Relationship of Intralymphocytic Cyclic Nucleotide and Calcium Ion Changes with Cardiac Function in Congestive Heart Failure Patients Treated with Amrinone

The contents of intralymphocytic cyclic nucleotide(cAMP and cGMP)and cal-cium ions(Ca~(++))were determined in 20 patients with refractory congestive heart failure be-fore and after the treatment of Chinese-made amrinone,and their cardiac index was alsomcasured with the thermodilution technique.It was found that the cAMP andCa~(++)contents were markedly elevated while the cardiac index increased under amrinonctreatment,and that both the cAMP and Ca~contents were in positive correlation withthe cardiac index before and after amrinone administration.It is suggested that amrinone is likcly to exert its positive inotropic effect on themyocardium through augmenting the cAMP and Ca~(++)contents in myocardial cells,andthat the determination of intralymphocytic cyclic nuclcotidc and Ca~(++)might bc of signifi-canoe to assess the impairment of cardiac function and the cfficacy of a thcrapcuticagent.     

小儿窦房结房室结电生理学功能观察初步报告

本文报告采用经食道程序心房刺激同时检测69例小儿的窦房结、房室结电生理功能,并与正常成年人、老年人参数相比较,以观察小儿窦房结、房室结功能特点。结果表明小儿窦房结恢复时间、窦房传导时间、校正窦房结恢复时间均显著低于成年人和老年人(P<0.001)。文氏阻滞点及2:1阻滞点则较成年人和老年人为高(P<0.001)。作者认为,由于小儿自律传导系发育程度及神经体液调节与成年人和老年人不同,故小儿窦房结、房室结应有其本身的正常值。     

犬窦房结组织带蒂自体移植治疗完全性房室传导阻滞疾病的实验研究

目的将窦房结组织带蒂移植入自体心室中,通过观察带蒂移植的窦房结组织能否存活并与心室肌建立细胞连接;射频消
融希氏束建立完全性房室传导阻滞动物模型,观察其能否起搏心室;为完全性房室传导阻滞探索新的治疗思路和方法。方法健
康家犬10只,随机分为移植组和对照组,每组各5只。安置临时心外膜起搏导线后,将犬窦房结组织带蒂移植于实验组自体右
心室心外膜下,对照组仅切除窦房结组织,于第1、2、3、4周观测体表心电图变化。4周后射频消融希氏束,建立完全性房室传导
阻滞动物模型。建立模型后对两组动物经股静脉微泵注射异丙肾上腺素（ISO）,观察心率变化。并观测带蒂移植后的窦房结组
织学及超微结构变化。结果体表心电图无明显变化。射频消融希氏束后,移植组和对照组均表现为完全性房室传导阻滞心电
图,两组室性心率无明显差别（P>0.05）。注射ISO后,两组室性心率改变不明显（P>0.05）。带蒂移植的窦房结组织可以存活,
并与心室肌细胞建立桥粒连接,但细胞连接数目不多,不能起搏心室。结论带蒂移植入自体心室的窦房结组织细胞可以和心肌
细胞建立细胞连接。
     

Effect of short-duration electrically induced tachycardia on regional myocardial contractility.

BACKGROUND: Tachycardia is a physiological mechanism for adapting cardiac output to modifications in energy consumption in the organism. The repercussions that short-duration tachycardia has on myocardial contractility have not been sufficiently studied.
To study the effects of short-duration tachycardia on regional myocardial function in the anterior face of the left ventricle depending on the rate, duration, and origin of the electrical stimulation producing the tachycardia. MATERIAL/METHODS: Two series were studied in an in vivo canine experimental model. Stimulation was performed in the right atrium and in the base of the left ventricle at a frequency 20 and 40% above the basal rate. The duration of each pacing episode was 10, 20, and 40 minutes followed by a recovery period of 40 minutes. ECG, left ventricular pressure, and regional function curves of a myocardial segment were studied. RESULTS: During atrial pacing there was a similar decrease in both regional segment lengths (end-systolic and end-diastolic lengths) and no variation in the shortening fraction or in hemodynamic parameters. During ventricular pacing, systolic pressure in the left ventricle decreased, end-diastolic pressure increased, end-diastolic length shortened (meaning less ventricular filling), and the end-systolic length increased, leading to a reduced shortening fraction or regional contractility alteration which was temporarily maintained once pacing ceased. CONCLUSIONS: The transient persistence of segment dysfunction after induced ventricular tachycardia ceases indicates the activation of a different, unknown mechanism.     

超声心动图观察冠心病对心脏结构和心功能的影响

本研究应用数字化 M 型超声心动图观察40例正常人和40例陈旧心肌梗塞患者的心脏结构和心功能,发现心肌梗塞组主动脉根部内径、左房及左室内经、左室后壁及室间隔厚度均明显大于正常组,左室短轴缩短率及射血分数明显低于正常组,等容收缩期、射血前期、等容舒张期、QC 及A_2E 间期延长,二尖瓣室间隔角加大.提示心肌梗塞患者不仅心脏结构发生明显变化,心脏收缩功能、泵功能及舒张功能亦均明显减退.     

一氧化氮在肾性高血压大鼠心肌肥厚中的作用

目的：研究一氧化氮在二肾一夹（２Ｋ１Ｃ）肾性高血压大鼠心肌肥厚中的作用。方法：建立２Ｋ１Ｃ肾性高血压大鼠模型。实验分为５组：假手术组,２Ｋ１Ｃ组,卡托普利组,ＮＡＭＥ组和精氨酸组。测定各组大鼠的平均动脉血压（ＭＡＰ,ｐａ）、左心室质量／体质量和左心室心肌的环鸟苷酸（ｃＧＭＰ）的质量摩尔浓度。结果：在２Ｋ１Ｃ组大鼠,手术后４周的ＭＡＰ显著升高,心肌肥厚和心肌ｃＧＭＰ质量摩尔浓度显著下降。卡托普利可防止２Ｋ１Ｃ组大鼠ＭＡＰ升高,左心室心肌肥厚和增加心肌的ｃＧＭＰ质量摩尔浓度。Ｌ精氨酸显著减轻２Ｋ１Ｃ大鼠的左心室心肌肥厚,但ＭＡＰ水平无改变,心肌的ｃＧＭＰ质量摩尔浓度显著升高。用一氧化氮合酶抑制剂ＬＮＡＭＥ处理２Ｋ１Ｃ大鼠,血压进一步升高,但不影响心肌肥厚和心肌ｃＧＭＰ质量摩尔浓度。结论：这些结果提示,肾素血管紧张素系统可能参与２Ｋ１Ｃ肾性高血压,左心室心肌产生的ＮＯ,可能通过依赖ｃＧＭＰ途径防止心肌肥厚     

萨木与扎冲合用对猫实验性心力衰竭和心源性休克的影响

目的 观察萨木和扎冲注射液合用对心力衰竭和心源性休克的作用。方法 给麻醉猫注射戊巴比妥钠制造实验性心力衰竭和心源性休克的模型，然后给药观察。结果 萨木格扎冲注射液合用可使左心室收缩压、左室压力最大变化率、心输出量及平均动脉压明显增加，左心室舒张末期压明显降低。结论：萨木和扎冲液射液合用可增强麻醉猫衰竭心脏的心肌收缩力和心脏泵血功能，具有明显改善心功能的作用。     

等容血液稀释和葡萄糖-胰岛素-氯化钾溶液对狗急性心肌梗塞早期左心室功能的改善

在麻醉开胸纯氧呼吸狗急性心肌梗塞(AMI)模型上,观察了右旋糖酐40等容稀释血液和静滴葡萄糖-胰岛素-氯化钾溶液(GIK)对狗AMI 6h内左心功能(±dP/dt-max,LVSP)的改善作用。结果:单用等容血液稀释或静滴GIK溶液仅使+dP/dt-max较对照组(未给治疗)明显升高(P<0.05),但前者发挥作用较快;二者联合应用不仅能使+dP/dt-max、LVSP较对照组均明显升高(P<0.05),而且可使-dp/dt-max、LVSP较单用等客血液稀释或静滴GIK溶液组明显升高(P<0.05)。提示:①等容血液稀释或静滴GIK溶液对AMI早期左心室收缩功能均有显著改善作用;②前者发挥作用较快;③二者联合应用不仅能进一步改善AMI后左心室收缩功能,且对舒张功能也有显著改善作用,表现出良好的协同效应。     

曲美他嗪对大鼠心力衰竭模型心肌能量代谢的干预

目的探讨曲美他嗪对大鼠心力衰竭模型心肌能量代谢的干预作用。方法腹主动脉缩窄法制备SD大鼠心力衰竭模型,心脏超声测定室间隔(IVS)及左心室后壁(LVPW)厚度、左心室舒张末期内径(LVD)和收缩末期内径(LVS)、左心室射血分数(LVEF)和短轴缩短率(FS);电镜观察心肌线粒体结构变化;放射免疫法检测CA-ATP、游离脂肪酸(FFA)。结果曲美他嗪治疗组和模型组比较,IVST、LVPWT、LVESD、LVEDD明显缩小,LVEF、FS升高;线粒体结构明显改善;CA-ATP水平升高,FFA水平降低。结论曲美他嗪能改善大鼠心力衰竭模型心肌能量代谢,改善心功能。