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Cardioprotection by Aldosterone Receptor Antagonism in Heart Failure: 1.
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Thus, the renin-angiotensin-aldosterone system (RAAS) plays a major role in the development of both hypertension and heart failure and is, therefore, a key target for therapeutic interventions.
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Commonly prescribed medications for control of hypertension and congestive heart failure are inhibitors of the RAAS, including angiotensin converting enzyme inhibitors (ACE-Is) and angiotensin II (A-II) receptor antagonists.
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These findings support the pivotal role of aldosterone in the pathophysiology of progressive heart failure.
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Recently, eplerenone was successfully introduced for the treatment of hypertension and heart failure.
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| Effects of acute hypoxia and acute ischemia on myocardial metabolism werestudied on thirteen dogs,eight hypoxic ones and five controls.The hypoxicanimals were given various hypoxic gas(mixture of air and nitrogen)and nitrogenat last.The blood samples of the coronary artery and sinus were taken for analyzingthe Po_2 and lactic acid contents.The biopsies of left ventricles were taken for analy-zing succinic dehydrogenase,lactic dehydrogenase,ATP,creatine phosphate,inor-ganic phosphate and lactic acid contents.The... Effects of acute hypoxia and acute ischemia on myocardial metabolism werestudied on thirteen dogs,eight hypoxic ones and five controls.The hypoxicanimals were given various hypoxic gas(mixture of air and nitrogen)and nitrogenat last.The blood samples of the coronary artery and sinus were taken for analyzingthe Po_2 and lactic acid contents.The biopsies of left ventricles were taken for analy-zing succinic dehydrogenase,lactic dehydrogenase,ATP,creatine phosphate,inor-ganic phosphate and lactic acid contents.The results obtained were as follows:(1)Acute hypoxia induced a signi-ficant increase in lactic dehydrogenase activity but not in succinic dehydrogenaseactivity.(2)ATP store was decreased and creatine phosphate store was unchangedduring acute hypoxic heart failure.But creatine phosphate store was decreasedand ATP store was unchanged during acute ischemic heart failure.(3)The changeof lactic acid content in the blood of coronary vessels was independent of that in themydcardium.It appeared that there were different changes of myocardial metabolism duringacute hypoxic heart failure and acute ischemic heart failure. | 成年雄性狗13条,低氧组8条,麻醉后开胸,暴露心脏,给于不同程度的低氧气体及纯氮气体,于不同时间取冠状动静脉血液及心肌活组织,测定血液氧分压,乳酸含量和心肌琥珀酸-细胞色素 C 还原酶、乳酸脱氢酶、三磷酸腺苷、磷酸肌酸、无机磷以及乳酸含量。对照组5条狗,不给于低氧气体,用主动脉放血代替吸入纯氮气体,其它操作均同低氧组。结果表明:(1)低氧组的乳酸脱氢酶活力升高,琥珀酸-细胞色素 C 还原酶无变化.对照组的这两种酶的活力均升高;(2)急性低氧性心力衰竭时三磷酸腺苷明显降低,磷酸肌酸不变。急性缺血性心力衰竭时三磷酸腺苷不变,磷酸肌酸显著降低;(3)冠状动静脉乳酸量的变化与心肌乳酸量的变化之间不呈现相关。 | Vegetative endocarditis (VE) is a formidable complication in total artificial lheart (TAH)animals. The clinical manifestations, autopsy findings and management of VE in 46 of 114 TAH animal implantations (40.36%)during 1980-1983, in Division of Artificial Organs, University of Utah, are reviewed. Diagnostic criteria of VE were vegetations in prosthetic heart with positive blood orintraprosthetic cultures, and/or symptoms of sepsis. Infection of drive lines and contamination during perioperative period and autoinfection... Vegetative endocarditis (VE) is a formidable complication in total artificial lheart (TAH)animals. The clinical manifestations, autopsy findings and management of VE in 46 of 114 TAH animal implantations (40.36%)during 1980-1983, in Division of Artificial Organs, University of Utah, are reviewed. Diagnostic criteria of VE were vegetations in prosthetic heart with positive blood orintraprosthetic cultures, and/or symptoms of sepsis. Infection of drive lines and contamination during perioperative period and autoinfection of animals were considered to be the main sources of VE infection. The most common pathogen was P. aeuroginosa. The major causes of termination or death of TAH recipients were sepsis, congestive heart failure and mechanical failure of the TAH. The main pathological findings of VE animals were septic thromboembolism, and vegetation-associated congestive heart failure. Vegetations were present more commonly in the inflow valve area than the outflow valve area. According to the postulated pathogenesis of VE, control of infection, improved design of the TAH and biocompatible materials, judicious anticoagulation and strict aseptic surgical techniques and animal care are important for the prevention of VE. The investigation of VE in TAH animals and its prevention wiit greatly contribute to successful clinical applications of the TAH. | 赘生性心内膜炎是全人工心脏动物的一个致命的并发症。本文分析美国犹他大学人工器官研究所在1980—1983四年间,114例全人工心脏动物中46例(40,35％)合并赘生性心内膜炎的临床表现、尸检所见及治疗经过。诊断标准为人工心脏中有赘生物,及血培养或心内培养有阳性或伴有明显感染症状者。感染多来源于驱动管道的感染,术中或术后污染及动物的自身感染,最常见的致病菌为绿脓杆菌。动物的死亡原因及尸检所见多系与赘生物有关的感染,充血性心力衰竭及人工心脏的机械故障。赘血物常见于输入瓣膜区。其发病机制与人工心脏的异物,血液流态,凝血机制及感染有密切关系。主要预防方法为改进人工心脏的设计与制作,提高材料的生物相容性,合宜的抗凝治疗,以及严格的无菌技术。药物治疗只能延缓病程,外科手术可能有所裨益。对全人工心脏赘生性心内膜炎的研究,将有助于全人工心脏在临床上的成功应用。 | Animal model of chronic cardiac failure induced by abdominal aortic stenosis was utilized to charaterize | 本文建立了一种主动脉不完全结扎慢性心力衰竭的动物模型,并研究了其超微结构变化。慢性心力衰竭的心肌存在不同类型的心肌细胞变性:(一)严重变性的心肌细胞胞质内充满增生的线粒体,肌原纤维被取代;(二)变性细胞中大片肌原纤维溶解,肌浆网小管和小泡增殖,粗面内质网丰富,溶酶体活跃;(三)变性细胞肌原纤维完整而线粒体全部被溶酶体自噬破坏。与此同时,还经常观察到线粒体灶性增生、肌原纤维灶性溶解以及走向紊乱等局灶变性改变。结果表明:心肌细胞的肌原纤维和线粒体破坏导致心肌收缩性障碍,可能是心力衰竭发生的重要机制。 | | | | << 更多相关文摘 |
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心力衰竭
heart failure 
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