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|本期目录/Table of Contents|

胺碘酮对犬左心室M细胞动作电位和心室跨壁复极离散度的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第2期
页码:
155-158
栏目:
基础研究
出版日期:
2006-03-01

文章信息/Info

Title:
Acute effects of amiodarone on action potential of M cell and transmural dispersion of repolarization in canine left ventricule
作者:
周筠1; 臧伟进1; 杜克莘2; 于晓江1; 崔长琮3
西安交通大学医学院：1.药理学系，2.机能中心，3.第一附属医院心内科，陕西 西安 710061
Author(s):
ZHOU Jun1; ZANG Wei-jin1; DU Ke-xing2; YU Xiao-jiang1; CUI Chang-cong3
Department of Pharmacology, Medical College, Xi′an Jiaotong University, Xi′an, Shaanxi 710061, China
关键词:
心律失常; 动作电位; 跨膜复极离散度; 胺碘酮
Keywords:
arrhythmias;  M cells;  transmural dispersion of repolarization;  amiodarone
分类号:
R331.3
DOI:
-
文献标识码:
A
摘要:
目的 通过研究胺碘酮对犬左心室M细胞动作电位和心室跨壁复极离散度（TDR）的影响，探讨胺碘酮抗心律失常机制。方法 应用标准玻璃微电极技术，在不同频率刺激下，记录应用胺碘酮前后犬左室游离壁内、外膜及中层心肌细胞跨膜动作电位（AP）各种参数的变化。结果 ①胺碘酮延长内、外膜层心肌细胞的动作电位时程（APD）, 当基础周长（BCL）为1 000 ms时，使用胺碘酮后心内膜层肌细胞的APD90由（254±38） ms延长为（274±37） ms ﹙P<0.01﹚，外膜层肌细胞的APD90由（205±37） ms延长为（229±16） ms ﹙P<0.01﹚；但其明显缩短中层肌细胞的APD， 其APD90由（331±50） ms缩短为（290±62） ms﹙P<0.01﹚。②胺碘酮能显著缩短TDR，当BCL为1 000 ms时，用药后TDR由（126±20） ms减小为（61±11） ms (P<0.01﹚。结论 胺碘酮对左室三层肌细胞电生理具有不同影响，延长内外膜心肌细胞的APD，而缩短中层肌细胞的APD。使左室TDR缩短。
Abstract:
AIM To invistigate the acute effects of amiodarone on the action potential (AP) of M cell and the transmural dispersion of repolarization (TDR) in canine left ventricule. METHODS We used a dermatome to obtain thin endocardium, midcardium and epicardium transmural strips from left ventricular free wall of canine (weight 15-18 kg) and standard microelectrode techniques to record and measure the transmembrane action potential duration (APD). RESULTS Amiodarone produced a prolongation of APD in epicardium and endocardium but a decrease in the M region. At basic cycle length (BCL) of 1000ms, APD90 was (254±38) ms, (274±64) ms in endocardium, (331±50) ms, (290±62) ms in midmyocyte, (205±37) ms, (229±16) ms in epicardium before and after use of amiodarone, and the TDR decreased from 125 ms to 61 ms. CONCLUSION Amiodarone has different effects on the electrophysiologic properties of the three layers of left ventricle and plays an important role in the decrease of TDR. Amiodarone has a low incidence of arrhythmia genic effect than other Class III agents.

参考文献/References

［1］Goldschlager N, Epstein AE, Naccarelli G, et al. Practical guidelines for clinicians who treat patients with amiodarone. Practice Guidelines Subcommittee, North American Society of Pacing and Electrophysiology ［J］. Arch Intern Med, 2000,160(12):1741-1748.

［2］ Anyukhovsk EP, Sosunoy EA, Rosen MR. Regional differences in electrophysiologic properties of epicardium, midmyocardium, and endocardium: in vitro and in vivo correlations ［J］. Circulation, 1996, 94(8):1981-1988.

［3］ Yan GX, Shimizu W, Antzelevitch C. Characteristics and distribution of M cells in arterially perfused canine left ventricular wedge preparations［J］. Circulation, 1998, 98(18):1921-1927.

［4］ Kamiya K, Nishiyama A, Yasui K, et al. Short and longterm effects of amiodarone on the two components of cardiac delayed rectifier K+ current ［J］. Circulation, 2001, 103(9):1317-1324.

［5］ Opstal JM, Schoenmakers M, Verduyn SC, et al. Chronic amiodarone evokes no torsade de pointes arrhythmias despite QT lengthening in an animal model of acquired longQT syndrome［J］. Circulation, 2001,104(22):2722-2727.

［6］ Aiba T, Shimizu W, Inagaki M, et al. Excessive increase in QT interval and dispersion of repolarization predict recurrent ventricular tachyarrhythmia after amiodarone［J］. Pacing Clin Electrophysiol，2004，27(7): 901-909.

［7］ 臧益民,臧伟进. M细胞、跨室壁离散度与心律失常的关系 ［J］. 心脏杂志, 2002，14(4):343-345.

［8］ You B, Pu J, Liu N, et al. Effect of lidocaine and amiodarone on transmural heterogeneity of ventricular repolarization in isolated rabbit hearts model of sustained global ischemia ［J］. J Huazhong Univ Sci Technolog Med Sci，2005，25(4): 400-403.

［9］ Zygmunt AC, Eddlestone GT, Thomas GP, et al. Larger late sodium conductance in M cells contributes to electrical heterogeneity in canine ventricle［J］. Am J Physiol Heart Circ Physiol, 2001 , 281(2):H689-H697.

备注/Memo

备注/Memo:
收稿日期：2005-12-15.基金项目：国家自然科学基金项目资助（No.30270554）；教育部高校博士学科点基金项目资助（No.20050698012） 通讯作者：臧伟进，教授，主要从事心血管生理和药理学研究 Tel：（029）82655150Email: zwj@mail.xjtu.edu.cn 作者简介：周筠, 讲师，博士 Tel：（029）82655150 Email: jzhou 829@yahoo.com.cn
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