INVIVO MEASUREMENT OF NEURONAL UPTAKE OF NOREPINEPHRINE IN THE HUMAN-HEART
INVIVO MEASUREMENT OF NEURONAL UPTAKE OF NOREPINEPHRINE IN THE HUMAN-HEART
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DOI：
10.1161/01.cir.78.1.41
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发表时间：
1988-07-01
期刊：
影响因子：
37.8
通讯作者：
ESLER, M
中科院分区：
文献类型：
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作者：
GOLDSTEIN, DS;BRUSH, JE;ESLER, M
通过三种技术在体内评估了人类心脏循环中交感神经递质去甲肾上腺素的神经元摄取（uptake -1）。1)地西帕明阻断Uptake-1前后静脉滴注示踪标记去甲肾上腺素的心脏切除量；2)放射性去甲肾上腺素和放射性异丙肾上腺素（非神经元摄取的底物）的分式提取之间的差异，被用来估计uptake -1在心脏与其他血管床（手臂、腿、脑和肺）中对去甲肾上腺素的去除；3)在这些床上比较放射性和内源性二氢苯乙二醇（DHPG）的区域动静脉差异，DHPG是一种去甲肾上腺素的神经元内代谢物。在未经治疗的患者中，放射性去甲肾上腺素的心脏去除率平均为79%，而在去西帕明治疗的患者中，放射性去甲肾上腺素的心脏去除率平均为19%，与未经治疗的异丙肾上腺素的心脏去除率（14%）相似，证实了在心脏中，异丙肾上腺素和去甲肾上腺素的非神经元去除率相似。在心脏中，估计有69%的去甲肾上腺素被Uptake-1去除，远高于手臂（14%）、腿部（7%）、大脑（10%）和肺部（4%）。内源性DHPG在心脏动静脉的增加（137%）远远超过其他床（分别为49%、26%、39%和-19%），心大静脉的放射性DHPG超过动脉水平113%，而在其他床，动脉放射性DHPG超过静脉水平。结果表明，人的心脏是异常依赖于神经元摄取在体内去除循环去甲肾上腺素。
Neuronal uptake (Uptake-1) of the sympathetic neurotransmitter norepinephrine from the circulation in the human heart was assessed in vivo with three techniques. 1) Cardiac removal of intravenously infused tracer-labeled norepinephrine was measured before and after Uptake-1 blockade with desipramine; 2) the difference between the fractional extraction of radioactive norepinephrine and of radioactive isoproterenol, which is not a substrate for neuronal uptake, was used to estimate the removal of norepinephrine by Uptake-1 in the heart compared with other vascular beds (arm, leg, brain, and lungs); and 3) regional arteriovenous differences in radioactive and endogenous dihydrophenylglycol (DHPG), an exclusively intraneuronal metabolite of norepinephrine, were compared in these beds. In untreated patients, cardiac removal of radioactive norepinephrine averaged 79%, whereas in desipramine-treated patients, cardiac removal of radioactive norepinephrine averaged 19%, a value similar to that of isoproterenol in untreated patients (14%), confirming that in the heart the non-neuronal removals of isoproterenol and norepinephrine were similar. In the heart, 69% of delivered norepinephrine was estimated to be removed by Uptake-1, a much higher percentage than that in the arm (14%), leg (7%), brain (10%), and lungs (4%). The cardiac arteriovenous increment in endogenous DHPG (137%) far exceeded that of the other beds (49%, 26%, 39%, and -19%, respectively), and radioactive DHPG in the great cardiac vein exceeded arterial levels by 113%, whereas in the other beds, arterial radioactive DHPG exceeded venous levels. The results indicate that the human heart is exceptionally dependent on neuronal uptake for in vivo removal of circulating norepinephrine.