Почему расслабление миокарда всегда замедляется при патологии сердца?

Хроническая сердечная недостаточность (ХСН) в большинстве случаев обусловлена снижением сократимости миокарда. Это, в частности, проявляется снижением максимальной скорости развития давления в левом желудочке. Одновременно снижается и скорость снижения давления при расслаблении. Это неудивительно, поскольку оба параметра зависят от концентрации Са++ в миоплазме. Но при большинстве патологий сердца расслабление миокарда нарушается в большей степени, чем сокращение. В обзоре выдвинуто новое представление, согласно которому этот феномен обусловлен изменением структуры титина – саркомерного белка, соединяющего концы миозиновых нитей с концами саркомеров – линиями Z. Пружиноподобная структура молекулы титина сжимается при сокращении саркомеров и распрямляется при удалении Са++ из миофибрилл. Снижение её упругости, направленное на облегчение наполнения левого желудочка, может снижать распрямляющую силу и тем самым снижать скорость расслабления. В обзоре приведены сведения о функции системы кальциевого транспорта и титина в норме и при ХСН, полученные на экспериментальных моделях и у пациентов

Хроническая сердечная недостаточность, сердце, диастола, расслабление, кальциевый транспорт, титин

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