Role of K+ATP channels in local metabolic coronary vasodilation.

K N Richmond, J D Tune, M W Gorman, E O Feigl
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引用次数: 26

Abstract

ATP-sensitive potassium (K+ATP) channels have been shown to play a role in the maintenance of basal coronary vascular tone in vivo. K+ATP channels are also involved in the coronary vasodilator response to adenosine. The aim of this study was to determine the role of K+ATP channels in local metabolically mediated increases in coronary blood flow during cardiac electrical paired pacing without catecholamine effects. In 10 anesthetized closed-chest dogs, coronary blood flow was measured in the left circumflex coronary artery, and myocardial O2 consumption was calculated using the arteriovenous O2 difference. Cardiac interstitial adenosine concentration was estimated from coronary venous and arterial plasma adenosine measurements using a previously described, multicompartmental, axially distributed, mathematical model. Paired stimulation increased heart rate from 57 to 120 beats/min, myocardial O2 consumption 88%, and coronary blood flow 76%. During K+ATP channel blockade with glibenclamide, baseline coronary blood flow decreased in relation to myocardial O2 consumption and thus coronary sinus O2 tension fell. Paired-pulse pacing with glibenclamide resulted in increases in myocardial O2 consumption and coronary blood flow similar to those during control pacing. Coronary venous and estimated interstitial adenosine concentration did not increase sufficiently to overcome the glibenclamide blockade. In conclusion, K+ATP channels are not required for locally mediated metabolic increases in coronary blood flow that accompany myocardial O2 consumption during pacing tachycardia without catecholamines, and adenosine levels do not increase sufficiently to overcome the glibenclamide blockade.

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K+ATP通道在局部代谢性冠状动脉舒张中的作用。
ATP敏感的钾(K+ATP)通道已被证明在维持体内基底冠状动脉血管张力中发挥作用。K+ATP通道也参与冠状动脉血管扩张剂对腺苷的反应。本研究的目的是确定K+ATP通道在没有儿茶酚胺作用的心脏电配对起搏期间局部代谢介导的冠状动脉血流量增加中的作用。10只麻醉闭胸犬,测量左旋冠状动脉冠状动脉血流量,利用动静脉氧差计算心肌耗氧量。心脏间质腺苷浓度通过冠状静脉和动脉血浆腺苷测量来估计,使用先前描述的多室、轴向分布的数学模型。配对刺激使心率从57次/分增加到120次/分,心肌耗氧量增加88%,冠状动脉血流量增加76%。在格列本脲阻断K+ATP通道期间,基线冠状血流量与心肌氧消耗相关降低,因此冠状窦氧张力下降。与格列本脲配对脉冲起搏导致心肌耗氧量和冠状动脉血流量的增加,与对照起搏时相似。冠状静脉和估计间质腺苷浓度没有增加到足以克服格列本脲阻断。综上所述,在没有儿茶酚胺的起搏性心动过速期间,伴随心肌氧消耗的局部介导的冠状动脉血流代谢增加不需要K+ATP通道,腺苷水平的增加不足以克服格列本脲的阻断。
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