Takaoka H, Takeuchi M, Hata K, Hayashi Y, Mori M, Yamakawa H, Yamaguchi K, Yokoyama M
First Department of Medicine, Kobe University School of Medicine, Japan.
Am Heart J. 1997 Mar;133(3):283-9. doi: 10.1016/s0002-8703(97)70221-7.
Although conventional inotropic agents such as catecholamines increase myocardial oxygen consumption, a newly developed inotropic agent, a Ca2+ sensitizer, may be able to increase cardiac output with less myocardial oxygen consumption. By using right-side heart catheterization, we assessed the ratio of the increase in myocardial oxygen consumption per unit increase in cardiac output during beta-adrenergic receptor stimulation (dobutamine, n = 15), phosphodiesterase inhibition (E-1020, n = 10), and Ca2+ sensitization (MCI-154, n = 17) in patients with coronary artery disease. Dobutamine increased cardiac output and myocardial oxygen consumption. E-1020 increased cardiac output but did not change myocardial oxygen consumption. MCI-154 increased cardiac output and decreased myocardial oxygen consumption. The oxygen cost of increasing cardiac output with dobutamine and with E-1020 was different from that with dextran infusion (n = 18); in contrast, the oxygen cost with MCI-154 was significantly smaller. Thus a newly developed Ca2+ sensitizer, MCI-154, may be beneficial for the treatment of heart failure.
尽管传统的正性肌力药物如儿茶酚胺会增加心肌耗氧量，但一种新开发的正性肌力药物，即一种钙敏化剂，或许能够在降低心肌耗氧量的同时增加心输出量。通过右侧心导管插入术，我们评估了冠心病患者在β-肾上腺素能受体刺激（多巴酚丁胺，n = 15）、磷酸二酯酶抑制（E-1020，n = 10）以及钙敏化（MCI-154，n = 17）过程中，每增加单位心输出量时心肌耗氧量增加的比率。多巴酚丁胺增加了心输出量和心肌耗氧量。E-1020增加了心输出量，但未改变心肌耗氧量。MCI-154增加了心输出量且降低了心肌耗氧量。多巴酚丁胺和E-1020增加心输出量的氧耗与右旋糖酐输注（n = 18）不同；相比之下，MCI-154的氧耗显著更小。因此，新开发的钙敏化剂MCI-154可能对心力衰竭的治疗有益。
