左西孟旦对右心室衰竭大鼠右心功能、心肌能量代谢和心肌代谢的影响  

Effects of levosimendan on right ventricular function,myocardial energy metabolism and myocardial metabolism in rats with right ventricular failure

作　　者：潘莉[1] 陈旭红[2] PAN Li;CHEN Xu-hong(The First Affiliated Hospital of Shenzhen University and Shenzhen No.2 People＇s Hospital,1.Department of Pharmacy;Science and education department,Guangdong Shenzhen 518000,China)

机构地区：[1]深圳大学第一附属医院暨深圳市第二人民医院药学部,广东深圳518000 [2]深圳大学第一附属医院暨深圳市第二人民医院科教科,广东深圳518000

出　　处：《中国医院药学杂志》2018年第15期1590-1594,共5页Chinese Journal of Hospital Pharmacy

基　　金：深圳市科技计划项目(编号:JCYJ20140416180228582)

摘　　要：目的:探究左西孟旦对右心室(RV)肥厚和衰竭者右心功能,心肌耗氧量,心肌能量代谢(MEE)和心肌代谢的影响。方法:右心室衰竭(right ventricular heart-failure,RVF)大鼠肥大和衰竭是由肺部躯干条带诱导的。将大鼠随机(数字表法)分配到安慰剂组(n=16)或左西孟旦组(3 mg·kg^(-1)·d^(-1))(n=13)进行7周干预。通过超声心动图,11C-乙酸正电子发射断层扫描(PET),18F-FDG PET和有创压力测量来评估RV MEE和RV代谢。结果:左西孟旦在不影响RV心肌耗氧量的情况下,通过增加右室外径[(0.62±0.06)vs.(0.30±0.03)mm,P<0.001],可改善RV MEE[(26±3)%vs.(14±1)%,P<0.01]。RV MEE的改善与RV心肌葡萄糖摄取的变化无关[(1.3±0.1)vs.(1.0±0.1)μmol·g^(-1)·min^(-1),P=0.44]。在大鼠的肥大和衰竭RV中,左西孟旦改善RV功能而不增加心肌耗氧量,从而改善MEE。结论:左西孟旦对右心衰竭具有潜在的治疗价值,可扩展左西孟旦的临床应用范围。OBJECTIVE This study explored the effect of levosimendan on RV function,myocardial oxygen consumption,MEE and myocardial metabolism in rats with right ventricular hypertrophy and exhaustion,so as to clarify the relationship between the clinical efficacy,adverse reactions and pharmacokinetics of levosimendan. METHODS The hypertrophy and failure of RV rats is induced by the trunk bands of the lungs. The rats were randomly assigned to vectors（ n = 16） or levosimendan（ 3 mg·kg^-1·d^-1）（ n = 13） for seven weeks. The control animals without lung binding were treated with carrier therapy（ n = 11）. The metabolism of RV MEE and RV was assessed by echocardiography,11 C-acetate positron emission tomography（ PET）,18 F-FDG PET and invasive pressure measurements. RESULTS This study found that levosimendan did not affect the oxygen consumption of RV myocardium. By increasing the right ventricular diameter [（ 0. 62 ± 0. 06） vs.（ 0. 30 ± 0. 03） mm,P〈0. 001 ],RV MEE [（ 26 ± 3） % vs.（ 14 ± 1） %,P〈 0. 01] could be improved. The improvement of RV MEE was not related to the changes in myocardial glucose uptake in RV [（ 1. 3 ± 0. 1） vs.（ 1. 0 ± 0. 1） μmol·g^-1·min^-1,P = 0. 44]. In general,in the hypertrophic and depleted RV of rats,levosimendan improves the function of the RV without increasing the oxygen consumption of the myocardium,thus improving MEE. The improvement of RV MEE is not related to changes in the glucose uptake of the myocardium. CONCLUSION This study found that chronic levosimendan has a potential therapeutic value in the treatment of right heart failure,which extends the clinical application of levosimendan.

关 键 词：左西孟旦 心衰 临床疗效 不良反应 药动学 

分 类 号：R96[医药卫生—药理学]