家兔陈旧性心肌梗死心室肌细胞钾离子电流的变化

目的:探讨陈旧性心肌梗死(HMI)心律失常的发生机制,观察HMI非梗死区心肌细胞动作电位时程(APD)、瞬时外向钾电流(I_to)、延迟整流钾电流(I_K)和内向整流钾电流(I_K1)的变化。方法: 12只家兔随机分为2组,陈旧性心肌梗死组(HMI)开胸结扎冠状动脉左回旋支,假手术组开胸但不结扎冠状动脉。3个月后应用全细胞膜片钳技术记录非梗死区心肌细胞的APD、I_to、 I_K和I_K1。 结果: (1)HMI组心肌细胞的膜电容明显高于假手术组;(2)HMI组心肌细胞的APD显著延长,并有早期后除极(EAD)出现;(3)HMI组心肌细胞I_to 、I_K,tail和I_K1的电流密度分别为(4.03±0.33)pA/pF、(1.14±0.11)pA/pF和(17.6±2.3)pA/pF,显著低于假手术组的(6.72±0.42)pA/pF、(1.54±0.13)pA/pF和(25.6±2.6)pA/pF(P<0.01)。结论: HMI非梗死区心室肌细胞I_to 、I_K,tail、和I_K1的电流密度的降低是其APD延长和EAD出现的离子流基础,而APD延长和EAD的出现,可能在HMI恶性心律失常的发生中起着重要作用。

Changes of potassium currents in rabbit ventricle with healed myocardial infarction

AIM: To elucidate the mechanism of arrhythmia in healed myocardial infarction (HMI), and to investigate the changes of action potential duration (APD),transient outward potassium current (I_to), delayed rectifier potassium current (I_K) and inward rectifier potassium current (I_K1) of left ventricular myocytes in noninfarcted zone of HMI. METHODS: 12 rabbits were randomly assigned in two groups: HMI group (thoracotomy and ligation of the circumflex coronary); sham-operated group (thoracotomy but no conorary ligation). 3 months after operation, whole cell patch clamp technique was used to record APD, I_to, I_K and I_K1 of ventricular myocytes in non-infarcted zone. RESULTS: Membrane capacitance was larger in HMI group than that in sham-operated group. Action potential duration was lengthened significantly in HMI group and early after depolarization (EAD) appeared in HMI group. The densities of I_to, I_K,tail and I_K1 were reduced significantly in HMI group (P<0.01), from (6.72±0.42) pA/pF, (1.54±0.13) pA/pF and (25.6±2.6) pA/pF in Sham-operated group to (4.03±0.33) pA/pF, (1.14±0.11) pA/pF and (17.6±2.3) pA/pF, respectively. CONCLUSION: The reduced densities of I_to, I_K,tail and I_K1 in ventricular myocytes of non-infarcted zone in HMI are responsible for the prolongation of APD and the presentation of EAD, which play important roles in the malignant arrhythmia of HMI.