Levosimendan improves LV systolic and diastolic performance at rest and during exercise after heart failure.
Levosimendan improves LV systolic and diastolic performance at rest and during exercise after heart failure.
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左西孟旦可改善心力衰竭后静息和运动时的左心室收缩和舒张性能。
DOI：
10.1152/ajpheart.00465.2004
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Cheng,Che-Ping
中科院分区：
文献类型：
--
作者：
Tachibana,Hideo;Cheng,Heng-Jie;Ukai,Tomohiko;Igawa,Akihiko;Zhang,Zhu-Shan;Little,WilliamC;Cheng,Che-Ping
新型肌丝Ca2+增敏剂左西孟旦（LSM）是一种正性肌力和血管舒张剂。它的有益作用已在充血性心力衰竭（CHF）休息时被证明。然而，其在运动期间（Ex）对CHF的影响尚不清楚。我们评估了LSM对8只有起搏诱导的CHF的有意识仪器狗静息和前心室动力学的影响。通过左室压力-容积（P-V）关系斜率评估，在CHF后狗处于静止状态时，LSM降低了动脉弹性（Ea），提高了左室收缩性能。LSM导致二尖瓣血流峰值速率（dV/dtmax）增加约60%，原因是最小左室压力和左室弛豫时间常数（τ）降低。以收缩期末期弹性（Ees）与ea之比量化的左室动脉耦合从0.47增加到0.85%。低压机械效率，即行程功与总P-V面积之比，从0.54±0.09提高到0.61±0.07。这些有益作用在CHF后的Ex期间持续存在。与CHF Ex相比，LSM治疗可预防Ex诱导的平均左房压和舒张末压异常升高，并降低ed /Ea。在CHF Ex期间使用LSM治疗，左室P-V回路的早期舒张部分向下移动，最小左室压和τ值降低，dV/dtmax进一步增加。Ees/ e1得到改善，机械效率从0.61±0.07进一步提高到0.67±0.07，接近正常Ex时的水平。CHF后LSM产生动脉血管舒张；改善左室舒张和舒张充盈；增强收缩力、左室动脉耦合和机械效率；并将对Ex的反应标准化。
The new myofilament Ca2+sensitizer levosimendan (LSM) is a positive inotropic and vasodilatory agent. Its beneficial effects have been demonstrated at rest in congestive heart failure (CHF). However, its effect during exercise (Ex) in CHF is unknown. We assessed the effects of LSM on left ventricular (LV) dynamics at rest and during Ex in eight conscious, instrumented dogs with pacing-induced CHF. After CHF, with dogs at rest, LSM decreased arterial elastance (Ea) and increased LV contractile performance as assessed by the slope of LV pressure-volume (P-V) relation. LSM caused a >60% increase in the peak rate of mitral flow (dV/dtmax) due to decreases in minimal LV pressure and the time constant of LV relaxation (τ). LV arterial coupling, quantified as the ratio of end-systolic elastance (Ees) toEa, was increased from 0.47 to 0.85%. LV mechanical efficiency, determined as the ratio of stroke work to total P-V area, was improved from 0.54 ± 0.09 to 0.61 ± 0.07. These beneficial effects persisted during Ex after CHF. Compared with CHF Ex dogs, treatment with LSM prevented Ex-induced abnormal increases in mean left atrial pressure and end-diastolic pressure and decreasedEes/Ea. With LSM treatment during CHF Ex, the early diastolic portion of the LV P-V loop was shifted downward with decreased minimal LV pressure and τ values and a further augmented dV/dtmax.Ees/Eaimproved, and mechanical efficiency further increased from 0.61 ± 0.07 to 0.67 ± 0.07, which was close to the value reached during normal Ex. After CHF, LSM produced arterial vasodilatation; improved LV relaxation and diastolic filling; increased contractility, LV arterial coupling, and mechanical efficiency; and normalized the response to Ex.
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影响因子：
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DOI：
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影响因子：
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作者：
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影响因子：
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