced substrate availability for or an endogenous competitive antagonist of NO synthase in venous endothelial cells.
在9只脾切除犬中,于轻度戊巴比妥麻醉下,研究了在以250次/分钟的频率进行17±1天快速右心室起搏(RRVP)前后,静脉注射250mg/kg的L-精氨酸10分钟对血流动力学和静脉功能的影响。慢性RRVP诱导了轻度充血性心力衰竭,表现为平均循环充盈压(Pmcf)、右心房压(Pra)和肺毛细血管楔压(Ppcw)升高,心输出量(CO)降低。在心力衰竭发展过程中,根据循环停止期间Pmcf与血容量关系评估的总血管顺应性未改变,但总血管容量显著降低,应激血容量增加,非应激血容量减少。在基线时而非RRVP后,L-精氨酸增加了CO并降低了肺血管阻力。Pra、Ppcw或总外周阻力无显著变化。L-精氨酸未能改变基线或衰竭状态下的总血管顺应性、容量或中心血容量。这些结果不支持以下假说:起搏诱导的心力衰竭早期Pmcf升高和总血管容量降低是由静脉内皮细胞中一氧化氮合酶的底物可用性降低或内源性竞争性拮抗剂所致。