Antibodies against &-adrenoceptor can be detected in serum of patients with dilated cardiomyopathy (DCM), which have 5-agonist-like activity, and induce a positive chronotropic effect on cardiac myocytes by its pe...Antibodies against &-adrenoceptor can be detected in serum of patients with dilated cardiomyopathy (DCM), which have 5-agonist-like activity, and induce a positive chronotropic effect on cardiac myocytes by its persistence at full strength. Effects of the antibodies against Padrenoceptor from sera of patients with DCM on myocardial cytotoxicity and cytoplasmic free Ca2+-concentration (LCa2+ji) were observed in the cultured single layer SD rat ventricular cells by using the cytotoxicity assay and fluorescent Ca2+- indicat0r fura-2/AM. The positive sera of the anti-&adrenoceptor antibodies from patients with DCM markedly enhanced myocardial [Ca2+]i. Betaloc, a 5, -receptor blocker, might inhibit the increase of the antibody-mediated myocardial [Ca2+]i, and the sera from healthy donors had no effect on myocardial [Ca2+]i,. Our results suggest that the anti-β-adrenoceptor antibody might increase myocardial [Ca2+]i, and result in myocardial damage. The antibodies might activate receptor-gating Ca2+-channel, thereby causing myocardial [Ca2+]i, rise and calcium overload. Early use of betaloc is recommended in the treatment of dilated cardiomyopathy.展开更多
文摘背景心脏康复作为冠心病患者康复的有效干预措施已达成共识,但国内外制定的心脏康复相关指南的质量尚不明确,相关的推荐意见有待整合。目的系统评价冠心病患者心脏康复的相关指南,为临床实践提供参考。方法于2022年6月,计算机检索the Cochrane Library、Web of Science、PubMed、中国知网、维普网及万方数据知识服务平台,以及国内外指南网和相关学会网,获取冠心病患者心脏康复相关指南,检索时限均为建库至2022-06-30。2名研究者按照纳入与排除标准独立筛选文献并提取资料。采用临床指南研究与评估系统Ⅱ(AGREEⅡ)对纳入指南进行质量评价,并汇总冠心病患者心脏康复的推荐意见。结果最终纳入10部指南,8部来源于国外,指南发布时间为2011—2020年。纳入指南AGREEⅡ各领域平均得分为:范围和目的71%、参与人员65%、严谨性58%、清晰性80%、应用性64%、独立性45%。4部指南推荐级别为A级,6部指南推荐级别为B级。主要推荐意见汇总为心脏康复的基本要求、健康教育、危险因素控制、心理支持、运动训练及促进患者参与心脏康复6个方面。结论纳入指南的质量处于中等至较高水平,在参与人员、严谨性、应用性、独立性领域仍需提高;各指南推荐意见趋于一致,但在促进患者参与心脏康复方面意见仍显不足;我国心脏康复指南质量水平与国外相比仍存差距,应构建适用于我国冠心病患者的高质量心脏康复循证指南。
文摘Antibodies against &-adrenoceptor can be detected in serum of patients with dilated cardiomyopathy (DCM), which have 5-agonist-like activity, and induce a positive chronotropic effect on cardiac myocytes by its persistence at full strength. Effects of the antibodies against Padrenoceptor from sera of patients with DCM on myocardial cytotoxicity and cytoplasmic free Ca2+-concentration (LCa2+ji) were observed in the cultured single layer SD rat ventricular cells by using the cytotoxicity assay and fluorescent Ca2+- indicat0r fura-2/AM. The positive sera of the anti-&adrenoceptor antibodies from patients with DCM markedly enhanced myocardial [Ca2+]i. Betaloc, a 5, -receptor blocker, might inhibit the increase of the antibody-mediated myocardial [Ca2+]i, and the sera from healthy donors had no effect on myocardial [Ca2+]i,. Our results suggest that the anti-β-adrenoceptor antibody might increase myocardial [Ca2+]i, and result in myocardial damage. The antibodies might activate receptor-gating Ca2+-channel, thereby causing myocardial [Ca2+]i, rise and calcium overload. Early use of betaloc is recommended in the treatment of dilated cardiomyopathy.
