实验性心肌肥厚大鼠左室c-fos表达及卡托普利的作用

心肌肥厚时,心肌细胞作出适应性反应发生结构改建,这种重构与压力超负荷早期心肌细胞 原癌基因表达过盛密切相关。本文应用大鼠腹主动脉缩窄模型结合血管紧张素转化酶抑制剂 卡托普利(Cap),研究心肌肥厚早期c-fos表达及六周后血压、心功能及酶学指标的改变, 以探讨Cap抑制心肌肥厚的可能机制。 1　材料与方法 　　(1)动物模型复制　采用体重(250±20) g的健康、雄性SD大鼠(由本校动物室提供),按腹主 动脉缩窄法制备压力超负荷性心肌肥厚模型,使腹主动脉残留管腔直径为0.7 mm。 　　(2)动物分组　动物分成两部分：第一部分：大鼠19 只,其中4只,在腹主动脉缩窄前及缩 窄后1 h、3 h、12 h分别处死,留取心脏。另15只随机均分成手术组、伪手术组、Cap治疗 组(n=5)。复制心肌肥厚模型后3 h处死动物,留取心脏,提取总RNA,检测左室c-fos mRNA表达。第二部分,大鼠30 只,随机均分成手术组(LVH,n=10,腹主动脉缩窄后未 用Cap治疗),伪手术组(sham,n=10,行伪手术)及Cap治疗组［LVH+Cap,n=10,腹 主动脉缩窄后用Cap50 mg/(kg*d)治疗］。建立模型6周后,右颈总动脉插管,记录动脉血 压后,进一步插管入左室,测取并计算左室内压力最大上升、下降速率及等容舒张期左室压 力下降的时间常数(T值)。处死动物,留取心脏标本备用。 　　(3)左心室c-fos mRNA表达　取左室心肌组织50 mg,一步法抽提RNA。用地高辛随机引物法 标记的c-fos探针(华美生物试剂公司,cDNA片段,1.3kb)进行斑点杂交,IBAS图象分析仪 测定杂交信号的相对光密度(IOD)。 　　(4)心肌重量及质膜Na+-K+ATPase活性测定　称量左室重量(LVW)及体重(BW),计算LVW /BW。制备10%心肌匀浆,差速分离质膜及线粒体。通过检测反应液中ATP水解释放的无机磷 含量来确定酶活性。     

心肌肥厚大鼠心肌Cx43的表达及法舒地尔的干预作用

目的：研究腹主动脉缩窄大鼠心肌缝隙连接蛋白Cx43的变化及法舒地尔的干预作用。方法：腹主动脉缩窄建立心肌肥厚大鼠模型,随机分假手术组,腹主动脉缩窄组、腹主动脉缩窄＋10mg／kg法舒地尔（ip,每天1次,8周）组、腹主动脉缩窄＋40mg／kg（ip,每天1次,8周）。病理切片观察心肌组织学变化;免疫组化法检测心肌Cx43蛋白表达。结果：模型组大鼠心肌细胞排列紊乱,肥大,间隙增宽,Cx43蛋白表达量明显低于正常组;Fas治疗后,死亡率下降,cx43蛋白表达量高于模型组,差异具有统计学意义（P〈0．01）。结论：Fas可能通过调高Cx43蛋白表达,治疗大鼠心肌肥厚。     

细胞核CaMK和Calcineurin 对大鼠心肌肥厚发生的作用

目的:研究大鼠心肌肥厚时,钙依赖的蛋白激酶和蛋白磷酸酶在心肌细胞膜、细胞浆和细胞核的分布规律,以探讨核钙信号与核反应在心肌肥厚发生过程中的病理生理意义.方法:制备腹主动脉缩窄大鼠心肌肥厚模型,同位素32P掺入法分别测定心肌细胞核、细胞浆和细胞膜的蛋白激酶活性及用无机磷生成显色法测定其蛋白磷酸酶活性.结果:腹主动脉缩窄术后4周大鼠心肌显著肥厚,伴有明显的血液动力学异常.与正常对照组相比较,腹主动脉缩窄心肌肥厚组心肌细胞核钙调素蛋白激酶(CaMK)活性增加101.1%(P＜0.01),其膜的酶活性升高40.2%(P＜0.01),而胞浆的酶活性不变(P＞0.05);心肌细胞核钙调神经磷酸酶(Calcineurin)活性增加43.6%(P＜0.05),膜和胞浆中其活性增加无显著性(P＞0.05).正常组和腹主动脉缩窄心肌肥厚组心肌细胞CaMK和Calcineurin活性分布为核＞膜＞胞浆(P＜0.01).结论:腹主动脉缩窄心肌肥厚时核内钙依赖的CaMK和Calcineurin活性增加,提示压力超负荷时细胞核内钙调节的蛋白磷酸化和去磷酸化水平增高,可能在介导心肌肥厚的发生中起重要作用.     

压力负荷型心肌肥厚大鼠心肌组织相关基因的分离

心肌肥厚是心血管疾病常见的临床并发症 ,与冠心病、心衰、脑卒中等心血管疾病密切相关[1] ,其发生机制目前仍不清楚 .探讨其机制将为心肌肥厚及相关疾病的研究和治疗提供有益的线索 .本研究选用腹主动脉绑扎的左心室肥厚大鼠模型 ,运用差减杂交法 ,研究其中相关基因的表达变化 .1　材料和方法1 .1　压力负荷型左心室肥厚大鼠模型采用腹主动脉缩窄法[2 ] :雄性健康 Wistar大鼠 ( 2 0 0 g左右 )用速眠新 846合剂麻醉 ,将直径 0 .7mm的小圆棒以3/0丝线绕腹主动脉一起绑紧 ,抽出小圆棒 .对照组行假手术 .大鼠血压测量采用颈动脉插管 (术后 2 8…     

新基因C10orf97参与压力超负荷性心肌肥厚

目的检测新基因C10orf97是否参与压力超负荷型心肌肥厚病程。方法通过缩窄大鼠胸主动脉横支构建压力超负荷诱导的心肌肥厚模型,在缩窄手术后的连续时间点应用血流动力学检测评价心室重构和心功能,应用实时荧光定量PCR法检测心肌肥厚标志基因心房利钠肽和C10orf97的mRNA表达。结果主动脉缩窄手术后,大鼠心脏显著肥厚,心脏体重比逐渐增加,心功能先受损后代偿性增强。心房利钠肽表达显著上调,在缩窄后第15天升高为假手术组40倍。C10orf97基因的表达在缩窄后第2天即显著上调为假手术组的2倍,在第4天降低,随后逐渐上升,第15天时表达量升高为假手术组的3倍。结论C10orf97基因参与了压力超负荷引起的心肌肥厚病程。     

穿心莲内酯对大鼠心肌肥厚的影响

研究穿心莲内酯(AP)对由腹主动脉缩窄所致大鼠心肌肥厚的抑制作用。采用腹主动脉缩窄法制备大鼠心肌肥厚模型,10天后开始每天一次的AP0.5,1.0,2.0g/kg给药,共10周。测定心脏质量指数(HMI)、左心室质量指数(LVMI);检测血清及心肌组织的乳酸脱氢酶(LDH)和左心室心肌组织乳酸(LAC)、游离脂肪酸(FFA)含量。同假手术组相比,心肌肥厚模型组大鼠心肌组织LDH明显降低,其他指标明显升高;AP低中高给药组中,中、高剂量组各个指标明显改善。AP对心肌肥厚具有较好抑制作用,其具体原因可能与调节心肌细胞产能机制有关。     

辛伐他汀通过钙调神经磷酸酶通路抑制压力负荷性心肌肥大

目的:研究在压力负荷下辛伐他汀对钙调神经磷酸酶介导的心肌肥大的影响.方法:选用SD大鼠随机分为3组:假手术组(n=10)、单纯模型组(n=10)和辛伐他汀组(n=10).大鼠通过腹主动脉缩窄建立压力超负荷模型,8周后测定左室重量指数,B超检测左室形态结构,Westernblot检测心肌CaN蛋白表达,RT-PCR法检测心肌CaNmRNA水平.结果:①单纯模型组和辛伐他汀组心肌肥厚指数明显高于假手术组,辛伐他汀组心肌肥厚指数明显低于单纯模型组(P＜0.05).②单纯模型组和辛伐他汀组心肌CaN蛋白及CaNmRNS表达水平高于假手术组(P＜0.05),辛伐他汀组低于单纯模型组(P＜0.05).结论:辛伐他汀可能参与干预钙调神经磷酸酶介导的通路从而抑制心肌肥厚的形成.     

心肌细胞核钙调素I介导的bcl-2转录调节在大鼠心肌肥厚中的作用

为探讨心肌细胞核钙调素I(calmodulin I,CaM I)介导的bcl-2转录调节在大鼠心肌肥厚中的作用及其可能机制, 实验随机分为对照组和心肌肥厚组,采用腹主动脉缩窄法制备大鼠心肌肥厚模型。模型复制成功后4周,以改良差速离心和密度梯度离心提取并纯化细胞核;蛋白印迹法测定心肌细胞核cAMP反应元件结合蛋白(cAMP response-element binding protein,CREB)及磷酸化CREB(phosphorylated cAMP response-element binding protein,pCREB)表达;免疫组化法观察左室心肌组织CaM I蛋白表达及分布;延续转录分析法观察阻断CaM I后心肌细胞核bcl-2 mRNA的变化。结果表明,心肌肥厚组pCREB蛋白表达较对照组明显增加(P<0．05),CREB蛋白表达无明显变化(P>0．05);CaM I分布于细胞核及细胞浆,心肌肥厚组CaM I蛋白表达较对照组明显增加(P<0．05);使用CaM抑制剂后心肌细胞核bcl-2 mRNA表达明显上调(P<0．05)。结果提示,压力超负荷时心肌细胞核内CaM I激活,抗凋亡基因bcl-2表达下调,核转录因子CREB磷酸化增加,但CREB 在调节bcl-2基因转录过程中可能发挥次要作用。     

PTEN在心肌肥厚中的作用初探

目的：观察肿瘤抑制因子PTEN mRNA在腹主动脉狭窄大鼠及卡托普利处理的腹主动脉狭窄大鼠左心室肌中的表达,以探讨PTEN在心肌肥厚发生发展中的可能作用。方法：采用腹主动脉狭窄术制备压力超负荷心肌肥厚动物模型,于术后4周应用逆转录—聚合酶链式反应(RT—PCR)方法,分别检测和观察对照组、心肌肥厚组和卡托普利组大鼠左心室PTEN mRNA表达的变化。结果：①与对照组相比,心肌肥厚组大鼠左心室肌PTEN mRNA表达减少;②与心肌肥厚组相比,卡托普利组大鼠左心室肌PTEN mRNA表达增加,接近对照组。结论：PTEN在心肌肥厚发生发展中可能起负调控作用,该作用与肾素—血管紧张素系统密切相关。     

吡格列酮抑制大鼠心肌肥厚的实验研究

目的: 以体外实验和体内实验探讨噻唑烷二酮(Thiazolidinedione,TZD)类药物吡格列酮对大鼠心肌肥厚的影响.方法: 体外原代培养新生大鼠的心肌细胞,以血管紧张素Ⅱ刺激建立心肌肥大模型,分别给予不同浓度的吡格列酮处理.采用RT-PCR法检测心肌肥大特征性基因心钠素(ANP)和脑钠素(BNP)mRNA的表达,并以3H-亮氨酸掺入测定心肌细胞蛋白合成速率.体内实验中通过不完全结扎大鼠腹主动脉引起压力负荷增加,导致左心室肥厚.从术前1周起用灌胃器经口给予吡格列酮(20 mg*kg-1*day-1)直至术后4周.处死动物,计算心脏重/体重比值,测量左心室壁厚度和心肌细胞的平均直径,RT-PCR法测定心肌细胞中BNP及炎性细胞因子的mRNA表达.结果: 心肌细胞肥大模型出现后,心肌细胞的ANP和BNP mRNA的表达以及蛋白合成速率增加.经不同浓度的吡格列酮处理后,这些变化得以减轻,并呈一定的剂量依赖性.吡格列酮抑制左心室心肌白细胞介素-1β,心调理素-1的mRNA表达,同时减轻压力负荷升高引起的大鼠心脏重/体重比值、左心室壁厚度和心肌细胞平均直径的增加.结论: 吡格列酮在体外和体内实验研究中显示对大鼠心肌肥厚有保护作用,可能对防治以心肌肥厚为特征的心血管疾病有一定的应用前景.     

Localized endocrine conversion of ventricular cardiocytes in ventricular aneurysm

Atrial natriuretic peptide (ANP) is synthesized and stored in the atria of the heart, but not or at very low concentrations in the ventricles. We investigated the occurrence of ANP and its messenger RNA (mRNA) in human ventricular aneurysm where the cardiocytes were physically over-stretched. The techniques of light and electron microscopic immunocytochemistry, and RNA-RNA tissue in situ hybridization were employed. A large amount of ANP immunoreactivity was found in the cytoplasm of the cardiocytes in and around the aneurysm, but not in fibrous scar tissue or in the normal ventricles. Immunoelectron microscopy localized the immunoreactivity mainly to specific secretory granules in the cytoplasm of the cardiocytes. ANP mRNA was also detected in these cardiocytes. The abundance of both was much higher than that found in the hypertrophic ventricles of other types. The highest concentration of ANP immunoreactivity and of ANP mRNA was found in the cardiocytes located at the border zone. The quantities of both ANP and its mRNA decreased in cardiocytes more distant from the lesion. Our findings suggest that human ventricular cardiocytes in and around aneurysm can convert to produce large amounts of the endocrine peptide ANP. This ventricular endocrine conversion was localized and was probably caused by physical over-stretch of the cardiocytes.     

Bidirectional ventricular tachycardia: a hallmark of catecholaminergic polymorphic ventricular tachycardia

Catecholaminergic polymorphic ventricular tachycardia is a familial cardiac arrhythmia that is related to RYR2 or CASQ2 gene mutation. It occurs in patients with structurally normal heart and causes exercise-emotion triggered syncope and sudden cardiac death. We present a 13 year-old girl with recurrent episodes of exercise-related syncope and prior history of sudden death in a first degree relative.     

Left ventricular effects on right ventricular developed pressure.

The possibility that left ventricular (LV) performance might affect right ventricular (RV) function through the myocardium was examined by using isolated, flow-perfused, paced rabbit hearts beating isovolumically. Reducing LV volume from its optimal volume to zero caused a 5.7% decrease (N = 10, P less than 0.001) in right ventricular developed pressure (RVDP). Ligating the anterior ventricular branches of the left coronary artery which in the rabbit supply the LV free wall resulted in an additional 9.3% decrease in RVDP (N = 5, P = 0.05) within 3 min of ligation. Finally, cutting the LV free wall from the atrioventricular orifice to the apex (thereby preventing any developed LV free wall force during systole) caused a 45% further decrease in RVDP (N = 2, P less than 0.02). Cineradiographic study showed that the alterations in RVDP resulting from changes in LV volume and coronary occlusion correlated significantly (N = 5, P less than 0.01) with the magnitude of septal bulging into the RV cavity during systole. The results indicate that alteration in LV free wall function and changes in LV volume can directly effect RVDP through the myocardium.     

Prognostic significance of accelerated ventricular response during radiofrequency ablation of premature ventricular complexes

BackgroundAccelerated ventricular response is frequently observed during radiofrequency ablation (RFA) of premature ventricular complexes (PVCs). We hypothesized that acceleration indicates an appropriate site and adequate injury to the arrhythmogenic tissue, and sought to investigate its value in predicting the outcome.MethodsWe retrospectively analyzed RFA procedures performed for PVCs in our institution from 2011 to 2019.ResultsFifty-eight patients (29 male; age 42.7 ± 15.6 years) underwent 62 RFA procedures. The most common site was the right ventricular outflow tract (67.7%). Acute success was seen in 88.7%. Accelerated ventricular response was observed in 60.0% of the successful procedures. After a median follow-up of 14.0 months (IQR: 6.0–26.6 months), 16 patients had a recurrence. Recurrence was significantly lower in the group with acceleration than in the group without acceleration (12.5% vs. 57.1%; log-rank P < 0.001). The 1-year recurrence rate was 6.5% in the acceleration group and 41.6% in the group without acceleration. On multivariable analysis the adjusted hazard ratio was 0.17 (95% CI, 0.04–0.64; Cox regression P = 0.009). The sensitivity, specificity, positive predictive, and negative predictive values of accelerated response to predict long-term success were 75.7%, 75.0%, 87.5%, and 57.2%, respectively.ConclusionsThe recurrence after PVC ablation is significantly lower when an accelerated response was observed at the successful location during RFA. This can be an additional useful marker of long-term success.