厄贝沙坦对兔肥厚心肌钙调蛋白激酶活性及室性心律失常发生的影响  

Influence of irbesartan on the calmodulin kinase actirity of rabbit cardiac hypertrophy and the malignat ventricular arrhythmia

作　　者：肖志超[1] 张存泰[1] 马业新[1] 卜军[1] 王文广[1] 吴蔚[1] 林立[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院心内科,武汉430030

出　　处：《临床心血管病杂志》2006年第8期478-480,共3页Journal of Clinical Cardiology

基　　金：国家自然科学基金资助项目(304070714);湖北省自然科学基金资助项目(No:2004ABA230)

摘　　要：目的:研究厄贝沙坦对兔肥厚心肌局部钙调蛋白激酶活性的影响和对恶性心律失常发生的预防作用。方法:家兔30只,随机分为左心室肥厚组(手术组,腹主动脉缩窄术制备心肌肥厚模型),对照组(只暴露主动脉而不行缩窄)和厄贝沙坦干预组(干预组,行腹主动脉缩窄后予厄贝沙坦口服)。8周后,在体同步测量肥厚心肌3层的APD100以及透壁弥散复极化(TDR),用程序电刺激方法诱导心律失常发生。术后测量全心重量、室壁厚度和心肌局部钙调蛋白激酶活性。结果:手术组,3层心肌细胞的APD100,TDR较对照组明显延长,局部钙调蛋白激酶活性明显升高,更容易诱发室性心律失常;干预组APD100、TDR较手术组缩短,局部钙调蛋白激酶活性降低,而且不易诱发心律失常。结论:肥厚心肌发生电生理重构,局部钙调蛋白激酶活性增加,更容易发生恶性心律失常,厄贝沙坦能够部分恢复肥厚心肌的电重构,降低心肌局部的钙调蛋白激酶活性,从而减少心律失常的发生。Objective： To investigate the influence of irbesartan on the local calmudulin kinase activity and its protective effect against the malignant ventricular arrhythmia. Method： Thirty rabbits were randomly divided into 3 groups： LVH group（LVH was induced by partial ligation of abdominal aorta）, control group （sham operation） and treated group （ irbesartan was administered after abdominal aorta ligation）. Eight weeks later , the APD100 （action potential duration） and TDR（transmural dispersion of repolarization） of the rabbits were measured simultaneously in vivo by a conpound electrode, the arrhythmias were induced and recorded by programmed electrical stimulation. After the operation,the heart of the rabbits were taken out. The total weight of the heart ,the thickness of the ventricular wall and the activity of the local calmodulin kinase were measured. Result： The APD100 and TDR of the LVH group were longer, and the activity of local CAMKⅡ were higher than that of the control group. The hypertrophic hearts were more prone to arrhythmia induction. Whereas the APD, TDR were much shorter, the activity of the local CAMKⅡ were much lower, and the arrhythmia induction were much more difficult in the treated group. Conclusion：The electrical remodling takes place in the LVH group,and the activity of the local CAMKⅡ increases, which lead to the higher induction rate of arrhythmia. Irbesartan can partially restore the electrical characters of the LVH,decrease the activity of the local CaMKⅡ,and decrease the incidence of arrhythmia.

关 键 词：心肌肥厚 心律失常 钙调蛋白激酶 厄贝沙坦 

分 类 号：R542.2[医药卫生—心血管疾病]