Shinmura K, Tani M, Hasegawa H, Ebihara Y, Nakamura Y
Department of Geriatric Medicine, Keio University School of Medicine, Tokyo, Japan.
Jpn Heart J. 1998 Mar;39(2):183-97. doi: 10.1536/ihj.39.183.
The delayed outward rectifier K+ channel has a role in the increase in automaticity of myocytes under pathophysiological conditions. The purpose of the present study was to clarify the effect of blockade of outward rectifier K+ channels by a class III antiarrhythmic drug, E4031, on ischemia- and reperfusion-induced arrhythmias. Ion fluxes, energy metabolites and cardiac function were measured and the epicardial electrocardiograms of Langendorff-perfused rat hearts were recorded during initial perfusion, global or regional ischemia and reperfusion. 10(-7) M of E4031 administered during the initial perfusion did not prolong the QT interval, but slowed the heart rate (
222, E4031: 183 bpm, p < 0.05), increased myocardial 45Ca2+ uptake (
2.1, E4031: 2.9 mumol/g dwt, p < 0.05) and attenuated the loss of intracellular K+ during ischemia (
238, E4031: 248 mumol/g dwt, p < 0.05). E4031 tended to reduce ischemia-induced ventricular tachyarrhythmias (
60, E4031: 30%, n.s.), but reperfusion-induced ventricular tachyarrhythmias were sustained longer by the administration of E4031 (CONTROL: 255, E4031: 623 sec, p < 0.05). Prior exposure to E4031 decreased the depletion of high energy phosphates during ischemia, but suppressed their recovery during reperfusion. These results suggest that the attenuated loss of K+ from the ischemic myocardium and the decrease in heart rate by E4031 contributed to the reduction of ischemia-induced arrhythmias. However, the increase in myocardial Ca2+ uptake and altered energy metabolism may be responsible for the increase in reperfusion-induced arrhythmias.
延迟外向整流钾通道在病理生理条件下心肌细胞自律性增加中起作用。本研究的目的是阐明Ⅲ类抗心律失常药物E4031阻断外向整流钾通道对缺血和再灌注诱导的心律失常的影响。在初始灌注、全心或局部缺血及再灌注期间,测量离子通量、能量代谢物和心脏功能,并记录Langendorff灌注大鼠心脏的心外膜心电图。初始灌注期间给予10(-7) M的E4031未延长QT间期,但减慢了心率(对照组:222,E4031:183次/分钟,p<0.05),增加了心肌45Ca2+摄取(对照组:2.1,E4031:2.9 μmol/g干重,p<0.05),并减轻了缺血期间细胞内钾的丢失(对照组:238,E4031:248 μmol/g干重,p<0.05)。E4031倾向于减少缺血诱导的室性心律失常(对照组:60,E4031:30%,无统计学意义),但给予E4031后再灌注诱导的室性心律失常持续时间更长(对照组:255,E4031:623秒,p<0.05)。预先暴露于E4031可减少缺血期间高能磷酸盐的消耗,但抑制其在再灌注期间的恢复。这些结果表明,E4031减轻缺血心肌钾的丢失和降低心率有助于减少缺血诱导的心律失常。然而,心肌钙摄取增加和能量代谢改变可能是再灌注诱导的心律失常增加的原因。