• 제목/요약/키워드: Heart atria

검색결과 62건 처리시간 0.021초

심자도를 이용한 심근 전류분포 복원과 임상적 응용 (Reconstruction of Myocardial Current Distribution Using Magnetocardiogram and its Clinical Use)

  • 권혁찬;정용석;이용호;김진목;김기웅;김기영;박기락;배장호
    • 대한의용생체공학회:의공학회지
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    • 제24권5호
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    • pp.459-464
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    • 2003
  • 심자도 신호로부터 전류원의 분포를 복원하는 알고리듬을 구성하고 이를 WPW 증후군 환자에 대해 적용하여 임상적 유용성을 검토하였다. 40 채널 superconducting quantum interference device (SQUID) 미분계를 이용하여 심자도를 측정하고 minimum norm estimation (MNE) 알고리듬과 truncated singular value decomposition (SVD)을 적용하여 2 차원 평면에서의 전류원 분포를 구하였으며. 전류원의 분포가 실제 전류원의 정보를 잘 반영하고 있음을 시뮬레이션으로 확인하였다. 또한 좌심방과 좌심실 사이에 부전도로를 가진 WPW 증후군 환자의 심자도를 측정하여 수술 전후의 전류원 분포를 비교한 결과 수술 전에는 부전도로를 통한 비정상전류의 흐름을 볼 수 있었으나 부전도로를 절제한 후에는 더 이상 볼 수 없었다. 이 결과는 심자도 선호로부터 구한 전류원 분포가 심장의 전기 활동을 잘 반영하고 있으며 임상적으로 유용하게 활용 될 수 있음을 보여준다.

Catecholamines에 관(關)하여 -제4편(第四編) : 심실전동발생(心室顫動發生)에 있어서의 catecholamines의 의의(意義)- (Role of Catecholamines in Ventricular Fibrillation)

  • 이우주
    • 대한약리학회지
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    • 제19권1호
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    • pp.15-35
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    • 1983
  • Although it has been well known that ventricular fibrillation is the most important complication during hypothermia, much investigation has failed to show the exact nature of the etiology of ventricular fibrillation. Recently, there has been considerable research on the relationship between sympathetic activity and ventricular fibrillation under hypothermia. Cardiac muscle normally contains a certain amount of norepinephrine and the dramatic effect of this catecholamines on the cardiac muscle is well documented. It is, therefore, conceivable that cardiac catecholamines might exert an influence on the susceptibility of heart muscle to tachycardia, ventricular fibrillation and arrhythmia, under hypothermia. Hypothermia itself is stress enough to increase tonus of sympatheticoadrenal system. The normal heart is supplied by an autonomic innervation and is subjected to action of circulating catecholamines which may be released from the heart. If the reaction of the heart associated with a variable amount of cardiac catecholamines is. permitted to occur in the induction of hypothermia, the action of this agent on the heart has not to be differentiated from the direct effects of cooling. The studies presented in this paper were designed to provide further information about the cardio-physiological effects of reduced body temperature, with special reference to the role of catecholamines in ventricular fibrillation. Healthy cats, weighing about 3 kg, were anesthetized with pentobarbital(30 mg/kg) intraperitoneally. The trachea was intubated and the endotracheal tube was connected to a C.F. Palmer type A.C. respirator. Hypothermia was induced by immersing the cat into a ice water tub and the rate of body temperature lowering was $1^{\circ}C$ per 5 to 8 min. Esophageal temperature and ECG (Lead II) were simultaneously monitored. In some cases the blood pH and serum sodium and potassium were estimated before the experiment. After the experiment the animals were killed and the hearts were excised. The catecholamines content of the cardiac muscle was measured by the method of Shore and Olin (1958). The results obtained are summarized as follows. 1) In control animal the heart rate was slowed as the temperature fell and the average pulse rates of eight animals were read 94/min at $31^{\circ}C$, 70/min at $27^{\circ}C$ and 43/min at $23^{\circ}C$ if esophageal temperature. Ventricular fibrillation was occurred with no exception at a mean temperature of $20.3^{\circ}C(21-l9^{\circ}C)$. The electrocardiogram revealed abnormal P waves in each progressive cooling of the heart. there was, ultimately, a marked delay in the P-R interval, QRS complex and Q-T interval. Inversion of the T waves was characteristic of all animals. The catecholamines content of the heart muscle excised immediately after the occurrence of ventricular fibrillation was about thirty percent lower than that of the pre-hypothermic heart, that is, $1.0\;{\mu}g/g$ wet weight compared to the prehypothermic value of $1.41\;{\mu}g/g$ wet weight. The changes of blood pH, serum sodium and potassium concentration were not remarkable. 2) By the adrenergic receptor blocking agent, DCI(2-3 mg/kg), given intramuscularly thirty minutes before hypothermia, ventricular fibrillation did not occur in one of five animals when their body temperature was reduced even to $16^{\circ}C$. These animals succumbed at that low temperature, and the changes of heart rate and loss of myocardial catecholamines after hypothermia were similar to those of normal animals. The actual effect of DCI preventing the ventricular fibrillation is not predictable. 3) Administration of reserpine(1 mg/kg, i.m.) 24 hours Prior to hypothermia disclosed reduced incidence of ventricular fibrillation, that is, six of the nine animals went into fibrillation at an average temperature of $19.6^{\circ}C$. By reserpine myocardial catecholamines content dropped to $0.045\;{\mu}g/g$ wet weight. 4) Bretylium pretreatment(20 mg/kg, i.m.), which blocks the release of catecholamines, Prevented the ventricular fibrillation under hypothermia in four of the eight cats. The pulse rate, however, was approximately the same as control and in some cases was rather slower. 5) Six cats treated with norepinephrine(2 mg/kg, i.m.) or DOPA(50 mg/kg) and tranylcypromine(10 mg/kg), which tab teen proved to cause significant increase in the catecholamines content of the heart muscle, showed ventricular fibrillation in all animals under hypothermia at average temperature of $21.6^{\circ}C$ and the pulse rate increased remarkably as compared with that of normal. Catecholamines content of cardiac muscle of these animals markedly decreased after hypothermia but higher than control animals. 6) The functional refractory periods of isolated rabbit atria, determined by the paired stimulus technique, was markedly shortened by administration of epinephrine, norepinephrine and isoproterenol. 7) Adrenergic beta-blocking agents, such as pronethalol, propranolol and sotalol(MJ-1999), inhibited completely the shortening of refractory period induced by norepinephrine. 8) Pretreatment with either phenoxftenbamine or phentolamine, an adrenergic alphatlocking agent, did not modify the decrease in refractory period induced by norepinephrine. From the above experiment it is possible to conclude that catecholamines play an important role in producing ventricular fibrillation under hypothermia. The shortening of the refractorf period of cardiac muscle induced by catecholamines mar be considered as a partial factor in producing ventriculr fibrillaton and to be mediated by beta-adrenergic receptor.

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cAMP induction by ouabain promotes endothelin-1 secretion via MAPK/ERK signaling in beating rabbit atria

  • Peng, Li-qun;Li, Ping;Zhang, Qiu-li;Hong, Lan;Liu, Li-ping;Cui, Xun;Cui, Bai-ri
    • The Korean Journal of Physiology and Pharmacology
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    • 제20권1호
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    • pp.9-14
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    • 2016
  • Adenosine 3',5'-cyclic monophosphate (cAMP) participates in the regulation of numerous cellular functions, including the $Na^+-K^+$-ATPase (sodium pump). Ouabain, used in the treatment of several heart diseases, is known to increase cAMP levels but its effects on the atrium are not understood. The aim of the present study was to examine the effect of ouabain on the regulation of atrial cAMP production and its roles in atrial endothelin-1 (ET-1) secretion in isolated perfused beating rabbit atria. Our results showed that ouabain ($3.0{\mu}mol/L$) significantly increased atrial dynamics and cAMP levels during recovery period. The ouabain-increased atrial dynamics was blocked by KB-R7943 ($3.0{\mu}mol/L$), an inhibitor for reverse mode of $Na^+-Ca^{2+}$ exchangers (NCX), but did not by L-type $Ca^{2+}$ channel blocker nifedipine ($1.0{\mu}mol/L$) or protein kinase A (PKA) selective inhibitor H-89 ($3.0{\mu}mol/L$). Ouabain also enhanced atrial intracellular cAMP production in response to forskolin and theophyline ($100.0{\mu}mol/L$), an inhibitor of phosphodiesterase, potentiated the ouabain-induced increase in cAMP. Ouabain and 8-Bromo-cAMP ($0.5{\mu}mol/L$) markedly increased atrial ET-1 secretion, which was blocked by H-89 and by PD98059 ($30{\mu}mol/L$), an inhibitor of extracellular-signal-regulated kinase (ERK) without changing ouabain-induced atrial dynamics. Our results demonstrated that ouabain increases atrial cAMP levels and promotes atrial ET-1 secretion via the mitogen-activated protein kinase (MAPK)/ERK signaling pathway. These findings may explain the development of cardiac hypertrophy in response to digitalis-like compounds.

신우황청심원의 심혈관계에 대한 약효 (Pharmacological Actions of New Woohwangchungsimwon Pill on Cardiovascular System)

  • 조태순;이선미;김낙두;허인희;안형수;권광일;박석기;심상호;신대희;박대규
    • 약학회지
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    • 제41권6호
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    • pp.802-816
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    • 1997
  • In order to investigate the pharmacological properties of New Woohwangehungsimwon Pill (NWCH). Effects of Woohwangehungsimwon Pill (WCH) and NWCH were compared using various experimental models. In isolated rat aorta, NWCH and WCH showed the relaxation of blood vessels in maximum contractile response to phenylephrine ($10^{-6}$M) without regard to endothelium containing or denuded rings of the rat aorta. Furthermore, the presence of the inhibitors of NO synthase and guanylate cyclase did not affect significantly the relaxative effects of NWCH and WCH. NWCH and WCH inhibited the vascular contractions induced by acethylcholine, prostaglandin endoperoxide or peroxide in a dose-dependent manner. In conscious spontaneously hypertensive rats(SHRs), NWCH and WCH decreased significantly heart rate. These, at high doses, had a negative inotropic effect that was a decrease of LVDP and (-dp/dt)/(+dp/dt) in the isolated perfused rat hearts, and also decreased the contractile force and heart rate in the isolated rat right atria. In excised guinea-pig papillary muscle, these had no effects on parameters of action potential at low doses, whereas inhibited the cardiac, contractility at high doses. Furthermore, these had a significant inhibitory effects on heart acceleration in normotensive rats and SHRs. These results suggested that NWCH and WCH have weak cardiovascular effects, and that there is no significant differences between two preparations.

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심근 수축에 있어서 Calcium 이온의 기원에 관한 약리학적 연구 (The Pharmacological Studies on the Origin of Calcium ion in Myocardial Contraction)

  • 고창만;김경환
    • 대한약리학회지
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    • 제30권1호
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    • pp.67-73
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    • 1994
  • Na-Ca 교환은 calcium 이온을, 세포 내외의 Na 이온 농도차에 의해서 형성되는 원동력의 방향에 따라, 세포내로(역방향 Na-Ca 교환), 혹은 세포밖으로(정방향 Na-Ca 교환) 이동시킨다. 그러므로 Na-Ca 교환은 심근 수축 운동의 조절 기전의 하나로 받아 들여지고 있다. 그러나, 세포내의 Na 이온 농도는 항상 세포외의 농도보다 낮으므로, 역방향 Na-Ca 교환의 존재와 아울러 이의 심근 수축에 있어서의 역할 가능성에 대해 많은 연구자들이 회의를 가지고 있는 것이 사실이다. 그러므로 본 연구는 흰쥐의 좌심방을 이용하여, 역방향 Na-Ca 교환의 존재 여부와 그 역할의 존재 가능성을 추구하여 보고자 하였다. 흰쥐의 좌심방은 전기장 자극(0.5msec, supramaximal voltage)으로 수축을 유발하고, 자극 빈도를 안정시 4Hz에서 0.4, 1, 8Hz로 변동시킬때 그 수축 장력에서 특징적인 역 사다리 효과(negative staircase effect)가 나타내었으나, 이때 $^{45}Ca$ 섭취는 저빈도로 갈수록, 또한 고빈도로 갈수록 증가되는 이원적인 증가를 나타내었다 자극 빈도를 4Hz 에서 0.4Hz로 변동시에는 수축 장력이 특징적인 삼단계 변환, 즉 급격히 증가하는 첫단계에 이어 급격하게 감소하는 이단계와 안정되어지는 삼단계로 나타났다. $^{45}Ca$ 섭취도 장력 변동과 같은 양상으로 처음 30초 동안에 현저하게 증가한 후 감소되었다. Na-Ca 억제 약물인 benzamil은 $10^{-5}M$에서부터 $3{\times}10^{-4}M$까지 용량에 비례하여 특히 초기의 장력증가를 봉쇄하였다. Bay K-8644$(3{\times}10^{-5}M)$ 처치는 자극 빈도 감소에 따른 수축력 증가를 현저하게 항진시켰으며, benzamil처치는 이때에도 억압을 나타내었다. Verapamil $3{\times}10^{-5}M$ 전처치시에는 4Hz 자극시의 수축 운동은 완전히 소실시켰으나, 0.4 혹은 1 Hz로 바꿈에 따라 수축 운동이 재현되었다. 이때 $^{45}Ca$ 섭취는 verapamil을 전처치하지 않은 경우보다 현저하게 항진되었다. 이상의 결과로 보아, 흰쥐의 좌심방에서 자극 빈도 감소후에는, 먼저 역방향 Na-Ca 교환에 의해 calcium이온이 세포내로 유입되어 수축운동의 항진이 유발되고, 이어 Na-Ca 교환이 정방향으로 변환되어 calcium이온을 세포밖으로 유출시킴에 따라 수축 운동이 감소된다고 생각한다.

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자라 신장기능에 미치는 Atrial Natriuretic Peptide의 효과 (Renal and Hormonal Responses to Atrial Natriuretic Peptide and Furosemide in the Freshwater Turtle, Amyda japonica)

  • 조경우;김선희;고규영;설경환
    • The Korean Journal of Physiology
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    • 제21권1호
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    • pp.13-22
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    • 1987
  • Effects of synthetic atrial natriuretic peptide and furosemide on the cardiovascular and renal functions were examined in the freshwater turtle, Amyda japonica. Both atria and ventricle of turtle contained an immunoreactive atrial natriuretic peptide. Synthetic rat atrial natriuretic peptide (atriopeptin III) and turtle atrial extract caused a decrease in mean arterial blood pressure and the vasodepressor effect was dose-dependent. In hydrated turtles received either atriopeptin III or turtle atrial extract, no significant change in renal function was observed until 100 min except a slight natriuresis at 60 or 100 min after injection of 30 ug/kg atriopeptin III or atrial extract, respectively. However, furosemide, 2 mg/kg, caused marked diuresis, natriuresis and kaliuresis. In non-hydrated turtles, no significant change in renal function was observed until 6 hrs following injection of 30 ug/kg atriopeptin III. Plasma aldosterone decreased at 2 hr and increased at 24 hr after injection of atriopeptin III although plasma renin concentration did not change. But, furosemide caused persistent diuresis, natriuresis and kaliuresis. Additionally, plasma aldosterone and renin concentrations were significantly increased at 24 hrs after injection of furosemide. In conclusion, we suggest that the freshwater turtle may have an atrial natriuretic peptide in heart and vascular receptors for atrial natriuretic peptide, and that atrial natriuretic peptide is more important in the regulation of blood pressure rather than that of renal function in freshwater turtles. We also suggest that an increased plasma renin concentration caused by furosemide may not be due to the sodium concentration delivered to macula densa, but due to the dehydration caused by persistent diuresis and natriuresis.

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Comparative effects of angiotensin II and angiotensin-(4-8) on blood pressure and ANP secretion in rats

  • Phuong, Hoang Thi Ai;Yu, Lamei;Park, Byung Mun;Kim, Suhn Hee
    • The Korean Journal of Physiology and Pharmacology
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    • 제21권6호
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    • pp.667-674
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    • 2017
  • Angiotensin II (Ang II) is metabolized from N-terminal by aminopeptidases and from C-terminal by Ang converting enzyme (ACE) to generate several truncated angiotensin peptides (Angs). The truncated Angs have different biological effects but it remains unknown whether Ang-(4-8) is an active peptide. The present study was to investigate the effects of Ang-(4-8) on hemodynamics and atrial natriuretic peptide (ANP) secretion using isolated beating rat atria. Atrial stretch caused increases in atrial contractility by 60% and in ANP secretion by 70%. Ang-(4-8) (0.01, 0.1, and $1{\mu}M$) suppressed high stretch-induced ANP secretion in a dose-dependent manner. Ang-(4-8) ($0.1{\mu}M$)-induced suppression of ANP secretion was attenuated by the pretreatment with an antagonist of Ang type 1 receptor ($AT_1R$) but not by an antagonist of $AT_2R$ or $AT_4R$. Ang-(4-8)-induced suppression of ANP secretion was attenuated by the pretreatment with inhibitor of phospholipase (PLC), inositol triphosphate ($IP_3$) receptor, or nonspecific protein kinase C (PKC). The potency of Ang-(4-8) to inhibit ANP secretion was similar to Ang II. However, Ang-(4-8) $10{\mu}M$ caused an increased mean arterial pressure which was similar to that by 1 nM Ang II. Therefore, we suggest that Ang-(4-8) suppresses high stretch-induced ANP secretion through the $AT_1R$ and $PLC/IP_3/PKC$ pathway. Ang-(4-8) is a biologically active peptide which functions as an inhibition mechanism of ANP secretion and an increment of blood pressure.

Tetrodotoxin 중독가토(中毒家兎)의 심전도학적(心電圖學的) 연구(硏究) (An Electrocardiographic Study on Tetrodotoxin Intoxicated Rabbits)

  • 박용국;신홍기;김기순
    • The Korean Journal of Physiology
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    • 제10권1호
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    • pp.41-48
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    • 1976
  • Tetrodotoxin (TTX) is the purified active principle responsible for tetrodon (Puffer-fish) poisoning which has long been known in the Orient. The pharmacological actions of TTX have been rather extensively investigated. Two of the most prominent effects of intravenousely administered TTX are severe hypotension and respiratory paralysis resulting from its depressant actions on tissues. This depressant actions of TTX in turn result from the selective inhibition of sodium-carrying mechanism which is essential to generation of the action potential. TTX differs from local anesthetics in that it does not affect potassium conductance. Although the mechanism of the hypotensive action of TTX remains a subject of controversy, most investigator agree that TTX-induced hypotension is caused by alteration in the blood vessels rather than the heart. Not only the study on the effects of TTX on cardiac function is meager but the results of reported works are often contradictory. The present study was undertaken to investigate the effect of TTX on the electrocardiogram of the rabbit and to compare them with well known electrocardiographical characteristics found in digitalis and quinidine intoxicated animals. The results obtained from the present study are summarized as follows. 1. No changes were found in P-R interval and QRS duration after i.v. administration of $1.0\;{\mu}g/kg\;to\;1.5\;{\mu}g/kg$ TTX to the animals. It is obvious that there were no conduction disturbance between atria and ventricles as well as in the ventricular tissue. 2. In $1.0\;{\mu}g/kg$ TTX group, S-T interval and T-P segment were not changed whereas marked changes were observed in $1.5\;{\mu}g/kg$ TTX group. 3. The first and second degree A-V blocks appeared in the $2.0\;{\mu}g/kg$ TTX group. 4. TTX differs from digitalis and quinidine in that it does not cause S-T interval depression and T-wave inversion. In contrast with digitalis, TTX caused Q-T interval prolongation.

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CT를 이용한 심장 기능 검사 (Using CT to Evaluate Cardiac Function)

  • 이종민
    • 대한영상의학회지
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    • 제85권2호
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    • pp.308-326
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    • 2024
  • 심장 기능의 포괄적인 결과는 심장박출량과 전신 정맥 환류로 표현된다. 심장의 4개의 방실은 각자 고유한 기계적 기능을 가진다. 심장방실과 판막, 폐순환 시스템은 전부하 또는 후부하의 형태로 상호 연관되어 있다. 심장 기능 장애는 전반적인 심장 기능의 실패로 전형적인 임상 증상을 나타낸다. 심장 기능 장애의 근본 원인을 조사하려면 심장 내 혈류 유동 경로에 대한 단계별 평가가 필요하다. 이러한 맥락에서, 심장의 세부 구조를 볼 수 있는 영상검사의 표지자는 심장 기능 평가에 중요한 역할을 한다. 영상기반 평가를 통해 개별 심장 구성 요소의 기능을 단계별로 조사할 수 있다. 심장 기능 평가를 위한 영상검사 중 최근 심장 CT가 포함되고 검증되었다. 본 종설에서는 포괄적 및 단계별 심장 기능 평가를 위한 심장 CT 기반 영상 표지자에 대해 논의하겠다.

심장 종양의 수술적인 치료의 임상적 고찰 (Clinical Experience of the Surgical Treatment of Cardiac Tumor)

  • 방정희;우종수;최필조;조광조;김시호;박권재
    • Journal of Chest Surgery
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    • 제43권4호
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    • pp.375-380
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    • 2010
  • 배경: 심장의 원발성 종양은 아주 드문 질환이다. 이중 대부분의 경우는 양성인 점액종이고 이는 조기의 수술적인 치료로 거의 완치되는 반면 육종과 같은 악성종양은 수술적 제거가 어렵고 예후도 안 좋은 것으로 알려져 있다. 본원에서는 심장 종양으로 수술적인 치료를 했던 환자를 모아서 분석해 보았다. 대상 및 방법: 1993년 8월부터 2008년 12월까지 심장 종양으로 수술적인 치료를 하였던 28명의 환자를 대상으로 의무 기록 검토를 통한 후향적 분석을 하였다. 결과: 환자의 연령은 20세에서 76세 사이로 평균 $54.2{\pm}15.6$세였다. 남자가 11명(39%), 여자가 17명(61%)이었다. 15예(54%)에서 심부전의 증상 호전을 위해 응급 수술을 시행하였다. 술 전 주 증상은 호흡곤란이 15예(54%)로 제일 많았다. 전 환자에서 술 전 심장초음파로 진단이 되었다. 수술 시 종양의 크기는 장축이 2∼40 cm의 범위로 평균 $7.0{\pm}6.9$ cm였으며 종양의 부착부위는 18예(64%)에서 심방중격에, 9예(32%)에서 좌심방에, 2예(7%)에서 승모판막윤에, 2예(7%)에서 좌심실에 위치하고 있었다. 수술은 전 환자에서 양 심방절개를 통해 접근하였고 25예(89%)에서 완전절제가 가능하였다. 조직검사에서 육종이 4예(14%), 지방종이 1예(4%), 점액종이 23예(82%)였으며 완전절제를 못했던 3예는 모두 육종이었다. 술 후 사망은 없었다. 외래 추적은 24예(86%)에서 가능했으며 평균 추적 기간은 $46.8{\pm}42.7$개월이었다. 추적 환자 중 만기 사망은 조직검사에서 육종이었던 3명이 있었다. 육종으로 수술했던 환자로 재발 혹은 타 조직으로 전이하여 1예에서 2차례 재수술, 1예에서 전이 부위 절제술, 1예에서는 항암치료만을 했던 환자였다. 평균 재발 및 전이기간은 각각 $12.7{\pm}10.8$개월, $20.5{\pm}16.8$개월이었다. 결론: 심장 종양의 대부분인 점액종은 색전 등의 위험을 야기할 수 있으므로 조기에 수술함이 원칙이고 수술적 제거로 근본적인 치료가 가능하다. 악성종양인 육종은 발견 시 이미 상당히 진행되어 있는 경우가 많고 주위 조직으로의 침윤이 심해 수술적인 제거가 어려운 경우가 많다. 그러나 심부전 증상 등의 증상완화를 위해서는 가능한 부위의 절제를 함으로써 환자의 향후 삶의 질을 높일 수 있는 방편으로 보인다.