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Inotropic and electrophysiological action of humoral factors released in cardiogenic shock after acute myocardial infarction

Inotrope und elektrophysiologische Wirkungen von humoralen Faktoren beim kardiogenen Schock nach akutem Myokardinfarkt

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Summary

The inotropic and electrophysiological effects of plasma obtained from patients and experimental dogs during cardiogenic shock following acute myocardial infarction were studied. Changes in the isometric contraction and the intracellular action potential were determined in isolated papillary muscles of rabbits. Control plasma collected from normal subjects produced no significant changes in the contraction or the electrical parameters. Plasma from shock patients decreased peak force by 42% and the maximum rate of force development by 38% in comparison to control values; the time to peak of contraction, the relaxation time and the action potential parameters were not significantly altered. Corresponding results were obtained with plasma from dogs before and during experimental cardiogenic shock. Biochemical determinations failed to identify a single specific “myocardial depressant factor” in the plasma of patients and dogs with cardiogenic shock. The results suggest that (1) various humoral factors released during cardiogenic shock may depress the contractile function of cardiac muscle and (2) that the observed negative inotropic effect is not due to electrical changes in the cell membrane.

Zusammenfassung

Die Irreversibilität eines kardiogenen Schocks nach Myokardinfarkt soll angeblich wesentlich durch die Freisetzung eines humoralen, negativ inotropen Peptids, des “myocardial depressant factor” (MDF), mibestimmt werden. Bei Patienten und Hunden wurde Plasma während eines kardiogenen Schocks nach akutem Myokardinfarkt gewonnen. Gemessen wurde die Wirkung von Plasmadialysaten auf die isometrische Kontraktion und auf intrazelluläre Aktionspotentiale an isolierten Papillarmuskeln von Kaninchen in vitro. Kontrollplasma von herzgesunden Normalpersonen hatte keinen signifikanten Einfluß auf die Kontraktion und die elektrischen Parameter. Wechsel der Superfusions-flüssigkeit von Kontrollplasma auf Schockplasma verursachte eine signifikante Abnahme von Kontraktionsamplitude und maximaler Kontraktionsgeschwindigkeit um 30–40%; Kontraktionszeit, Relaxationszeit und die elektrophysiologischen Parameter des Aktionspotentials blieben unverändert. Ähnliche Ergebnisse wurden mit Plasmaproben von Hunden beobachtet, die während eines experimentellen kardiogenen Schocks entnommen wurden. Biochemische Untersuchungen mit der Polyacrylamid-Gel-Elektrophorese und der High-Voltage-Elektrophorese ergaben keinen Unterschied zwischen den Peptidfraktionen in Kontrollplasma und Schockplasma. Die Ergebnisse deuten auf eine Beteiligung von unspezifisch negativ inotropen Plasmafaktoren bei der Entstehung eines kardiogenen Schocks hin; dagegen konnte das von mehreren Autoren postulierte spezifische MDF-Peptid mit den angewendeten empfindlichen analytischen Verfahren nicht nachgewiesen werden.

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Author notes

  1. J. Senges

    Present address: Abteilung Innere Medizin III (Kardiologie), Medizinische Universitätsklinik, Bergheimer Str. 58, 6900, Heidelberg, Germany

Authors and Affiliations

  1. Abteilung Innere Medizin III (Kardiologie), Medizinische Universitätsklinik, Bergheimer Str. 58, 6900, Heidelberg, Germany

    T. Mizutani, D. Pelzer, J. Brachmann, E. Hennig, H. -Ch. Mehmel, W. Mäurer, H. Wieland, H. Katus & W. Kübler

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  1. J. Senges
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Additional information

With 3 figures and 7 tables

This work was supported by the German Research Foundation within the SFB 90 “Cardiovasculäres System”. Dr.Mizutani is a Research Fellow of the Alexander-von-Humboldt-Stiftung.

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Senges, J., Mizutani, T., Pelzer, D. et al. Inotropic and electrophysiological action of humoral factors released in cardiogenic shock after acute myocardial infarction. Basic Res Cardiol 73, 147–159 (1978). https://doi.org/10.1007/BF01906750

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  • DOI: https://doi.org/10.1007/BF01906750

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