Lack of desensitization and enhanced efficiency of calcium channel promoter in conscious dogs with heart failure.
Lack of desensitization and enhanced efficiency of calcium channel promoter in conscious dogs with heart failure.
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对患有心力衰竭的清醒犬缺乏脱敏作用和增强钙通道启动子的效率。
DOI：
10.1152/ajpheart.1998.275.6.h2219
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Vatner,SF
中科院分区：
文献类型：
--
作者：
Asai,K;Uechi,M;Sato,N;Shen,W;Meguro,T;Mathier,MA;Shannon,RP;Vatner,SF
这项研究的目的是比较钙促进剂Bay Y5959和多巴酚丁胺(道布)在心力衰竭(HF)中的反应。犬(n=9)在起搏诱发心力衰竭前、后的意识状态下进行慢性监测和研究。在对照组，BAY5959(20μg⋅kg−1⋅min−1)使左室压(LV)一阶导数(dp/dt)增加83±8%，平均动脉压(MAP)增加8±2%，心率(HR)降低30±3%。与道布(10μg⋅kg−1⋅min−1)相比，LV dp/dtrose相似(+80±6%)，但HR也增加(+25±4%)(P<；005vs.Bay y5959)。在心力衰竭发生后，Bay y5959仍使LV dp/dt增加108±8%，MAP增加21±2%，HR降低28±4%，而道布仅使LV dp/dt增加50±7%(P<；0.05 vs.Bay y5959)，MAP增加7±3%，HR无变化(P<；0.05 vs.Bay y 5959)。心衰组心脏做功增加更多(P<；0.05)，Bayy5959(+105±13%)与道布(+47±11%)相比，但心肌耗氧量增加相似。相应地，机械效率提高更多(P<；0.05)，比道布(+17±12%)高。这些数据表明：1)钙离子直接介导的心肌收缩能力的增加对心衰的脱敏反应具有相对的抵抗力；2)钙通道启动子能以明显较低的氧气消耗产生与道布相似的心肌收缩能力和心功的增加，从而提高心衰的机械效率。
The goal of this study was to compare responses to a calcium promoter, BAY y 5959, and dobutamine (Dob) in heart failure (HF). Dogs (n= 9) were chronically instrumented and studied in the conscious state before and after pacing-induced HF. In the control state, BAY y 5959 (20 μg ⋅ kg−1⋅ min−1) increased the first derivative of left ventricular (LV) pressure (dP/dt) by 83 ± 8% and mean arterial pressure (MAP) by 8 ± 2% and decreased heart rate (HR) by 30 ± 3%. With Dob (10 μg ⋅ kg−1⋅ min−1) LV dP/dtrose similarly (+80 ± 6%), but HR also rose (+25 ± 4%) (P< 0.05 vs. BAY y 5959). After HF developed, BAY y 5959 still increased LV dP/dtby 108 ± 8% and MAP by 21 ± 2% and decreased HR by 28 ± 4%, whereas Dob increased LV dP/dtby only 50 ± 7% (P< 0.05 vs. BAY y 5959) and MAP by 7 ± 3%, and HR did not change (+3 ± 3%) (P< 0.05 vs. BAY y 5959). In HF, cardiac work increased more (P< 0.05) with BAY y 5959 (+105 ± 13%) compared with Dob (+47 ± 11%), yet myocardial oxygen consumption increased similarly with the two drugs. Accordingly, mechanical efficiency increased more (P< 0.05) with BAY y 5959 (+73 ± 14%) than with Dob (+17 ± 12%). These data indicate that1) increases in contractility mediated directly by Ca2+are relatively resistant to desensitization in HF; and2) the calcium-channel promoter can produce increases in myocardial contractility and cardiac work similar to those of Dob at a significantly lower oxygen cost, thereby enhancing mechanical efficiency in HF.