Roegel J C, Yannoulis N, De Jong W, Feldman J, Bousquet P
Laboratoire de Pharmacologie Cardiovasculaire et Rénale, CNRS ERS 109, Faculté de Médecine, Strasbourg, France.
J Hypertens Suppl. 1998 Aug;16(3):S39-43.
Centrally acting antihypertensive drugs bearing an imidazoline or a related chemical structure inhibit sympathetic nervous output to the heart and vascular beds, and enhance parasympathetic tone. Cardiac ischaemia and ventricular arrhythmias that can result from hypertension are likely to benefit from such effects.
To investigate the effects of rilmenidine, an oxazoline with antihypertensive properties, in a model of neurogenically induced ischaemic ventricular arrhythmias.
Bicuculline, a alpha-aminobutyric acid (GABA(A)) receptor antagonist, was administered intracisternally in pentobarbitone anaesthetized rabbits; 10 microg/kg intracisternal bicuculline induced polymorphic ventricular ectopic beats and ventricular tachycardia, while blood pressure increased by about 50-60% and heart rate in sinus rhythm decreased by about 20%. Rilmenidine pretreatment (10 min), either administered intravenously (0.01, 0.1, 1 mg/kg) or intracisternally (3, 10, 30 microg/kg), dose-dependently prevented the occurrence of bicuculline-induced arrhythmias and, because of a lower baseline, the blood pressure values reached were less when compared with controls. Intracisternal idazoxan (15 microg/kg) had no significant antiarrhythmic effect but antagonized, in part, the haemodynamic and antiarrhythmic effects of rilmenidine (1 mg/kg intravenously; 30 microg/kg intracisternally).
The antiarrhythmic effects observed with rilmenidine are mainly mediated by blunting the bicuculline-induced increase in the sympathetic nervous output to the heart and the vascular beds. These effects of rilmenidine are likely to originate from action on the central as well as on the peripheral nervous systems. Direct coronary or cardiac effects might also play a role, in particular at low non-hypotensive intravenous doses.
具有咪唑啉或相关化学结构的中枢性抗高血压药物可抑制交感神经向心脏和血管床的输出,并增强副交感神经张力。高血压可能导致的心脏缺血和室性心律失常可能会受益于此类作用。
研究具有抗高血压特性的恶唑啉类药物利美尼定在神经源性缺血性室性心律失常模型中的作用。
在戊巴比妥麻醉的家兔脑池内注射γ-氨基丁酸(GABA(A))受体拮抗剂荷包牡丹碱;脑池内注射10μg/kg荷包牡丹碱可诱发多形性室性早搏和室性心动过速,同时血压升高约50-60%,窦性心律时的心率降低约20%。利美尼定预处理(10分钟),静脉注射(0.01、0.1、1mg/kg)或脑池内注射(3、10、30μg/kg),可剂量依赖性地预防荷包牡丹碱诱发的心律失常,并且由于基线较低,与对照组相比,达到的血压值更低。脑池内注射咪唑克生(15μg/kg)没有显著的抗心律失常作用,但部分拮抗了利美尼定(静脉注射1mg/kg;脑池内注射30μg/kg)的血流动力学和抗心律失常作用。
利美尼定观察到的抗心律失常作用主要是通过减弱荷包牡丹碱诱发的交感神经向心脏和血管床输出增加来介导的。利美尼定的这些作用可能源于对中枢和外周神经系统的作用。直接的冠状动脉或心脏作用也可能起作用,特别是在低剂量非降压静脉注射时。