Horkay F, Szokodi I, Merkely B, Solti F, Gellér L, Kiss P, Selmeci L, Horváth I, Kékesi V, Juhász-Nagy A, Tóth M
Department of Cardiovascular Surgery, Semmelweis University Medical School, Budapest, Hungary.
J Cardiovasc Pharmacol. 1998;31 Suppl 1:S401-2. doi: 10.1097/00005344-199800001-00115.
Recently, extremely high levels of endothelin-1 (ET-1) were detected in the pericardial fluid of patients undergoing cardiac surgery. This study was designed to assess the pathophysiologic importance of this finding by infusing ET-1 into the closed pericardial sac of anesthetized dogs. Systemic arterial blood pressure, heart rate, and standard ECG were recorded. Intrapericardial infusion of ET-1 (11 and 33 pmol/kg/min; n = 4/4) for 40 min induced ventricular arrhythmias in all instances. The lower dose of ET-1 induced a substantial number of ventricular extrasystoles, couplets, and triplets. In one instance, ventricular extrasystoles accelerated into nonsustained ventricular tachycardia (VT). In animals receiving the higher dose, nonsustained VTs occurred regularly, whereas sustained VTs were detected in two of four animals. Before the onset of arrhythmias, QT time was significantly prolonged [ET-1 (11 pmol/kg/min) 180 +/- 12 to 198 +/- 10 ms, p < 0.05; ET-1 (33 pmol/kg/min) 192 +/- 15 to 233 +/- 13 ms, p < 0.01]. Hemodynamic variables did not change significantly before the onset of ventricular arrhythmias. Our results show that administration of exogenous ET-1 into the pericardial space induces ventricular arrhythmias associated with prolongation of QT time.
最近，在接受心脏手术的患者心包液中检测到极高水平的内皮素-1（ET-1）。本研究旨在通过将ET-1注入麻醉犬的封闭心包腔来评估这一发现的病理生理重要性。记录了体循环动脉血压、心率和标准心电图。心包腔内注入ET-1（11和33 pmol/kg/min；n = 4/4）40分钟在所有情况下均诱发了室性心律失常。较低剂量的ET-1诱发了大量室性期前收缩、成对和三联律。在1例中，室性期前收缩加速为非持续性室性心动过速（VT）。在接受较高剂量的动物中，非持续性VT经常发生，而在4只动物中有2只检测到持续性VT。在心律失常发作前，QT间期显著延长[ET-1（11 pmol/kg/min）从180±12毫秒延长至198±10毫秒，p < 0.05；ET-1（33 pmol/kg/min）从192±15毫秒延长至233±13毫秒，p < 0.01]。在室性心律失常发作前，血流动力学变量无显著变化。我们的结果表明，将外源性ET-1注入心包腔会诱发与QT间期延长相关的室性心律失常。
