1、从兴奋收缩耦联机制看心力衰竭正性肌力药物发展田野 教授哈医大二院心内科提 要3 兴奋 -收缩耦联机制3 正性肌力药的循证研究- 洋地黄制剂- -肾上腺素能受体激动剂- 磷酸二酯酶抑制剂 - 钙增敏剂3 新型正性肌力药的探索- 亚硝酰氢兴奋 -收缩耦联机制3Excitation-contraction (EC) coupling is a term coined in 1952 to describe the physiological process of converting an electrical stimulus to mechanical response. Sandow A (1
2、952). “Excitation-contraction coupling in muscular response.“. Yale J Biol Med 25 (3): 176201. PMID 130159500Excitation-contraction coupling3Cardiac excitationcontraction coupling is the process from electrical excitation of the myocyte to contraction of the heart (which propels blood out). The ubiq
3、uitous second messenger Ca2+ is essential in cardiac electrical activity and is the direct activator of the myofilaments, which cause contraction. Bers, D. M. ExcitationContraction Coupling and Cardiac Contractile Force edn 2 (Kluwer Academic,Dordrecht, Netherlands, 2001).Cardiac excitationcontracti
4、on couplingCardiac tissue(Guinea-pig ventricular cell)Cardiac tissueCardiac cellsThe action potential moves through sarcolemmaT tubeCa2+- induced Ca2+- releaseCa+Ca+Ca+Ca2+PlbCa2+Ca+Ca2+Ca2+Ca2+Ca2+Ca2+Ca2+Ca2+ Ca+Ca+Ca+Ca+Ca2+Ca+Ca+Ca+Ca+Ca2+Ca+Ca+Ca2+Ca+Ca+Ca+Ca+Ca+Ca+Ca+Ca+Ca+Ca+Ca+Ca+Ca2+Ca+Ca+Ca+Ca+Ca+Ca+Ca+Ca+Ca+Ca2+Ca2+Ca2+Ca2+Ca2+Ca2+Na+Na+Na+Ca2+SERCASRRyRL-Type Ca2+ChannelNa+/Ca2+ ExchangerCa+SarcolemmaCa2+