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Biomedical subjects

H Refsum

Publications and source records attributed to H Refsum.

At least 55 records · Page 3Linked to original sources
PubMed1990

Mechanism of ECG changes and arrhythmogenic properties of low osmolality contrast media during coronary arteriography in dog.

STUDY OBJECTIVE: The aim of the study was to investigate the mechanisms behind ECG changes and ventricular arrhythmias during coronary arteriography. DESIGN: Transmembrane action potentials were recorded from isolated heart muscle preparations superfused with contrast media. Conductivity of plasma diluted with contrast media was determined in vitro. Epicardial ECG recordings were made during coronary arteriography. SUBJECTS: Epicardial ECG recordings were made in eight mongrel dogs of either sex, weight 14-22 kg. Atrial appendages were excised from the same dogs and used for heart muscle preparation studies. MEASUREMENTS AND MAIN RESULTS: Iohexol and ioxaglate affected the action potentials similarly: resting potential, amplitude, rate of depolarisation, and action potential duration increased; effective refractory period decreased. Both contrast media reduced plasma conductivity. During coronary arteriography both media increased R wave amplitude, depressed ST segment, and prolonged QT time on epicardial ECG. CONCLUSIONS: ST segment deviation on ECG reflects hyperpolarization and increased amplitude of action potential rather than depolarisation consistent with ischaemia. Increased rate of depolarisation and amplitude of action potential together with reduced conductivity after contrast media may explain increased amplitude of QRS voltage on ECG. Observed regional changes in depolarisation, repolarisation, and refractoriness may be important in the genesis of ventricular arrhythmias.

Action Potentials↗
PubMed1990

Rate-dependent class III antiarrhythmic action, negative chronotropy, and positive inotropy of a novel Ik blocking drug, UK-68,798: potent in guinea pig but no effect in rat myocardium.

The electromechanical effects of UK-68,798 (UK), a novel class III antiarrhythmic drug, were studied in guinea pig and rat papillary muscles (PMs) and atria in vitro using conventional microelectrode technique. UK (10(-8)-10(-6) M) prolonged the action potential duration (APD) by 21-58% and effective refractory period in parallel, without affecting the resting potential or maximum rate of depolarization in guinea pig PM stimulated at 1 Hz. UK increased the contractile force without prolonging the time to peak force or relaxation. In comparison, 5 x 10(-5) M d-sotalol was needed to induce the same electrophysiological effects as 10(-8) M UK. UK prolonged the APD significantly less at 2 Hz than at 1 and 0.5 Hz. Early afterdepolarizations (EADs) developed in 2 of 11 preparations after 10(-6) M at 0.5 Hz. No reversal of drug effect was seen after up to 2 h washout. UK (10(-9)-10(-5) M) reduced the spontaneous heart rate and prolonged the sinus node recovery time of guinea pig right atria. No effects on rat PM or atria, even after 10(-5) M, indicate a selective action of UK on the delayed rectifying outward potassium current, Ik. These results indicate a potent and selective, rate-dependent class III antiarrhythmic action of UK-68,798 linked with positive inotropy. Increased APD, bradycardia, and induction of EADs, however, represent a potential arrhythmogenic combination.

Action Potentials↗
PubMed1990

Class III antiarrhythmic action linked with positive inotropy: acute electrophysiological and inotropic effects of amiodarone in vitro.

Negative inotropy is an adverse feature of most antiarrhythmic drugs. Positive inotropy, however, has been demonstrated for some drugs with class III antiarrhythmic action. Although amiodarone exerts its antiarrhythmic effect by an interplay of different actions on cardiac cells, it has been regarded to be the prototype class III drug due to its prolongation of action potential duration. The present study was designed to test the hypothesis that class III antiarrhythmic action and positive inotropy may be linked. We compared the effects of amiodarone in Cordarone and its solvent Tween 80 on automaticity, refractoriness and inotropy. Two series of experiments were done; one with spontaneously beating rat atria to study the effects on sinus node function, and one with electrically stimulated left atria to study the effects on excitability, refractoriness and inotropy. Amiodarone 1 x 10(-4) M decreased spontaneous heart rate by 13% and prolonged sinus node recovery time by 105%. Without affecting the excitability amiodarone prolonged the effective refractory period by 12%. At the same time contractile force increased by 12%. Lower concentration of amiodarone (5 x 10(-6) M) or Tween 80 had no significant effects. In conclusion, amiodarone exerts acute electrophysiological and inotropic effects in vitro. The class III antiarrhythmic action of amiodarone is linked with positive inotropy.

Action Potentials↗
PubMed1990

Prolonged action potential duration of guinea-pig heart muscle after pethidine.

Since recent experiments indicated class III antiarrhythmic properties of pethidine in vitro, we studied cardiac effects of pethidine in vivo. Monophasic action potentials at different pacing rates were recorded from the left ventricular epicardium of pentobarbital anaesthetized guinea-pigs by means of suction electrode catheter. Intravenous injection of pethidine 2 mg/kg prolonged the action potential duration, and increased left ventricular developed pressure and dP/dt max, compared to animals receiving saline only. It is concluded that pethidine appears to have class III antiarrhythmic properties.

Action Potentials↗
PubMed1990

Electromechanical effects of two low osmolality contrast media, ioxaglate and iohexol, on isolated rat atria.

This study aimed at investigating the direct effects of two low osmolality radiographic contrast media, iohexol (non-ionic) and ioxaglate (ionic), on transmembrane action potentials, contractile force and refractoriness of isolated rat atrial preparations. Superfused with 10% solution, ioxaglate induced a biphasic mechanical response, initially decreasing and thereafter increasing contractile force. The same concentration of iohexol only increased contractile force. The two contrast media increased the resting membrane potential, action potential amplitude and rate of depolarization to the same extent. Iohexol prolonged repolarization. Both contrast media decreased the effective refractory period. The direct effects of contrast media on myocardial contractility in this study can explain the different haemodynamic effects of iohexol and ioxaglate in vivo. The observed effects on the action potentials in vitro can explain commonly observed ECG changes during coronary arteriography. The changes in depolarization, repolarization and refractoriness are probably related to the arrhythmogenic properties of these contrast media.

Animals↗
PubMed1990

Plasma concentrations and haemodynamic effects of d-sotalol after beta-blockade in dogs.

This study was designed to investigate the haemodynamic effects of d-sotalol at plasma concentrations producing class III antiarrhythmic effects. d-Sotalol 1, 4 and 10 mg/kg intravenously was given after beta-blockade (propranolol 0.25 mg/kg intravenously) to seven pentobarbital anaesthetized dogs. Left ventricular (LV) systolic and end-diastolic pressures, LV dP/dtmax, mean aortic pressure, stroke volume, cardiac output and total peripheral resistance were not significantly changed by d-sotalol. There was a linear correlation between the dose of d-sotalol infused and the plasma concentration of d-sotalol obtained. Heart rate decreased and QT-time increased with increasing plasma concentrations of d-sotalol, whereas the QRS-width did not change. There was a linear correlation between the decrease in heart rate and the increase in QT-time, and between the plasma concentration of d-sotalol and increase in QT-time. In conclusion, the study indicates that after beta-blockade, d-sotalol has no cardiodepressive effects at concentrations that prolong repolarization.

Adrenergic beta-Antagonists↗
PubMed1989

Fasting plasma homocysteine as a sensitive parameter of antifolate effect: a study of psoriasis patients receiving low-dose methotrexate treatment.

We have investigated the effect of low-dose methotrexate (25 mg weekly) on plasma homocysteine in 13 patients who had psoriasis. Total, free, and protein-bound homocysteine were determined both during fasting and after methionine loading. Psoriasis patients had significantly higher basal plasma homocysteine levels than age-matched control subjects. In addition, the methionine loading test was abnormal in four of the patients, but this was not significant. Psoriasis patients, although not folate deficient, did have lower serum folate levels than control subjects. There was a significant and transient increase in fasting plasma homocysteine levels within 48 hours after administration of low-dose methotrexate. This response was repeated after each administration and was observed eight to 20 times in three patients whose progress was monitored for 2 to 6 months. Notably, methotrexate did not affect the plasma profile for homocysteine after methionine loading. This study showed the level of fasting plasma homocysteine to be a sensitive and responsive parameter of antifolate drug treatment.

Adult↗
PubMed1989

Contributions of a transient outward current to repolarization in human atrium.

Conventional microelectrode recordings combined with enzymatic cell dispersion methods and a single microelectrode voltage-clamp technique were used to record transmembrane action potentials and ionic currents in isolated single myocytes and in excised segments of human right atrium. Recordings of the outward current(s), which is responsible for the resting potential and early repolarization of the action potential in human right atrium, consistently showed that this tissue has 1) a relatively small inwardly rectifying background potassium current (IK1) which generates the resting potential in mammalian ventricular tissue and Purkinje fibers, and 2) a large time- and voltage-dependent, but Ca2(+)-independent, transient outward current. A somewhat similar K+ current was originally described in neurons and recently has also been identified in a variety of mammalian cardiac tissues. As expected from previous work, this transient outward current in human atrium is blocked by 4-aminopyridine (4-AP; 0.5 mM) and exhibits time- and voltage-dependent inactivation and reactivation. Measurements of action potential shape changes and phasic tension as a function of stimulus frequency, or after 4-AP application, show that in human atrium this current can produce pronounced changes in both the early repolarization of the action potential and force generation.

4-Aminopyridine↗
PubMed1989

Fully automated fluorescence assay for determining total homocysteine in plasma.

Homocysteine exists in human plasma as various (mixed) disulfides. Most plasma homocysteine (about 70%) is protein bound, probably via a disulfide bond to albumin, whereas homocysteine-cysteine mixed disulfide is the predominating form in the free fraction. We here present a method for the determination of total homocysteine, which includes both fractions. Plasma was initially treated with sodium borohydride to reduce the disulfide bonds, and the liberated thiols were derivatized with monobromobimane. The derivatized sample, still containing the plasma proteins, was injected onto a strong cation-exchange column, from which the homocysteine derivative was directed by column switching into a cyclohexyl silica (CH) column. The homocysteine derivative was top-concentrated on the CH column, then rapidly eluted with a steep gradient of methanol. Both the derivatization procedure and chromatography were performed with a combined sample processor and sample injector from Gilson (Model 232-401). Within-run and between-run precision (CV) was less than 4%, and the detection limit of 0.2 pmol was sufficiently low for monitoring homocysteine in plasma. We verified the assay against two established manual methods for the determination of total homocysteine in plasma. This, the first fully automated assay for total plasma homocysteine, allows the unattended analysis of 70 samples per 24 h.

Autoanalysis↗
PubMed1989

[Plasma homocysteine, a risk factor for premature vascular disease. Plasma levels in healthy persons; during pathologic conditions and drug therapy].

Homocysteine is a branch-point metabolite, the biological fate of which is linked to vitamin B12, reduced folates and vitamin B6. Various inborn defects in homocysteine metabolism, among which cystathionine beta-synthase deficiency is most common, lead to the clinical condition homocystinuria. A central feature of this clinical state is premature arteriosclerosis. These patients benefit from agents serving as cofactors in homocysteine metabolism which both reduce the homocysteine levels in plasma and the incidence of vascular episodes. Experimental data point to homocysteine as an arteriosclerotic agent. Homocysteine in human plasma exists mainly as mixed disulfides with albumin (70 per cent) and cysteine. New methods determine total plasma homocysteine which includes all these species. Normal values for plasma homocysteine are lower in premenopausal women than in men and postmenopausal women. Impaired homocysteine metabolism seems to exist in 15-30 per cent of patients with premature cardiovascular disease. Moderate homocysteinemia is as a risk factor for cardiovascular disease, independent of conventional risk factors. Apart from homocystinuria, vitamin B12 deficiency causes the most extreme elevations of plasma homocysteine, and it has been established that plasma homocysteine is a more responsive parameter to impaired vitamin B12 function than serum cobalamin. Massive increase in plasma homocysteine level is also observed in folate deficiency, whereas renal failure, some malignant states and psoriasis cause a moderate homocysteinemia. High doses of folic acid reduce plasma homocysteine, and this innocuous mean should be considered as an intervention in patients with increased plasma level. Drugs like methotrexate, some anticonvulsants and 6-azauridine triacetate induce moderate elevation of plasma homocysteine, whereas a reduction is observed after penicillamine administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗
PubMed1988

Effect of methotrexate on homocysteine and other sulfur compounds in tissues of rats fed a normal or a defined, choline-deficient diet.

Methotrexate (MTX) affects homocysteine (Hcy) metabolism in both cultured cells and patients, and this may be explained by a lack of the 5-methyltetrahydrofolate required for salvage of Hcy to methionine. We here report the effect of MTX on Hcy in serum and Hcy, S-adenosylhomocysteine (AdoHcy), S-adenosylmethionine (AdoMet) and reduced glutathione (GSH) in tissues of rats fed either a normal or a defined, choline-deficient (CD) diet. The CD diet alone did not affect the amounts of Hcy in serum and tissues, but decreased the amount of AdoMet in most tissues and increased the GSH content in the liver. MTX increased the amount of Hcy about 2-fold in serum, liver and kidney, and decreased the amount of AdoMet in liver and kidney, whereas the AdoHcy content in these tissues was essentially unaffected. Accordingly, both choline deficiency and MTX treatment reduced the AdoMet to AdoHcy ratio. The increased GSH in the liver induced by CD diet seemed to be abolished by MTX. In the spleen MTX had only a marginal effect on the Hcy and AdoMet content and decreased the GSH content. It is concluded that the increase in serum Hcy during MTX exposure probably reflects a disturbance of the Hcy metabolism in some tissues, and especially in the liver. Altered metabolism of other sulfur-containing metabolites may only partly be related to the inhibition of Hcy salvage, and some metabolic effects of MTX may be modulated by tissue-specific metabolic pathways as well as by the diet.

Analysis of Variance↗
PubMed1988

Selenium deficiency and cardiac electrophysiological and mechanical function in the rat.

Earlier studies have shown that selenium and vitamin E are important in maintaining normal cardiac function. The present study was designed to test the effect of sole selenium deficiency on electrophysiological and mechanical characteristics of the rat heart. Male weanling rats were fed a standardized vitamin E adequate but selenium deficient diet, or a control diet. Deficiency of selenium was verified by direct (tissue selenium analyses) and indirect (glutathione-peroxidase tissue analyses) methods. In vivo electrocardiographic recordings as well as in vitro electrophysiological and mechanical recordings did not reveal abnormalities in any of the two groups. In conclusion, earlier studies have shown that the combined deficiency of selenium and vitamin E leads to abnormal cardiac function. Selenium deficiency alone, however, does not appear to significantly affect cardiac function in the rat.

Animals↗
PubMed1988

Class III antiarrhythmic action linked with positive inotropy: effects of the d- and l-isomer of sotalol on isolated rat atria at threshold and suprathreshold stimulation.

The beta-adrenoceptor blocker sotalol has been shown to possess class III antiarrhythmic action. The present study was designed to test the hypothesis that class III antiarrhythmic action and positive inotropy may be linked. Since d,l-sotalol has previously been reported to have variable inotropic effect, we studied direct effects of the d- and l-stereoisomer of sotalol on refractoriness and inotropy of isolated rat atria at different strengths of electrical stimulation. Both the d- and l-stereoisomer of sotalol (7.5 x 10(-5) M) increased the effective refractory period, and to the same extent. However, d-sotalol increased isometric contractile force by 10%, while l-sotalol had no significant effect, when the atria were stimulated at close to threshold values (10 +/- 1 mA). Probably due to release of noradrenaline within the myocardium, contractile force increased when the atria were stimulated at suprathreshold values (40 mA). At suprathreshold stimulation, however, d-sotalol induced a 10% decrease and l-sotalol a 20% decrease, in contractile force. In conclusion, the class III antiarrhythmic action of sotalol is linked with positive inotropy. In the presence of neurotransmitter release, negative inotropic effect of d- and in particular l-sotalol, may occur due to beta-adrenoceptor blocking activity.

Animals↗
PubMed1987

Quantification of effect of pericardium on LV diastolic PV relation in dogs.

The aim of the present study was to quantify the effect of the pericardium on the left ventricular (LV) diastolic pressure-volume relation. The experiments were done in 10 anesthetized closed-chest dogs. Pericardial and cardiac volumes were determined by computed tomography. Pericardial effusion (n = 5) and volume loading (6% dextran iv; n = 5) were used to increase pericardial volume. Volumes were normalized as multiples of the LV volume measured when LV transmural pressure was 6 mmHg (VLV6). Using the data from the pericardial effusion experiments, we calculated the best-fit exponential equations for the pericardial pressure-volume relations. From these equations we calculated that the changes in pericardial volume necessary to shift the LV diastolic pressure-volume curve upward by 2, 5, 10, and 20 mmHg were 0.6 +/- 0.1, 1.1 +/- 0.2, 1.6 +/- 0.2, and 2.2 +/- 0.3 times VLV6, respectively. Using the data from the volume loading experiments, we also calculated the degree of upward shift of the LV pressure-volume relation caused by volume loading, which increased LV mean diastolic pressure by 12 mmHg. (The upward shift is that increment in pericardial pressure caused by the total increase in volume of the extra-LV contents of the pericardium, i.e., the atria, the right ventricle, and any pericardial effusion.) This volume loading increased the total volume of the right ventricle and the atria by 1.0 +/- 0.1 VLV6, which, in itself, increased pericardial pressure by 3.6 +/- 0.8 mmHg. We conclude that in situations in which heart or pericardial volume increases acutely, the pericardium shifts the diastolic pressure-volume relation of the LV upward by a significant amount.

Animals↗
PubMed1987

Arrhythmogenic, antiarrhythmic and inotropic properties of opioids. Effects of piritramide, pethidine and morphine compared on heart muscle isolated from rats.

Since the effects in the intact organism are complicated by central as well as peripheral effects, we compared the direct cardiac effects of three commonly used opioids on isolated heart muscle. Concentration-response curves for electrophysiological and inotropic effects of piritramide, pethidine and morphine (10(-6)-10(-4) mol/l) on spontaneously beating and electrically stimulated rat atria were obtained. Piritramide decreased spontaneous frequency, induced arrhythmia and cardiac arrest. It had no significant effect on effective refractory period and electrical threshold for excitation, but decreased contractile force. Pethidine increased effective refractory period, had no effect on electrical threshold and increased contractile force. Morphine induced no significant electrophysiological effects, but decreased contractile force slightly. These results indicate direct negative chronotropic and arrhythmogenic actions of piritramide, possible class III antiarrhythmic action of pethidine and lack of major direct cardiac effects of morphine.

Animals↗