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地塞米松治疗的严重低输出综合征(LOS)犬左心室心肌的脂肪酸和前列腺素组成

Fatty acid and prostaglandin composition of left ventricular myocardium from dexamethasone-treated dogs with severe low output syndrome (LOS).

作者信息

Bonilla C A, Dupont J

出版信息

Prostaglandins. 1976 Jun;11(6):935-51. doi: 10.1016/0090-6980(76)90003-4.

Abstract

The effects of dexamethasone (DEX) administration on the left ventricular myocardial content of fatty acids and prostaglandins E1, E2 and F2alpha were studied. Following a complete right and left cardiac catheterization, either DEX (8 mg/kg) or an equivalent volume of its vehicle was given intravenously 30 minutes prior to low output syndrome (LOS induction, and supplemental doses of DEX (4 mg/kg) or vehicle administered at 15 and 75 minutes post-LOS induction. Low output syndrome was induced by intravenous administration of a myocardial depressor protein (MDP) which has been isolated from the venom of the Western diamondback rattlesnake, Crotalus atrox. Neither DEX nor its vehicle had a significant effect during the entire experiment, that is, in the normal or low cardiac output state in most of the hemodynamic parameters investigated. The three hour mortality rate for the DEX-treated animals was 22% (n=10) while that of the control group was 41% (n=26) indicating that the beneficial effects of this corticosteroid are not really apparent from hemodynamic evaluation alone. Since DEX only had a significant post-LOS induction effect in maintaining a lower left ventricular end-diastolic and pulmonary capillary wedge pressures, a higher arterio-venous oxygen saturation difference, and a more efficient contractile state of myocardial fibers (Vmax), an indirect correlation to coronary arterial blood flow at the subcellular level was sought. To this effect, prostaglandins and specific lipid classes of left ventricular myocardium (LVM) from control and LOS animals receiving either vehicle or DEX were analyzed. Low output state induction alone raised myocardial PG levels above those of sham-catheterized animals; on the other hand, dexamethasone induced a significant decrease in the three prostaglandins studied when administered to control (no LOS) animals. In the presence of LOS, however, dexamethasone overrode in part the increase in PGE1 and PGE2 brought about by LOS while in the case of PGF2alpha the LOS effect was totally prevented and its concentration was not significantly higher than in control animals receiving dexamathasone. LOS induction led to an increase in myristic and arachidonic acids and a decrease in palmitic and linolenic acids. Dexamethasone administration to control animals increased the concentration of stearic acid above all the other groups but decreased the concentration of linolenic acid when compared to DEX-treated animals with LOS or sham-catheterized animals. There were no significant differences in the total myocardial lipid among the four groups of animals studied. It is suggested that the potentially beneficial effects of corticosteroid administration to animals with low output syndrome are related to their effects on fatty acid and prostaglandin content of myocardium.

摘要

研究了地塞米松(DEX)给药对左心室心肌脂肪酸以及前列腺素E1、E2和F2α含量的影响。在完成左右心导管插入术后,在低输出综合征(LOS)诱导前30分钟静脉注射DEX(8mg/kg)或等量的溶媒,在LOS诱导后15分钟和75分钟补充注射DEX(4mg/kg)或溶媒。通过静脉注射从西部菱斑响尾蛇(Crotalus atrox)毒液中分离出的心肌抑制蛋白(MDP)诱导低输出综合征。在整个实验过程中,即在所研究的大多数血流动力学参数的正常或低心输出状态下,DEX及其溶媒均无显著影响。DEX治疗组动物的3小时死亡率为22%(n=10),而对照组为41%(n=26),这表明仅从血流动力学评估来看,这种皮质类固醇的有益作用并不明显。由于DEX仅在LOS诱导后对维持较低的左心室舒张末期和肺毛细血管楔压、较高的动静脉血氧饱和度差以及心肌纤维更有效的收缩状态(Vmax)有显著作用,因此寻求在亚细胞水平上与冠状动脉血流的间接相关性。为此,分析了接受溶媒或DEX的对照动物和LOS动物的左心室心肌(LVM)中的前列腺素和特定脂质类别。单独诱导低输出状态会使心肌PG水平高于假导管插入动物;另一方面,地塞米松在给予对照(无LOS)动物时会使所研究的三种前列腺素显著降低。然而,在存在LOS的情况下,地塞米松部分抵消了LOS引起的PGE1和PGE2的增加,而在PGF2α的情况下,LOS的影响被完全阻止,其浓度并不显著高于接受地塞米松的对照动物。LOS诱导导致肉豆蔻酸和花生四烯酸增加,棕榈酸和亚麻酸减少。与有LOS的DEX治疗动物或假导管插入动物相比,给对照动物注射地塞米松会使硬脂酸浓度高于所有其他组,但会降低亚麻酸浓度。在所研究的四组动物中,心肌总脂质无显著差异。提示给低输出综合征动物使用皮质类固醇的潜在有益作用与其对心肌脂肪酸和前列腺素含量的影响有关。

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