Incidence of sudden cardiac death associated with coronary artery occlusion in dogs with hypertension and left ventricular hypertrophy is reduced by chronic beta-adrenergic blockade.
Incidence of sudden cardiac death associated with coronary artery occlusion in dogs with hypertension and left ventricular hypertrophy is reduced by chronic beta-adrenergic blockade.
复制标题
慢性β-肾上腺素能阻断可降低患有高血压和左心室肥厚的狗与冠状动脉闭塞相关的心源性猝死的发生率。
DOI：
10.1161/01.cir.82.3.941
复制
发表时间：
1990
期刊：
影响因子：
37.8
通讯作者：
Marcus,ML
中科院分区：
文献类型：
--
作者：
Dellsperger,KC;Martins,JB;Clothier,JL;Marcus,ML
由于β-肾上腺素能阻断的众多效应之一是改变左心室肥大犬冠状动脉闭塞后的电生理学异常，因此我们测试了这样的假设：美托洛尔（200-400毫克/天）会降低单肾一夹左心室肥大犬的死亡率，而依那普利（20-40毫克/天）则不会降低动脉压。左心室肥大的狗在 3 小时冠状动脉闭塞之前给予美托洛尔或依那普利 5-7 天。分别用氯化三苯基四唑染色和钡血管造影测量梗塞面积和风险面积。对于对照组（n = 15）、左心室肥大（n = 17）、左心室肥大加美托洛尔（n = 12）和左心室肥大加依那普利（n = 15）组，平均动脉压、梗死面积与风险区域的比率以及经历猝死的狗分别为110 +/- 4、142 +/- 4、121 +/- 7和120 +/- 3 毫米汞柱； 44 +/- 5%、65 +/- 5%、44 +/- 7% 和 30 +/- 4%；分别为 27%、65%、17% 和 53%。因此，当患有高血压和左心室肥大的狗经历冠状动脉闭塞时，早期死亡率的过度增加会被β-阻滞剂所中断，这可能是通过电生理效应而不是动脉压或梗塞面积的变化来中断。
Because beta-adrenergic blockade has as one of its many effects altered electrophysiological abnormalities after dogs with left ventricular hypertrophy have been subjected to coronary occlusion, we tested the hypothesis that metoprolol (200-400 mg/day) would reduce mortality rates in dogs with one-kidney, one clip left ventricular hypertrophy while a similar reduction in arterial pressure with enalapril (20-40 mg/day) would not. Dogs with left ventricular hypertrophy were given metoprolol or enalapril for 5-7 days before a 3-hour coronary occlusion. Infarct size and risk area were measured with triphenyltetrazolium chloride stain and barium angiography, respectively. For control (n = 15), left ventricular hypertrophy (n = 17), left ventricular hypertrophy plus metoprolol (n = 12), and left ventricular hypertrophy plus enalapril (n = 15) groups, mean arterial pressure, ratio of infarct size to risk area, and dogs experiencing sudden death were 110 +/- 4, 142 +/- 4, 121 +/- 7, and 120 +/- 3 mm Hg; 44 +/- 5%, 65 +/- 5%, 44 +/- 7%, and 30 +/- 4%; and 27%, 65%, 17%, and 53%, respectively. Thus, the excessive increase in early mortality occurring when dogs with hypertension and left ventricular hypertrophy undergo coronary occlusion is interrupted with beta-blockade, possibly via electrophysiological effects rather than by changes in arterial pressure or infarct size.