基于小波变换的心肌梗塞体表电位特征分析

小波变换已被很多心电学者用于ＥＣＧ信号的特征分析检测,在虚拟心脏基础上,选取合适的小波,对心肌梗塞的仿真体表电位进行小波变换细节分量处理,提出了一种新的体表电位形态特征的分析方法。结果表明,基于小波变换处理后体表电位图可以更地提示不同部位心肌在体表电位分布的特征,其表征出的拓扑形态对体表电位和虚拟心脏方法用于心肌梗塞临床诊断提供了一种新的途径。     

从体表电位分布图中提取陈旧性心肌梗塞诊断信息的研究

如何从体表电位分布图（ＢｏｄｙＳｕｒｆａｃｅＰｏｔｅｎｔｉａｌＭａｐｐｉｎｇｓ：ＢＳＰＭ）中得到有价值的诊断特征或信息是将ＢＳＰＭ技术应用于临床的重要研究课题之一。基于计算机心脏仿真模型,详细研究了ＢＳＰＭ中能够对陈旧性心肌梗塞的发生部位与范围进行准确诊断的特征与信息。研究结果表明：ＱＲＳ期间正常ＢＳＰＭ中为正电位、陈旧性心肌梗塞ＢＳＰＭ中为负电位的导联分布区域与出现Ｑ波的导联分布区域是陈旧性心肌梗塞发生部位较准确、可靠的定位信息;可以用正常ＢＳＰＭ为正电位、而梗塞ＢＳＰＭ为负电位的导联区域的面积或导联数来识别陈旧性心肌梗塞的发生范围或大小。     

肌型血管生物数学模型的自适应Backstepping控制设计

提出了基于Backstepping自适应控制方法研究医学上容易引发心肌梗塞等疾病的血管痉挛,即肌型血管生物数学模型的受控问题．设计了一个自适应控制器,使系统的状态量都渐近稳定到0,并使系统全局稳定,从理论上得出处于混沌运动状态的血管能趋于正常化,对有效防治和治疗心肌梗塞等疾病具有重要的意义．最后的仿真结果表明了此方法在理论上的有效性．     

激光心肌血管重建术后激光管道的形态学观察

为临床研究和应用激光心肌血管重建术提供解剖学基础,本文在１６只杂交犬的心肌梗塞模型上,行ＣＯ２激光心肌打孔。术后３或６个月取出心脏,观察不同时间未铸型及铸型激光心肌管道的形态特征。结果表明激光管道心内膜侧管径大于心外膜侧,管道多呈锥形。     

新生小鼠心肌再生：模型与机制

既往的观点认为,哺乳动物的心肌受损后只能进行瘢痕修复,无法实现组织再生,最终诱发心力衰竭。近年来的大量报道则指出,哺乳动物在出生早期具备基于心肌细胞增殖的再生能力,其强度足以修复受损的心脏组织,恢复心脏的正常功能;但这一能力会在出生后早期快速丢失。新生小鼠心肌再生现象的发现,为探讨心肌再生的分子机制提供了理想的动物模型,继而有助于心肌再生修复干预靶点的开发。目前,已经广泛应用的新生小鼠心肌损伤再生模型包括:心尖切除模型、心肌梗死模型、冷冻损伤模型等。该文总结了构建新生小鼠心肌损伤后再生模型的不同方法,并综述了利用新生小鼠心肌再生模型研究取得的心肌再生机制进展。     

一种新的心肌梗塞面积的测量方法及实验验证

这种方法以计测心肌梗塞面积的数学模型电动力学原理为依据,用Frank导联体系的正交心电图取得所需数据计算心梗面积.在狗的心肌梗塞模型上证明(1)用这种方法计算得到的梗塞面积在较大范围内(1～13cm~2)与染色后直接测得的梗塞面积密切相关.心肌损伤时r=0.97(P<0.01);心肌坏死时r=0.92(P<0.05).(2)由经纬角(φ,θ)能比较准确的判断梗塞部位.(3)经纬角(φ,θ)与方位角(α、β、γ)联合分析,又可判知梗塞是发生在心内模下还是心外模下.     

慢性氯化钴处理对GK糖尿病大鼠缺氧诱导因子1的表达及心梗面积的影响

缺血导致的心肌细胞缺氧是缺血性心脏病的主要病理因素,糖尿病是缺血性心脏病最常见的合并症之一.冠心病合并糖尿病患者心肌损伤明显加重,预后差,可能与缺氧诱导因子1 (hypoxia-inducible factor 1,HIF-1)表达减少有关.但糖尿病时HIF-1信号转导系统改变的机制目前尚不清楚.近年来的研究表明,提高HIF-1α在缺血心肌中的表达及活性能明显促进新生血管形成,促进心肌细胞存活,减少缺血再灌注损伤,降低心肌梗塞面积,提高心肌功能,因此,调节HIF-1α的表达及活性成为治疗缺血性心脏病的新方法.通过制作GK糖尿病大鼠心肌梗塞模型,应用免疫组织化学染色、RT-PCR等方法研究发现,GK糖尿病大鼠合并心肌梗塞时,HIF-1α表达减少,心梗面积增大,而给予糖尿病大鼠慢性氯化钴处理后,其血糖水平降低,HIF-1α表达增加,心梗面积减小,这为如何调节HIF-1信号转导系统治疗冠心病合并糖尿病提供一个可能的新的治疗视点和策略.     

高频电刺激股神经减小大鼠心肌缺血-再灌注后的梗塞范围

通过氨基甲酸乙酯麻醉大鼠观察股神经电刺激对缺血- 再灌注心肌的影响,旨在证实外周神经刺激对心肌有无保护效应,并明确其可能的作用机制。心肌缺血区和梗塞区分别用伊文思蓝和氯化硝基四氮唑蓝染色确定,心肌梗塞范围定义为心肌梗塞区重量占心肌缺血区重量的百分比。所得结果如下:(1)在心肌缺血30 min 和再灌注120 min 过程中,梗塞心肌占缺血心肌的(54.96±0.82)%。 高频电刺激(10 V,100 Hz,1ms)股神经5 min 可使心肌梗塞范围减少到(36.94±1.34)% (P<0.01), 表明 (2)高频电刺激股神经对缺血-再灌注心肌有保护作用。然而,低频电刺激(10 V, 10 Hz, 1 ms)股神经对缺血-再灌注心肌梗塞范围无影响。 预先应用非选择性阿片肽受体阻断剂纳洛酮(5 mg/kg, i.v.)或非选择性KATP 通道阻断剂格列苯脲(5 mg/kg, i.v.)均能完全 (3)取消高频电刺激股神经对缺血-再灌注心肌的保护作用。以上结果提示,高频外周神经刺激可以减小缺血- 再灌注心肌的梗塞范围,其可能的作用机制是: 高频电刺激股神经时中枢神经系统内释放的内源性阿片肽和由此激活的心肌KATP通道的开放介导了这种保护作用。     

ATP敏感性钾通道在预缺血对麻醉家兔缺血心肌保护中的作用

在氨基甲酸乙酯和戊巴比妥钠两种不同麻醉的家兔心肌缺血－再灌注模型,观察了ＡＴＰ敏感性钾通道开发剂ｃｒｏｍａｋｌｉｍ（Ｃｒｏ）和预缺血（ＩＰ）对血流动力学和心肌梗塞范围的影响,旨在阐明ＫＡＴＰ通道是否与ＩＰ对ＩＲ心肌的保护机制。     

人Mn-SOD的重组生产系统

三井东压化学公司已合成人Mn-SOD的基因,并确立了重组人Mn-SOD的生产系统.重组产物将作为心肌梗塞治疗后的血液再灌流时的心肌保护剂.这是今年12月在大阪大学蛋白质研究所召开的第2次SOD讨论会上,三井东压化学综合研究所生命科学研究所首席研究员高桥正士发表的.以前开发的是Cu-Zn-SOD,但是Mn-SOD对心肌组织浸透性高. 三井东压化学公司对心肌梗塞的临床治疗试验先是用组织纤维蛋白溶酶原激活剂     

扶正化瘀胶囊对心肌梗死大鼠心肌纤维化的影响

目的：急性心肌梗死是危害人类健康的重大疾病之一,心肌梗死后心肌纤维化是造成心脏结构破坏、心功能下降、心律失常发生、心衰甚至猝死的微观病理机制。防治心肌纤维化是当前医学研究的重点和热点。本研究主要探讨扶正化瘀胶囊对心肌梗死大鼠心肌纤维化的干预作用。方法：大鼠随机分为假手术组、模型组、扶正化瘀胶囊组和卡托普利组,采用结扎冠状动脉前降支的方法建立心肌梗死模型,假手术组只穿线,不结扎。于造模成功后第10天开始给予相应药物治疗2个月。治疗结束后,检测左心室梗死范围和心肌胶原含量。结果：与假手术组比较,模型组、扶正化瘀胶囊组和卡托普利组的非梗死区面积显著减小（P〈0.01）。与模型组比较,扶正化瘀胶囊组和卡托普利组的梗死区面积和梗死百分比显著减小（P〈0.05,P〈0.01）。在心肌胶原表达上,与假手术组比较,模型组和扶正化瘀胶囊组胶原含量显著增加（P〈0.01）。与模型组比较,卡托普利组和扶正化瘀胶囊组胶原含量显著降低（P〈0.05,P〈0.01）。结论：扶正化瘀胶囊能够改善心肌缺血,缩小心肌梗死范围,抑制心肌胶原表达,除能用于肝纤维化的治疗外,还能用于防治心肌梗死后的心肌纤维化。     

A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery

Acute or chronic myocardial infarction (MI) are cardiovascular events resulting in high morbidity and mortality. Establishing the pathological mechanisms at work during MI and developing effective therapeutic approaches requires methodology to reproducibly simulate the clinical incidence and reflect the pathophysiological changes associated with MI. Here, we describe a surgical method to induce MI in mouse models that can be used for short-term ischemia-reperfusion (I/R) injury as well as permanent ligation. The major advantage of this method is to facilitate location of the left anterior descending artery (LAD) to allow for accurate ligation of this artery to induce ischemia in the left ventricle of the mouse heart. Accurate positioning of the ligature on the LAD increases reproducibility of infarct size and thus produces more reliable results. Greater precision in placement of the ligature will improve the standard surgical approaches to simulate MI in mice, thus reducing the number of experimental animals necessary for statistically relevant studies and improving our understanding of the mechanisms producing cardiac dysfunction following MI. This mouse model of MI is also useful for the preclinical testing of treatments targeting myocardial damage following MI.     

Deficiency of Capn4 Gene Inhibits Nuclear Factor-κB (NF-κB) Protein Signaling/Inflammation and Reduces Remodeling after Myocardial Infarction

Calpain has been implicated in acute myocardial injury after myocardial infarction (MI). However, the causal relationship between calpain and post-MI myocardial remodeling has not been fully understood. This study examined whether deletion of Capn4, essential for calpain-1 and calpain-2 activities, reduces myocardial remodeling and dysfunction following MI, and if yes, whether these effects of Capn4 deletion are associated with NF-κB signaling and inflammatory responses in the MI heart. A novel mouse model with cardiomyocyte-specific deletion of Capn4 (Capn4-ko) was employed. MI was induced by left coronary artery ligation. Deficiency of Capn4 dramatically reduced the protein levels and activities of calpain-1 and calpain-2 in the Capn4-ko heart. In vivo cardiac function was relatively improved in Capn4-ko mice at 7 and 30 days after MI when compared with their wild-type littermates. Deletion of Capn4 reduced apoptosis, limited infarct expansion, prevented left ventricle dilation, and reduced mortality in Capn4-ko mice. Furthermore, cardiomyocyte cross-sectional areas and myocardial collagen deposition were significantly attenuated in Capn4-ko mice, which were accompanied by down-regulation of hypertrophic genes and profibrotic genes. These effects of Capn4 knock-out correlated with restoration of IκB protein and inhibition of NF-κB activation, leading to suppression of proinflammatory cytokine expression and inflammatory cell infiltration in the Capn4-ko heart after MI. In conclusion, deficiency of Capn4 reduces adverse myocardial remodeling and myocardial dysfunction after MI. These effects of Capn4 deletion may be mediated through prevention of IκB degradation and NF-κB activation, resulting in inhibition of inflammatory responses.     

蓝莓花色苷预处理对大鼠心肌梗死的保护作用

目的观察蓝莓花色苷（blueberryanthocyanin,BBA）预处理对实验性急性心肌梗死大鼠心肌梗死面积,心肌肌钙蛋白-T（cTn-T）表达,Bax、Bcl-2mRNA表达的影响,探讨其干预心肌梗死的机制。方法40只Wistar大鼠随机分为假手术组,心肌梗死模型组,BBA低、中、高剂量组,药物干预4周,末次给药30min后结扎左冠状动脉前降支建立心梗动物模型。24h后,TTC检测心肌梗死面积;Westernblotting方法检测心肌细胞cTn-T蛋白表达;realtimePCR方法检测Bcl-2mRNA、BaxmRNA表达。结果模型组和假手术组相比,模型组心肌梗死面积显著升高（P〈0．01）,心肌细胞cTn．T蛋白表达下降（P〈0．05）,Bcl-2mRNA表达下降（P〈0．05）,BaxmRNA表达显著升高（P〈0．01）,Bcl-2／Bax比值显著降低（P〈0．01）。BBA干预给药组和模型组相比,中剂量组心肌梗死面积低于模型组（P〈0．05）,低剂量组心肌细胞cTn-T蛋白表达升高（P〈0．05）,中剂量组Bcl-2mRNA表达升高（P〈0．05）,低、中剂量组BaxmRNA表达下降（P〈0．05）,中剂量组Bcl-2／Bax比值升高（P〈0．05）。结论蓝莓花色苷对心肌梗死后心肌细胞具有明确的保护作用,其机制可能与减少心肌梗死面积,上调心肌细胞eTn-T蛋白的表达,上调Bcl-2mRNA表达、下调BaxmRNA表达,抑制心肌梗死后心肌细胞凋亡有关。     

Overexpression of long non‐coding RNA ANRIL promotes post‐ischaemic angiogenesis and improves cardiac functions by targeting Akt

Angiogenesis is critical for re‐establishing the blood supply to the surviving myocardium after myocardial infarction (MI). Long non‐coding RNA ANRIL (lncRNA‐ANRIL) has been reported to regulate endothelial functions in cardiovascular diseases. This study was to determine the role of lncRNA‐ANRIL in Akt regulation and cardiac functions after MI. Human umbilical vein endothelial cells (HUVECs) were exposed to oxygen‐glucose deprivation (OGD) to mimic in vivo ischaemia. The MI model in mice was induced by ligating left anterior descending coronary artery. OGD remarkably decreased lncRNA‐ANRIL expression level, reduced the phosphorylated levels of Akt and eNOS proteins, and inhibited NO release and cell viability, which were duplicated by shRNA‐mediated gene knockdown of lncRNA‐ANRIL. Conversely, all these effects induced by OGD were abolished by adenovirus‐mediated overexpression of lncRNA‐ANRIL in HUVECs. Further, OGD impaired cell migrations and tube formations in HUVECs, which were reversed by lncRNA‐ANRIL overexpression or Akt up‐regulation. RNA immunoprecipitation analysis indicated that the affinity of lncRNA‐ANRIL to Akt protein was increased in OGD‐treated cells. In animal studies, adenovirus‐mediated lncRNA‐ANRIL overexpression increased the phosphorylated levels of Akt and eNOS, promoted post‐ischaemic angiogenesis and improved heart functions in mice with MI surgery. LncRNA‐ANRIL regulates Akt phosphorylation to improve endothelial functions, which promotes angiogenesis and improves cardiac functions in mice following MI. In this perspective, targeting lncRNA‐ANRIL/Akt may be considered to develop a drug to treat angiogenesis‐related diseases.     

猪冠状动脉前降支结扎位点和左室功能的线性回归

目的探讨猪冠状动脉前降支(LAD)结扎百分位点和心梗体积、左室射血分数的关系,以期指导研究者能够根据急性心肌梗死模型的心功能要求选择合适的LAD结扎百分位点。方法将47只小型猪开胸结扎心脏LAD中远段约30%~75%的不同百分位点,分别于术前、术后1 h心脏超声检查左室射血分数(LVEF),术后3 d进行常规冠状动脉造影,4周处死测量前降支结扎位点和梗死体积,最后用简单直线回归模型分析LAD结扎百分位点和心梗体积、左室射血分数回归方程和相关系数。结果47例动物手术过程中死亡8只,剩余39只存活动物冠状动脉造影均显示LAD中远段结扎部位处完全闭塞,表明手术成功。LAD结扎百分位点和术后1 h LVEF、术后1 hLVEF下降值、梗死心肌体积均明显相关(相关系数r分别为0.87、0.78和0.90,P均<0.001),其回归方程分别为:术后LVEF(%)=65.88-0.55x结扎百分位点;术后LVEF下降值(%)=0.12 0.59x结扎百分位点;心肌梗死体积(%)=0.53x结扎百分位点-5.43。结论猪LAD结扎百分位点和术后左室功能、梗死心肌体积均存在显著的相关性,可根据实验目的和对心功能的要求选择合适的结扎百分位点。     

罗布麻通过抑制氧化应激反应减轻心肌缺血再灌注损伤

目的:观察罗布麻叶提取物(apocynum venetum leaf extract AVLE)预处理对心肌缺血再灌注(MI/R)损伤的影响。方法:采用SD大鼠MI/R模型,随机分为sham(假手术)组、MI/R组、AVLE预处理+MI/R组,检测血流动力学,采用氯化三苯基四氮唑和伊文思蓝双染法检测心梗面积、以血浆肌酸激酶(CK)和乳酸脱氢酶(LDH)活性检测心肌损伤情况、以超氧化物、丙二醛(MAD)和超氧化物歧化酶(SOD)含量检测心肌氧化应激以及Western blot方法检测gp91phox的表达。结果:与MI/R组相比,AVLE预处理组左室压上升、下降最大速率(±LVdp/dtmax)升高(P0.05),心肌梗死面积减少,两组分别为41.5±4.5%和32.0±3.5%(P0.05),血浆CK和LDH活性分别降低到1653±62 U/L和2461±152 U/L(P0.05),减少了心肌组织超氧化物的含量(P0.05)。AVLE治疗显着降低gp91phox的表达(P0.05),使SOD活性增加(P0.05),MDA水平显著降低(P0.05)。结论:AVLE通过抑制I/R心肌的氧化应激发挥心脏保护作用。     

左旋精氨酸在冠脉搭桥术中心肌保护作用研究进展

冠状动脉搭桥术(Coronary artery bypass grafting,CABG)中发生心肌缺血再灌注损伤是难以避免的,而冠状动脉内皮损伤导致一氧化氮(nitrogen monoxidum NO)合成及释放减少是导致心肌缺血/再灌注损伤(Myocardial ischemia/reperfusion injury MI/RI)的重要因素。本文通过对左旋精氨酸(left-arginine,L-Arg)与NO、MI/RI之间的联系、L-Arg对MI/RI的保护作用及其机制、L-Arg-NO的心肌保护作用与剂量之间关系以及L-Arg在CABG中的临床应用等方面的研究进行综述,阐明提供外源性L-Arg通过L-Arg-NO通路促进体内NO的合成及释放,探讨左旋精氨酸在冠脉搭桥术中心肌保护作用的可行性。     

Regulation of alternative macrophage activation by MSCs derived hypoxic conditioned medium,via the TGF-β1/Smad3 pathway

Macrophages are re-educated and polarized in response to myocardial infarction (MI). The M2 anti-inflammatory phenotype is a known dominator of late stage MI. Mesenchymal stem cells (MSCs) represent a promising tool for cell therapy, particularly heart related diseases. In general, MSCs induce alteration of the macrophage subtype from M1 to M2, both in vitro and in vivo. We conjectured that hypoxic conditions can promote secretome productivity of MSCs. Hypoxia induces TGF-β1 expression, and TGF-β1 mediates M2 macrophage polarization for anti-inflammation and angiogenesis in infarcted areas. We hypothesized that macrophages undergo advanced M2 polarization after exposure to MSCs in hypoxia. Treatment of MSCs derived hypoxic conditioned medium (hypo-CM) promoted M2 phenotype and neovascularization through the TGF-β1/Smad3 pathway. In addition, hypo-CM derived from MSCs improved restoration of ischemic heart, such as attenuating cell apoptosis and fibrosis, and ameliorating microvessel density. Based on our results, we propose a new therapeutic method for effective MI treatment using regulation of macrophage polarization.