Temperature-dependent inotropic effects of lignocaine and ethanol on rat heart papillary muscles.

1. The main objective of the present study was to investigate the temperature dependence of the cardiac inotropic effects of lignocaine and ethanol (EtOH). 2. We studied the in vitro inotropic actions and interactions of EtOH (2.4 g/L) and lignocaine (25 mg/L) on rat papillary muscles superfused with Tyrode's solution and stimulated at 1 Hz at either 37 or 30 degrees C. Peak tension developed (PTD), maximum velocity of development of tension (VmaxT) and time to peak tension (TPT) were measured. 3. At 37 degrees C, EtOH depressed PTD, while VmaxT and TPT remained unchanged. At 37 degrees C, lignocaine alone or in combination with EtOH depressed all three parameters. 4. At 30 degrees C, EtOH did not modify PTD or VmaxT, whereas TPT decreased. At 30 degrees C, lignocaine decreased TPT, but VmaxT did not change and the effect of lignocaine on PTD was smaller at 30 degrees C than at 37 degrees C. Ethanol and lignocaine in combination decreased all three parameters at 30 degrees C. However, the depression of VmaxT by the combination of lignocaine and EtOH was less at 30 degrees C than at 37 degrees C. 5. Hypothermia (30 degrees C) protected the myocardium against the depressant actions of EtOH and lignocaine, alone or in combination. With EtOH alone, the protection resulted in no change in PTD. When lignocaine was involved, the protection resulted in a weaker action on PTD and VmaxT. The temperature dependence of the action of lignocaine may explain, at least in part, the development of ventricular failure in cardiac surgical patients exposed to lignocaine during hypothermia and rewarming.

[Serum lipids and blood pressure levels in the +Mapuche population living in the Chilean region of Araucanía]. / Niveles de lípidos y de presión arterial en población Mapuche de la Región de la Araucanía, en Chile.

BACKGROUND: Chilean aboriginal populations (Mapuche) predominantly live in the region of Araucanía, in the southern part of the country. Their cardiovascular risk factors have not been systematically assessed. AIM: To study the prevalence of cardiovascular risk factors in the Mapuche population. SUBJECTS AND METHODS: Blood pressure, weight, height, dietary habits, fasting serum total cholesterol, HDL cholesterol and triglycerides were measured in 1.948 adults living in 28 Mapuche communities. RESULTS: Thirteen percent of males and 16% of females had high blood pressure. Body mass index was 25.5 kg/m2 in males and 28.1 kg/m2 in females. Forty five percent of women and 24% of men were classified as obese. Mean serum total cholesterol was 186.7 +/- 9.6 mg/dl, HDL cholesterol was 58.7 +/- 30.7 mg/dl, total cholesterol/HDL cholesterol was 3.4 +/- 2 and triglycerides were 155.2 +/- 91.2 mg/dl. Twenty eight percent of males and 9.6% of females smoked. CONCLUSIONS: Mapuche individuals have higher levels of HDL cholesterol a better total cholesterol/HDL cholesterol ratio and lower frequency of smoking than non aboriginal Chileans subjects.

Actions and interactions of ethanol and imipramine on the rat sinus node.

We studied the actions and interactions of ethanol and imipramine on the sinus node. Strips of the right rat atrium including the sinus node were superfused with Tyrode's solution at 37 degrees C while beating spontaneously. The preparations were exposed to imipramine or ethanol alone as well as to the two drugs in combination while recording membrane potentials with standard intracellular microelectrodes. The results obtained show that ethanol 0.8 and 2.4 g/l exerted a positive chronotropic action. On the other hand, imipramine 0.25 mg/l did not modify the sinus node rate. However, it reduced significantly the positive chronotropic action of ethanol. The sinus node rate decreased under the action of a higher concentration of imipramine (1 mg/l). When ethanol was tested in combination with this concentration of imipramine, the effect of the latter prevailed. In conclusion, a concentration of imipramine that did not affect the sinus node rate antagonized the positive chronotropic action of ethanol. In addition, the negative chronotropic action of a higher concentration of imipramine prevailed over the positive action of ethanol. The results obtained provide additional support to the notion that the use of ethanol and cardioactive drugs in combination may result in significant changes in the actions of either of the two, or both. This is of clinical relevance, since at least some of the individuals under treatment with cardioactive drugs will be alcoholics and/or social drinkers.

[Digoxin is effective in th treatment of patients with heart failure and sinus rhythm]. / La digoxina es efectiva en el tratamiento de pacientes con insuficiencia cardiaca y ritmo sinusal.

Due to differences in treatment effect in studies on the effectiveness of digoxin in patients with congestive heart failure in sinus rhythm, a cross-over placebo-controlled, randomized double blind clinical trial was performed. Thirty one patients, without previous treatment with digoxin, in New York Heart Association (NYHA) functional class II to IV, with a dilated left ventricle and/or ventricular systolic dysfunction were included. Patients received digoxin, adjusted for blood levels, or placebo, during an 8 week period, prior to crossing over to the other treatment for another 8 weeks. The order of treatments was randomly allocated. Outcome measurement were performed at the end of each 8 week period. Digoxin, compared with placebo, improved NYHA class, 6.9% vs 41.4% (p = 0.013) and increased the treadmill exercise time, 406 +/- 204 s vs 484 +/- 185 s (p = 0.003). During the digoxin treatment the left ventricular and systolic diameter was reduced from 52.9 +/- 8.9 to 50.1 +/- 9.7 mm (p = 0.016) and the shortening fraction increased from 21.4 +/- 8.3 to 24.8 +/- 8.1% (p = 0.009). No significant difference was observed in the left ventricular end diastolic diameter (LVED) of the left ventricle and in a estimation of quality of life. In conclusion, digoxin treatment produced a significant improvement in functional capacity, exercise time, and left ventricular performance.

[Cholinergic action of Bay K-8644 on the rat heart sinus node automaticity]. / Acción colinergica de Bay K-8644 sobre el automatismo sinusal en corazon de rata.

The actions of different concentrations of a dihydropyridine agonist (Bay K-8644) on rat heart sinus node automaticity and their interactions with atropine, were studied. The experiments were performed using a portion of the right atrium that contained the sinus node, perfused with Tyrode's solution at 37 degrees C and registering the action potentials with intracellular microelectrodes (Ag-KCL). The series of Bay K with or without atropine were perfused during 10 min. Atropine, 1 x 10(-5) M, did not change sinus frequency after 30 min of perfusion (237 +/- 6 to 229 +/- 7 action potentials/min; n = 24). Bay K, 2.8 x 10(-8) M (10 ug/L) did not change sinus frequency (240 +/- 9 to 246 +/- 12; n = 8, but in the presence of atropine, caused an increment (225 +/- 7 to 256 +/- 12 p < 0.05). Bay K, 7 x 10(-8) M (25 ug/L) and 1.4 x 10(-7) M (50 ug/L, caused an increase in sinus frequency (237 +/- 5 to 279 +/- 15; n = 9 p < 0.05 and 254 +/- 6 to 291 +/- 6; n = 6 p < 0.05 respectively) that occurred sooner in the presence of atropine. It is concluded that Bay-K has a cholinergic effect that interferes with its positive chronotropic action, specially at low concentrations.

Cardiac beta-adrenergic mediated chrono- and inotropic effects of imipramine in vitro.

Clinical and experimental studies show that tricyclic antidepressants in "therapeutic plasma concentrations" can increase heart rate, myocardial contractility and blood pressure. Our study was undertaken to analyze the role of beta-adrenergic stimulation in the chronotropic and inotropic effects of imipramine. Strips of rat right atrium including the sinus node, which were beating spontaneously, were used to study chronotropism. Strips of the left atrium, electrically stimulated to beat at 1 Hz, were used to study inotropism. The preparations were superfused in vitro with Tyrode's solution at 37 degrees C and exposed to imipramine while recording membrane potentials or force of contraction. Imipramine exerted dose-dependent biphasic actions. Imipramine 0.8 microM produced positive chronotropic and inotropic actions which were blocked by propranolol. Imipramine 1.6 microM depressed the sinus node automaticity, but it did not modify the force of contraction. Imipramine 3.2 microM depressed both the sinus node automaticity and the myocardial contractility. In conclusion, imipramine in "therapeutic plasma concentrations" produces beta-adrenergic mediated cardiac positive chronotropic and inotropic actions. The possible mechanisms of the depressant effects of imipramine itself on automaticity and contractility are still not clear. The results presented can explain stimulatory and depressant cardiac effects of therapeutic doses and overdoses of tricyclic antidepressants.

[Prevalence of cardiovascular risk factors in Temuco City]. / Prevalencia de factores de riesgo cardiovascular en la ciudad de Temuco.

A random sample of 200 males from 25 to 64 years of age was surveyed for cardiovascular risk factors in Temuco, a city in Southern Chile. Blood pressure was 130 +/- 18/85 +/- 10 mmHg and total cholesterol was 193 +/- 50 mg/dl. 33% were smokers (mean of 8.2 cigarettes per day) and 34% were ex smokers. Prevalence of hypertension was 6.5% from 35 to 44 years of age, 15% from 45 to 54 and 31.9% from 55 to 64 (mean 15%). Cholesterol levels above 240 mg/dl were found in 11.8, 18.3 and 19.1%, respectively (mean 15.5%). Half of the hypertensive subjects were not aware of their high blood pressure and only 16.6% received therapy.

Characterization of angiotensin pressor responses in the turtle Pseudemys scripta.

Studies were conducted in turtles (Pseudemys scripta) to characterize vascular responses to administration of exogenous angiotensin [Asp1-Ile5]angiotensin II (AII). Marked pressor responses were present following AII administration (2 microgram/kg iv). The pressor response was completely blocked by concomitant administration of an analogue of AII, [Sar1-Ile8]AII. Both alpha-receptor blockade with phenoxybenzamine or catecholamine depletion by reserpine administration reduced the pressor response approximately 50%. Further treatment with [Sar1-Ile8]AII completely blocked the AII pressor response. We conclude that the pressor response to AII in this species that represents an ancient group of reptiles includes a catecholamine-dependent component and direct vascular receptors, both of which are sensitive to AII.