辛伐他汀对急性心肌梗死兔的心室肌细胞钠离子通道电流的影响

目的 研究辛伐他汀预处理对兔急性心肌梗死（AMI）后24 h心室肌细胞钠离子通道电流的影响,并探讨他汀类药物抗心律失常的细胞学离子机制。方法 采用结扎兔冠状动脉左前降支的方法,建立AMI动物模型。将45只新西兰大耳白兔随机分为3组:心梗组、辛伐他汀治疗组［他汀组,手术前3 d给予辛伐他汀 5 mg/(kg·d)］及假手术对照组（只开胸不结扎血管）。采用酶解法分离心室肌外膜单个心室肌细胞;采用全细胞膜片钳技术,记录跨膜钠离子通道电流（INa）,同时应用全自动生化分析仪检测各组血脂的水平。结果 各组动物血脂的水平无显著差异。对照组、心梗组和他汀组的INa电流密度峰值（-30 mV）分别为(-42.78±5.48)pA/pF(n=16)、(-23.26±5.18)pA/pF(n=12)和(-39.23±5.45)pA/pF(n=13)。心梗组较对照组明显下降（P<0.01）,他汀组较心梗组明显升高（P<0.01）。另外,心梗组INa失活曲线左移,失活后恢复时间延长,他汀组这些异常也明显恢复。结论 AMI可导致梗死区心肌细胞INa明显下降,辛伐他汀预处理可减轻INa的异常变化,逆转电重构,而不依赖于降血脂的效应,可能为他汀类药物降低心律失常发生率的细胞学离子机制。     

兔冠状动脉结扎1小时缺血区心室肌细胞瞬间外向钾通道的变化

为探讨在急性心肌梗死 (AMI)早期瞬间外向钾通道的变化及其在室性心律失常发生中的作用 ,以开胸冠状动脉 (简称冠脉 )结扎法制备兔急性心肌缺血模型 ,1h后处死动物分离心室肌细胞 ,采用全细胞膜片钳记录技术观察缺血区心外膜心室肌细胞瞬间外向钾通道电流 (Ito)的变化 ,以正常心肌Ito为对照。结果 :急性冠脉结扎 1h兔缺血区心室肌细胞Ito受到抑制 ,电流密度$C电压关系曲线下移 ,测试电压 + 60mV时的Ito电流密度对比显示 :对照组为 1 7.39± 5 .2 4pA/pF (n =1 2 ) ,冠脉结扎 1h组为 7.75± 3.1 1pA/pF (n =1 0 ) ,与对照组相比下降了 5 7% ,P <0 .0 0 1 ;其失活曲线左移 ,半数最大失活电压 (V1 /2 )对照组为 - 35 .2± 5 .3mV(n =1 2 ) ,冠脉结扎 1h组为 - 5 5 .1± 5 .6mV(n =1 0 ) ,与对照组比较失活速度加快 ,P <0 .0 1 ;冠脉结扎后 1h组Ito恢复明显减慢 ,恢复时程延长 ,P <0 .0 5。结论 :冠脉结扎后 1h缺血区心室肌细胞瞬间外向钾通道受抑制 ,影响动作电位复极 ,容易诱发 2相折返 ,可能为AMI后室性心律失常发生的机制之一。     

急性心肌梗死后一周对心室肌细胞瞬间外向钾电流的影响

研究急性心肌梗死 (AMI)心室肌细胞瞬间外向钾电流 (Ito)的变化。采用结扎兔冠状动脉左前降支的方法建立AMI动物模型 ,应用膜片钳全细胞记录方法 ,研究AMI后 1周心外膜梗死区心肌细胞Ito的变化。结果 :正常对照组 (n =16 )心肌细胞在 - 30mV激活 ,心肌梗死 (简称心梗 )组细胞在 - 2 0mV激活 ,均呈线性电压依赖性。心梗组梗死区细胞 (n =12 )Ito的电流密度明显下降 ,I V曲线明显下移。心梗组Ito电流密度 (去极化电位 +6 0mV时 )明显低于对照组 (7.4 7± 2 .39vs 17.39± 5 .2 4pA/pF ,P <0 .0 1)。结论 :AMI可引起心室肌细胞Ito电流密度下降 ,导致梗死区细胞动作电位平台期相对延长 ,复极异常 ,造成心肌细胞之间动作电位及不应期离散度增大 ,容易形成折返 ,此可能是导致心肌梗死后出现折返性室性心律失常的原因。     

伊布利特对兔急性心肌梗死后梗死周边区心外膜心室肌细胞L型钙电流的影响

目的观察伊布利特对急性心肌梗死(AMI)后一周心室肌细胞L型钙通道电流(ICa-L)的影响。方法兔开胸,左前降支结扎造成AMI,1周后酶解分离梗死周边区心外膜心室肌细胞,用全细胞膜片钳技术记录10-6mol/L伊布利特细胞外液(伊布利特组)对梗死周边区心外膜心室肌细胞ICa-L活性的影响,并与正常对照组(对照组)及AMI但未灌流伊布利特组(AMI组)比较。结果①AMI 1周时兔梗死周边区心室肌细胞ICa-L受到抑制,电流密度-电压曲线(I-V)上移,ICa-L电流密度峰值降低[-3.52±0.91 pA/pF(n=10)vs-5.68±1.53 pA/pF(n=10),P<0.05];伊布利特组电流密度峰值为-4.84±1.22 pA/pF(n=8),较AMI组显著增大(P<0.05),与对照组比较,虽有减小,但无差异(P>0.05)。②AMI组、伊布利特组ICa-L失活曲线明显左移,以AMI组左移更加明显,对照组半数失活电压(V0.5)为-32±4 mV(n=10),AMI组V0.5增加为-46±7 mV(n=10,P<0.05),伊布利特组V0.5为-36±6mV(n=8),与对照组比较无差异(P>0.05)。结论AMI后1周梗死周边带心室肌细胞L型钙通道受阻滞,伊布利特对缺血引起的ICa-L的异常有明显改善作用。     

缬草单萜氧化物对单个兔心室肌细胞钠通道的影响

利用全细胞膜片钳记录技术研究缬草单萜氧化物 (VMO)对兔单个心室肌细胞钠离子电流 (INa)的影响。结果 :30 μg/L和 6 0 μg/L的VMO使兔心室肌细胞INa峰值 (INamax)从 5 3.4 7± 5 .1 3pA/pF分别降至 4 0 .2 5± 4 .1 8pA/pF和 30 .89± 2 .95pA/pF(n =8,P <0 .0 5和P <0 .0 1 ) ,抑制率分别为 2 4 .7%和 4 1 .9% ;VMO使INa的电流 电压曲线上移 ,但不改变其激活电位、电位峰值和反转电位 ;VMO还减慢钠通道灭活后的恢复过程。结论 :VMO对INa具有浓度依赖性阻滞作用 ,这可能是其抗心律失常的重要机制之一。     

稳心颗粒甘松提取物对大鼠心室肌细胞钠电流和瞬时外向钾电流激活动力学的影响

目的研究步长稳心颗粒中甘松提取物对大鼠心室肌细胞钠电流(INa)、瞬时外向钾电流(Ito)激活动力学的影响。方法采用全细胞膜片钳技术,研究10 g/L甘松提取物对急性分离的成年大鼠心室肌细胞INa、Ito激活动力学的影响。结果①10 g/L甘松提取物使大鼠心室肌细胞INa峰值(INa,max)从-58.96±2.71 pA/pF降至-31.66±1.29 pA/pF(n=5,P<0.01);②10 g/L甘松提取物使Ito峰值(Ito,max)由3.40±1.52 pA/pF降到1.43±0.64 pA/pF(n=7,P<0.05)。10 g/L甘松提取物对INa和Ito的抑制率分别达38.2%和57.9%。结论10 g/L甘松提取物对大鼠心室肌细胞INa、Ito具有显著抑制作用。     

兔急性心肌梗死后梗死周边带心肌细胞L-型钙通道的变化

探讨L型钙通道在急性心肌梗死 (AMI)后室性心律失常发生中的作用及其机制。方法 :以开胸冠状动脉结扎法制备兔AMI模型 ,1周后处死动物分离心室肌细胞 ,采用全细胞膜片钳记录技术观察梗死周边缺血带心外膜心室肌细胞L型钙通道电流 (ICa L)的变化 ,以正常心肌ICa L为对照。结果 :AMI 1周时兔梗死周边区心室肌细胞L型钙电流受到抑制 ,其电流峰值由正常状态下的 - 5 .58± 1 .53pA/pF(对照组 ,n =1 0 )降至 - 3 .52± 0 .93pA/pF(AMI组 ,n=6) ,最大峰电流下降 2 9.1 % ,P <0 .0 5 ,I V曲线上移 ;其失活曲线左移 ,半数最大失活电位由 - 1 3 .1± 4 .2mV左移至 - 2 5 .9± 7.0mV ,P <0 .0 5 ,失活速度加快。结论 :AMI后 1周梗死周边带心外膜心室肌细胞L型钙通道受抑制 ,可能为AMI后室性心律失常发生的机制之一。     

心肌梗死后残存心室肌细胞L型钙通道的改变

目的　探讨L型钙通道在急性心肌梗死 (AMI)后室性心律失常发生中的作用及其机制。方法　开胸冠脉结扎制备兔AMI模型 ,于 1周和 2个月处死动物分离心室肌细胞 ,以膜片钳技术记录梗死及周边区心外膜细胞L -型钙通道电流 (ICa -L)的变化。结果　AMI兔梗死周边区心外膜细胞L型钙电流受到抑制 ,电流密度 -电压关系 (I -V)曲线上移 ,其峰值电流密度在正常对照组、AMI后 1周和 2个月分别为 - ( 5 5 8± 1 5 3) pA /pF(n =10 )、- ( 3 5 2± 0 93) pA/ pF (n =6 ,与对照组比较P <0 0 5 )和 - ( 4 84± 1 4 8)pA/ pF(n =11,与对照组比较P <0 0 5 ) ,但I -V曲线的形态轨迹不变。其失活曲线左移 ,失活速度加快 ,半数最大失活电位 3组分别为 -( 13 1± 4 2 )mV、- ( 2 5 9± 7 0 )mV和 - ( 2 1 3± 5 6 )mV ,P <0 0 5。结论　AMI后梗死周边带心外膜细胞L型钙通道受抑制 ,可能为AMI后室性心律失常发生的机制之一 ;AMI后 2个月钙通道的异常程度减轻 ,有恢复正常的趋势     

增强型绿色荧光蛋白转染小鼠心脏后瞬时外向钾电流及钠钙交换电流的变化

目的探讨绿色荧光蛋白(GFP)转染对心脏瞬时外向钾电流(Ito)及钠钙交换电流(INCX)的影响。方法20只雄性小鼠等量随机分为对照组和增强型GFP(EGFP)组。EGFP组小鼠采用8点注射法均匀注射100μl腺病毒于左室游离壁上,对照组注射等量无菌生理盐水。一周后分离单个心室肌细胞,用膜片钳记录Ito及INCX。结果与对照组相比,EGFP组几乎所有测定电压下,Ito电流密度显著减小[如+60 mV时为8.40±1.55 pA/pF(n=9)vs 36.77±8.12 pA/pF(n=11),P<0.05]。INCX的前向模式不因转染EGFP变化[如-80 mV时为-0.35±0.05 pA/pF(n=8)vs-0.42±0.08 pA/pF(n=10),P>0.05],但反向模式电流显著增大[如+80 mV时为1.47±0.10 pA/pF(n=8)vs 0.72±0.05 pA/pF(n=10),P<0.05]。结论 EGFP转染可使心脏Ito显著减小,而INCX仅反向模式电流增大,其综合效应可能导致细胞内钙增加。     

辛伐他汀对血脂正常兔心肌缺血再灌注后L型钙电流的影响

目的通过研究辛伐他汀预处理对兔心肌缺血再灌注后L型钙离子通道电流(ICa-L)的影响,探讨他汀类药物抗心律失常的细胞学离子机制。方法45只新西兰大耳白兔随机分为3组:缺血再灌注组(I-R组,结扎冠状动脉左前降支30min后再开放120min);辛伐他汀治疗组(他汀组,手术前给予辛伐他汀5mg·kg-1·d-1,3天);假手术对照组(对照组,只开胸不结扎血管)。观察心律失常发生情况。采用酶解法分离缺血部位心室肌外膜单个心室肌细胞,采用全细胞膜片钳技术,记录ICa-L,同时检测各组血脂水平。结果各组动物血脂水平无显著差异。I-R组心律失常发生率较对照组增加,他汀组较I-R组心律失常发生率明显下降。对照组、I-R组和他汀组ICa-L电流密度峰值(0mV)分别为-3.13±1.22pA/pF(n=16),-4.24±0.92pA/pF(n=15)和-3.46±0.85pA/pF(n=13)。I-R组较对照组明显升高(P<0.05),他汀组较I-R组明显下降(P<0.05),他汀组与对照组无差异(P>0.05)。结论缺血再灌注可导致梗死区心室肌细胞I明显增加,辛伐他汀预处理可逆转这种变化。     

Altered Pharmacologic Responsiveness of Reduced L-Type Calcium Currents in Myocytes Surviving in the Infarcted Heart

Altered Pharmacology of I_ca,L in Myocytes From Infarcted Heart. The pharmacologic responses of macroscopic L-type calcium channel currents to the dihydropyridine agonist, Bay K 8644, and β-adrenergic receptor stimulation by isoproterenol were studied in myocytes enzymatically dissociated from the epicardial border zone of the arrhythmic 5-day infarcted canine heart (IZs). Calcium currents were recorded at 36° to 37° C using the whole cell, patch clamp method and elicited by applying step depolarizations from a holding potential of -40 mV to various test potentials for 250-msec duration at 8-second intervals. A Cs⁺ -rich and 10 mM EGTA-containing pipette solution and a Na⁺-and K⁺-free external solutions were used to isolate calcium currents from other contaminating currents. During control, peak I_ca,L, density was found to be significantly less in IZs (4.0 ± 1.1 pA/pF) than in myocytes dispersed from the epicardium of the normal noninfarcted heart (NZs; 6.5 ± 1.8 pA/pF). Bay K 8644 (I μM) significantly increased peak I_ca,L density 3.5-fold above control levels in both NZs (to 22.5 ± 6.2 pA/pF; n = 7) and IZs (to 12.8 ± 3.0 pA/pF; n = 5), yet peak I_ca,L density in the presence of drug was significantly less in IZs than NZs. The effects of Bay K 8644 on kinetics of current decay and steady-state inactivation relations of peak I_ca,L were similar in the two cell types. In contrast, the response of peak L-type current density to isoproterenol (1 μM) was significantly diminished in IZs compared to NZs regardless of whether Ba²⁺ or Ca²⁺ ions carried the current. Thus, these results indicate an altered responsiveness to β-adrenergic stimulation in cells that survive in the infarcted heart. Furthermore, application of forskolin (1 μM and 10 μM) or intracellular cAMP (200 μM), agents known to act downstream of the β-receptor, also produced a smaller increase in peak I_Ba density in IZs versus NZs, suggesting that multiple defects exist in the β-adrenergic signaling pathway of IZs. In conclusion, these studies illustrate that reduced macroscopic calcium currents of cells in the infracted heart exhibit an altered pharmacologic profile that has important implications in the development of drugs for the diseased heart.     

Abnormal electrical properties of myocytes from chronically infarcted canine heart. Alterations in Vmax and the transient outward current.

BACKGROUND. Reentrant ventricular arrhythmias can occur in the surviving muscle fibers of the epicardial border zone of the canine heart 5 days after coronary artery occlusion. To understand the cellular basis of these arrhythmias, we developed a method of dispersing myocytes (IZs) from the epicardial border zone. METHODS AND RESULTS. We compared the electrophysiological properties of IZs with those of cells dispersed from the epicardium of control noninfarcted (NZs) and of sham-operated animals (NZsham). Transmembrane action potentials of IZs are reduced in total action potential amplitude and maximum upstroke velocity compared with NZs. However, resting potential of IZs is no different from that of NZs. Action potential duration at -10 mV is significantly reduced in IZs compared with control, and IZ potentials do not show the typical "spike and dome" morphology that is evident in all NZs. Using Vmax as an indirect measure of the peak inward current available for the upstroke of the action potential, we found that the availability curve for IZs is significantly different from the NZ curve. Furthermore, the time course of recovery of Vmax after a depolarizing voltage clamp step was significantly altered in IZs. Using whole-cell voltage clamp techniques, we determined that the voltage-dependent, Ca(2+)-independent, 4-aminopyridine-sensitive transient outward current (ito1) occurred in all NZs (n = 16) but existed in only 37% of IZs (n = 16). There was a significant reduction in the density of ito1 elicited by depolarizing steps in those IZs showing ito1 compared with ito1 density in NZs. CONCLUSIONS. We have developed a single-cell model of cells that survive in the infarcted heart. Our studies indicate that there are changes in Vmax in IZs. In addition, there is no prominent phase 1 of repolarization in IZ action potentials. This is consistent with the dramatic loss in the function of the ionic channel responsible for the voltage-dependent transient outward current, ito1.     

Can PKA activators rescue Na+ channel function in epicardial border zone cells that survive in the infarcted canine heart?

OBJECTIVE AND METHODS: In this study, we investigated the effects of a PKA stimulating cocktail on sodium currents from normal epicardial cells (NZs) and on those from cells dispersed from the epicardial zone of the 5-day infarcted canine heart (IZs). To do so, we used whole-cell voltage-clamp techniques. RESULTS: During superfusion with the PKA activator cocktail, peak sodium current (I(Na)) density significantly increased by 32+/-5.3% (NZs) and 17+/-5.4% (IZs). However, despite this increase, IZ peak I(Na) still was not fully restored to NZ values. In both cell types, the density effect was accompanied by a shift in I/I(max) curves, as well as a slowing in recovery from inactivation. Inactivation from a closed state was accelerated. Furthermore, in the presence of chloroquine, which is known to interrupt intracellular vesicular traffic, PKA activator effects to augment I(Na) were only partially inhibited in NZs but abolished in IZs. To understand whether the phosphorylation status of basal Na(+) channels in the two cell groups differed, the effects of okadaic acid and PP2A1 were studied. Results suggest that in IZs, Na(+) channels in the basal state are already phosphorylated. CONCLUSIONS: PKA stimulation of I(Na) of the remodeled IZ does augment current density possibly by augmenting the trafficking of channels to an active site on the membrane. However, the resulting I(Na), while partially rescued, is not similar to the potentiated I(Na) of NZs. Specific kinetic changes also occur with the PKA stimulation of IZs and results with okadaic acid and PP2A1 suggest that in their remodeled state, Na(+) channels in IZs are already phosphorylated.     

胺碘酮对模拟缺氧状态下大鼠心室肌细胞瞬时外向和内向整流钾电流的影响

目的通过观察胺碘酮对模拟缺氧状态下急性分离的大鼠心室肌单细胞复极相中瞬时外向钾电流(Ito)和内向整流钾电流(IK1)通道的影响,探讨其在该条件下抗心律失常的作用机制。方法使用酶解法分离获取大鼠单个心室肌细胞,通过持续通以模拟缺氧细胞外液建立体外模拟缺氧模型,采用全细胞膜片钳实验技术研究胺碘酮对该条件下Ito和IK1的作用。结果胺碘酮呈剂量依赖性降低Ito和IK1电流幅值,对Ito抑制效应的起始浓度为1μmol/L,100μmol/L时抑制作用达最大,最大抑制幅度为56.78%±4.27%(23.98±2.18pA/pFvs10.38±4.27pA/pF;测试电压为+70mV;P<0.01;n=5),IC50(半数抑制浓度)为74.35μmol/L,但Ito的I-V曲线趋势并没有发生变化,稳态激活和失活曲线几乎不发生移动。胺碘酮对IK1内向电流部分抑制起始浓度为1μmol/L,外向电流部分抑制效应的起始浓度为2μmol/L,其最大抑制幅度分别为58.77%±10.76%(56.32±7.24pA/pFvs23.22±7.30pA/pF;测试电压为-150mV;P<0.01)和33.29%±2.15%(6.70±0.89pA/pFvs4.46±0.93pA/pF;测试电压为+40mV;P<0.01;n=5)。对内向电流成分的IC50为63.75μmol/L,IK1通道的稳态激活曲线无明显改变。结论在大鼠离体心室肌单细胞模拟缺氧条件下,胺碘酮对Ito和IK1电流幅度呈剂量依赖性抑制,有对抗缺氧本身造成的动作电位时程缩短效应;对I内向电流成分的敏感性高于外向成分。     

Abnormalities in Ca(i)handling in myocytes that survive in the infarcted heart are not just due to alterations in repolarization

Studies from our laboratory have defined alterations in Ca(i)handling in the non-dialyzed subepicardial cells that have survived in the 5 day infarcted heart (IZs). To determine whether changes in the action potential profile contributed to the observed Ca(i)changes we have used a combined voltage clamp/epifluorescent technique to determine and compare changes in fura 2 ratios in IZs compared to those of epicardial cells from the non-infarcted canine hearts (NZs). We found that Ca(i)changes in voltage clamped IZs persisted. In NZs, Ca(i)transients showed the expected voltage dependence while IZs did not. To determine whether altered NaCa exchanger activity contributed to the observed changes in Ca(i)in IZs, we measured NaCa exchanger Ca(2+)fluxes (reverse and forward mode) and ionic currents in both cell types and under different Na(i)loads (10 and 20 m m). We found that there were no significant differences in resting, peak or magnitude of fura 2 ratio changes or in outward current densities between NZs and IZs even under the different Na(i)loads. Thus, we suggest that chronic up- or downregulation of the NaCa exchanger protein does not underlie observed Ca(i)changes in IZs. Additionally, Ca(2+)released with paced voltage steps represented 79% of that released by caffeine in NZs while, in IZs, caffeine releasable Ca(2+)was equivalent to that released with step depolarization. Thus, abnormalities in Ca(i)handling in IZs appear not to arise secondarily to changes in action potential configuration nor do they appear to be due to disease-induced alteations in NaCa exchanger function.