紫杉醇抑制急性心梗大鼠离体心脏牵张诱导的电生理改变

机械敏感性离子通道是心脏机械电反馈的机电传导器, 目前认为其与心律失常的发生有关. 近年来, 细胞骨架对离子通道的调控得到广泛研究. 本实验旨在探讨紫杉醇是否能够抑制牵张缺血心肌所诱导的电生理改变. 32只wistar大鼠随机分为4组: 对照组(n=9)、紫杉醇组(n=7)、心梗组(n=9)和心梗+紫杉醇组(n=7). 经langendorff离体灌流后, 以0.2和0.3 mL的幅度对离体心脏进行牵张, 分别为5 s, 观察牵张效应30 s, 包括90%的单相动作电位、室性早搏和室速. 结果发现, 牵张后, 正常对照组和心梗组MAPD₉₀均延长, 且同等牵张幅度下心梗组MAPD₉₀延长得更为明显. 紫杉醇(5 mmol/L)对于基础状态下的MAPD₉₀无影响. 牵张后, 紫杉醇MAPD₉₀较正常对照组轻度延长(P>0.05). 但紫杉醇可使心梗组心肌牵张后的MAPD₉₀缩短(ΔV=0.3 mL时, P<0.05). 心梗组PVB和VT的发生率高于正常对照组(均P<0.01). 紫杉醇对正常心肌的心律失常发生无影响, 但可抑制梗死心肌PVB和VT的发生(均P<0.01). 综上, 紫杉醇可明显抑制急性心肌梗死离体大鼠心脏牵张时, MAPD的改变和心律失常的发生, 提示紫杉醇可能参与到急性心肌梗死时的机械电反馈过程.     

大鼠肢体缺血/再灌注后的心肌损伤和NO的保护效应

目的:探讨大鼠肢体缺血/再灌注(LI/R)后心肌的损伤性变化及NO的保护效应。方法:制备LI/R动物模型,将Wistar大鼠随机分为4组(n=10):C(control)组、I/R组、L-Arg组和L-NAME组。用生物化学方法测定大鼠血浆CK、CK-MB及NO水平,测定心肌组织XOD、SOD、MDA含量。用BL-420生物机能实验系统监测大鼠MAP、LVSP、±dp/dtmax等。结果:LI/R后,血浆CK、CK-MB水平均明显升高(P<0.01);心肌组织SOD活性降低而MDA、XOD含量增加(P<0.01或P<0.05);MAP、LVSP、dp/dtmax、-dp/dtmax均降低(P<0.01或P<0.05);血浆NO水平在L-Arg组明显升高(P<0.01),在L-NAME组显著降低(P<0.05)。结论:大鼠LI/R可引起心肌损伤,机体的氧化应激状态可能是其发生机制之一;提高体内NO水平可在一定程度上减轻LI/R后心肌损伤的程度。     

碱性成纤维生长因子转染骨髓间充质干细胞移植对心肌病心力衰竭大鼠心功能的影响

目的探讨碱性成纤维生长因子(bFGF)转染的骨髓间充质干细胞(BMSCs)移植对心肌病心力衰竭大鼠心功能的影响。方法通过腹腔注射阿霉素建立心肌病心力衰竭SD大鼠模型,存活33只大鼠随机分成3组:模型组、BMSCs组和BMSCs+bFGF组,每组11只。另设正常对照组(n=8)。取体外培养的第三代SD大鼠BMSCs,质粒-bFGF转染BMSCs,BrdU标记后,分别将BMSCs(3×10~6个)、bFGF转染的BMSCs(3×10~6个)或等体积培养基通过尾静脉注射的方法进行移植。用生物信号采集系统检测大鼠心功能,大鼠心脏切片行免疫组化了解移植细胞在受体心脏的存活情况,实时荧光定量PCR和Western Blotting检测心室组织bFGF的表达水平。多组间比较采用单因素方差分析或精确概率法。结果 BMSCs移植4周后,正常对照组大鼠的心功能指标LVSP(121.13±12.28)mmHg,LVDEP(3.86±1.25)mmHg,LV+d P/dt(3671.25±172.50)mmHg/s和LV-d P/dt(3221.63±259.57)mmHg/s;模型组心功能指标LVSP(81.29±12.39)mmHg,LVDEP(16.43±4.12)mmHg,LV+d P/dt(2344.29±98.63)mmHg/s和LV-d P/dt(2244.29±103.10)mmHg/s;BMSCs组心功能指标LVSP(97.00±6.39)mmHg,LVDEP(12.00±2.73)mmHg,LV+d P/dt(2876.25±118.31)mmHg/s和LV-d P/dt(2726.25±303.23)mmHg/s;BMSCs+bFGF组心功能指标LVSP(109.38±12.78)mmHg,LVDEP(9.25±1.67)mmHg,LV+d P/dt(3037.50±161.22)mmHg/s和LV-d P/dt(3000.13±149.77)mmHg/s,移植组各指标均有改善,比较差异有统计学意义(F=17.29、36.61、111.11、26.54,P均0.01)。免疫组织化学检查示细胞移植组大鼠的心室组织切片上可见Brd U阳性细胞存在。模型组大鼠心室心肌组织bFGF mRNA表达水平高于正常对照组(1.28±0.06 vs 1.00±0.00,t=10.46,P0.01),BMSCs组高于模型组(1.37±0.05 vs 1.28±0.06,t=3.39,P0.01),而BMSCs+bFGF组高于BMSCs组(1.44±0.03 vs 1.37±0.05,t=2.86,P=0.01)。Western Blotting示,正常对照组大鼠心室组织bFGF蛋白表达最低,模型组高于正常对照组(1.31±0.09 vs 1.00±0.00,t=5.48,P=0.01),BMSCs组高于模型组(1.46±0.05 vs 1.31±0.09,t=2.68,P=0.03),而BMSCs+bFGF组高于BMSCs组(1.84±0.09 vs 1.46±0.05,t=6.79,P0.01)。结论转染bFGF基因的BMSCs移植可提高阿霉素所致心肌病心力衰竭大鼠心脏的bFGF水平,改善大鼠心功能,其效果优于单纯BMSCs移植。     

不同部位起搏对正常和心力衰竭犬心室跨壁复极梯度的影响（英文）

跨壁复极梯度的改变可能导致跨壁复极离散度的增加和室速的增多,跨壁复极离散可能在左室心外膜起搏相关猝死中发生重要作用。本研究对心力衰竭(心衰)犬进行心室不同部位起搏,观察左心室跨壁复极梯度的变化。选用8条健康杂种犬,随机分成健康对照组和心衰组(n=4),心衰组4条健康犬经快速右心室心内膜心尖部(right ventricular apical endocardium,RV_(Endo))起搏4～5周建立慢性充血性心衰模型。健康对照组和心衰组分别在右心房(right atrium, RA)起搏、RV_(Endo)起搏、左心室心外膜(left ventricular lateral epicardium, LV_(Epi))起搏及双心室(biventricular, Biv)同步起搏的条件下,应用自制的跨室壁单相动作电位(monophasic action potential, MAP)记录电极,于左心室同步记录和测量三层心肌(内层、中层、外层)的MAP时程(MAP duration, MAPD)。结果显示,健康对照组窦性心律时左心室三层心肌MAPD比较:中层内层外层,各层之间比较均有统计学差异(均P 0.05);RV_(Endo)、LV_(Epi)、Biv起搏时MAPD仍为中层内层外层,心外膜层与心内膜层MAPD比较无统计学差异(P 0.05);每种起搏时中层与心外膜层及心内膜层的MAPD比较均有统计学差异(均P 0.05)。与健康对照组比较,心衰组不同起搏模式(RA起搏、RV_(Endo)起搏、LV_(Epi)起搏、Biv起搏)时左心室心肌各层的MAPD均延长(均P 0.05)。心衰组RA、RV_(Endo)、LV_(Epi)及Biv起搏时左心室三层心肌MAPD均表现为中层内层外层,但各层心肌MAPD均无统计学差异(均P 0.05)。通过应用改良标测导管记录MAP的方法,我们发现健康犬RA起搏时左心室心内膜层、中层及心外膜层存在明显的跨壁梯度,RV_(Endo)、LV_(Epi)、Biv起搏时左心室心内膜与心外膜间跨壁梯度消失;然而心衰犬左心室的三层心肌在RA、RV_(Endo)、LV_(Epi)、Biv起搏时均不存在跨壁梯度,这些结果有助于加深对心衰患者室性心律失常发生机制的理解。     

甲状腺素心肌病大鼠血流动力学和心肌钠、钙电流的变化

本文旨在研究L-甲状腺素(L-thyroxine,L-thy)所致的大鼠心肌病模型上血流动力学及心室肌细胞钠电流(INa)、L-钙通道电流(ICa-L)的变化。实验大鼠随机分成两组:心肌病组和对照组。心肌病组以0.5mg/kg腹腔注射L-thy,连续注射10d,建模成功后测定血流动力学变化,然后急性酶解法分离心肌细胞,应用全细胞膜片钳技术记录心肌细胞INa和ICa-L。结果显示:(1)与对照组相比,心肌病组大鼠左心室收缩压(leftventricular systolic pressure,LVSP)、左心室发展压(left ventricular developed pressure,LVDP)和左心室舒张期室内压最大下降速率(-dp/dtmax)均显著降低(P0.01),左心室收缩期室内压最大上升速率(+dp/dtmax)也表现为降低(P0.05),左心室舒张末期压(left ventricular end-diastolic pressure,LVEDP)显著升高(P0.01);(2)与对照组相比,在去极化电位为-30mV时,心肌病组大鼠心肌细胞INa电流密度由(-21.1±6.3)pA/pF增大至(-26.2±3.2)pA/pF(n=12,P0.01),INa的激活曲线左移,失活曲线左移,去失活曲线右移;(3)与对照组相比,在去极化电位为-10mV时,心肌病组大鼠心肌细胞ICa-L电流密度由(-5.4±0.6)pA/pF增至(-7.9±0.8)pA/pF(n=12,P0.01),ICa-L的激活曲线左移,失活曲线左移,去失活曲线左移。以上结果表明,甲状腺素心肌病模型心功能与心力衰竭相似,其INa和ICa-L功能明显增强,尤其是ICa-L,提示在INa和ICa-L功能异常增强的心肌病治疗中若使用的钙通道拮抗剂带有降低心肌对Na+通透性的药物效果应更佳。     

通心络胶囊对心肌梗死模型大鼠MMP-2和TIMP-1表达的影响

目的:探讨通心络胶囊对心肌梗死大鼠基质金属蛋白酶-2(MMP-2)及基质金属蛋白酶抑制剂1(TIMP-1)的表达、心脏结构和功能改变的影响.方法:取SD大鼠24只,随机分成假手术组(SH group,n=8),心肌梗死模型组(MI group,n=8),用药组(Treated group,n=8).术后4w,测量左室收缩压(LVSP)、左室舒张末压(LVEDP)、左室上升最大速率(+dP/dtmax)、左室下降最大速率(-dP/dtmax);测定全心重(THW)及左心室称重(LVW),计算THW/体重(BW)、LVW/BW值和心肌梗死面积;用酶联免疫吸附法(ELISA)检测血清MMP-2及TIMP-1水平.结果:与SH组比较,MI组心室重量增加,心室功能显著降低,MMP-2升高,TIMP-1降低;与MI组比较,Treated组心室重量降低,心室功能显著增高,MMP-2减少,TIMP-1增加.结论:大鼠心肌梗死后,通心络胶囊能降低血清MMP-2水平,升高TIMP-1水平,抑制左室重构、改善心功能.     

慢性心力衰竭大鼠心肌毛细血管密度及血管内皮生长因子变化

目的观察慢性心力衰竭大鼠心肌毛细血管密度及血管内皮生长因子(VEGF)变化,探究冠脉微循环障碍的病理特点及病因机制.方法实验组(n=15)皮下注射异丙肾上腺素,对照组(n=10)皮下注射生理盐水,间隔24h,连续2次.12周后测定血液动力学;计算左心室重量/体重;HE染色、Masson染色分别观察左心室病理改变、胶原变化;西非单叶豆素组织化学染色结合图像分析确定心内膜下心肌毛细血管密度、心肌细胞密度、毛细血管密度与心肌细胞密度的比值(毛细血管/心肌细胞);观察心内膜下心肌VEGF免疫组织化学变化.结果同对照组比较,实验组左心室收缩、舒张功能下降(P<0.05);左心室重量/体重升高(P<0.001);心内膜下心肌散在坏死,胶原沉积;心内膜下心肌毛细血管密度、心肌细胞密度、毛细血管/心肌细胞下降(P<0.05);VEGF合成增加(P<0.001).结论慢性心力衰竭大鼠心内膜下心肌毛细血管分布稀疏;该区域毛细血管代偿性生成减少与心肌VEGF表达无关.     

大鼠心肌梗死后螺内酯与氯沙坦干预对其心肌胶原变化的影响

目的:观察大鼠急性心肌梗死(acmemyocardial infarction,AMI)后左心室心肌重构分析和非梗死区Ⅰ、Ⅲ型胶原含量的变化,分别使用螺内酯和氯沙坦以及将两药合用对AMI模型进行干预,探索醛固酮受体拮抗剂和血管紧张素受体阻断剂对AMI后心室重构和胶原增生的影响.方法:将50只雌性SD大鼠随机分为AMI组、螺内酯组、氯沙坦组、联合用药组和假手术组,每组10只,结扎大鼠左前降支建立急性心肌梗死模型.术后8周进行血流动力学测定、病理分析和非梗死区Ⅰ、Ⅲ型胶原含量的测定.结果:AMI组与假手术组相比,左心室舒张末压(LVEDP)、容积、重量和非梗死区Ⅰ、Ⅲ型胶原含量均显著增加(P<0.05);左心室球形指数、左心室内压最大上升和下降速率(±dp/dt/LVSP)均显著降低(P<0.05).螺内酯组与AMI组相比,左心室非梗死区Ⅰ、Ⅲ型胶原含量显著减少(P<0.05),其余各指标差异无统计学意义(P>0.05).氯沙坦组和联合用药组与AMI组相比,LVEDP、左心室实际重量显著降低(P<0.05);左心室容积仅联合用药组有显著降低(P<0.05);而两组的±dp/dt/LVSP显著增加(P<0.05).螺内酯、氯沙坦和联合用药3组与AMI组相比,左心室非梗死区Ⅰ、Ⅲ型胶原含量均显著减少(P<0.05);且3组之间差异无统计学意义(P>0.05).结论:螺内酯能有效抑制AMI左心室非梗死区Ⅰ、Ⅲ型胶原的增生,提示螺内酯可能有改善左心室重构的潜在作用.氯沙坦与螺内酯合用可更有效防治AMI后左心室重构,改善左心室舒张功能.     

雌激素通过调节Gα_s-cAMP通路减轻异丙肾上腺素导致的大鼠心肌损伤

本研究旨在通过给予去卵巢大鼠异丙肾上腺素制作心肌损伤及心功能异常模型,探讨雌激素通过调节兴奋性G(Gαs)蛋白-环磷酸腺苷(cAMP)信号通路纠正儿茶酚胺导致的心功能异常的机制。观察雌激素对大鼠血流动力学参数:左心室收缩峰压(LVSP)、左心室舒张末压(LVEDP)、左心室内压上升的最大变化速率(+dp/dtmax)、左心室内压下降的最大变化速率(-dp/dtmax),血浆脑尿钠肽(brain natriuretic peptide,BNP),cAMP浓度和心肌中Gαs蛋白表达的影响。结果显示:与假手术组相比,去卵巢大鼠的血流动力学参数、血浆BNP水平、血浆cAMP水平没有显著改变;但给予去卵巢大鼠异丙肾上腺素后,血流动力学参数LVSP、+dp/dtmax降低(P0.01),LVEDP、-dp/dtmax升高(P0.01),血浆BNP水平升高(P0.01),血浆cAMP水平降低(P0.01);而进一步的雌激素补充则改善了心功能:LVSP、+dp/dtmax升高(P0.01),LVEDP、-dp/dtmax降低(P0.05,P0.01),血浆BNP水平降低(P0.01),cAMP水平升高(P0.01);雌激素对Gαs蛋白表达没有显著影响。结果提示:雌激素对心肌损伤具有保护作用,升高cAMP水平,改善心肌收缩过度抑制,调节心脏的功能状态。     

Ang(1-7)和依那普利拉对大鼠严重烧伤早期心脏保护作用的研究

目的:观察Ang(1-7)和依那普利拉对烧伤早期心功能及心肌损伤的保护作用.方法:健康雄性Wistar大鼠24只,随机分为正常组、烧伤组、Ang(1-7)组和依那普利拉组.于烧伤后6H检测血流动力和心肌力学指标(SBP,DBP,LVSP,LVEDP, LVdp/dt-max,-LVdp/dtmax),血清cTnI,及血清和心肌组织中AngⅡ含量变化.结果:ACEi组和Ang(1-7)组SBP,DBP,LVSP, LVdp/dt-max,-LVdp/dtmax较烧伤组均明显增高(P＜0.01),LVEDP和血清cTnI明显降低(P＜0.01),ACEi组血清和心肌中AngⅡ较烧伤组明显降低(P＜0.01).结论:Ang(1-7)和ACEi均能有效的改善大鼠烧伤早期心功能,减轻心肌损伤.     

Taxol inhibits stretch-induced electrophysiological alterations in isolated rat hearts with acute myocardial infarction

Mechanosensitive channels have been determined to work as transducers of mechanoelectric feedback in the heart, which is associated with the generation of arrhythmias. Recent studies have investigated the role of the cytoskeleton in ion channels control. This study explored the ability of taxol to inhibit stretch-induced electrophysiological alterations in the ischemic myocardium. Thirty-two Wistar rats were randomly divided into four groups: normal control group (n=9), taxol group (n=7), myocardial infarction (MI) group (n=9), and MI+taxol group (n=7). After Langendorff perfusion, the isolated hearts were stretched for 5 s by balloon inflation to 0.2 or 0.3 mL. The effects of stretching on 90% monophasic action potential duration (MAPD₉₀), premature ventricular beats (PVB), and ventricular tachycardia (VT) were observed for 30 s. Stretching increased MAPD₉₀ in both the normal control and MI groups, but MAPD₉₀ increased more in the MI group for the same degree of stretch. Taxol (5 μmol L⁻¹) had no effect on MAPD₉₀ under baseline, unstretched conditions, but MAPD₉₀ in the taxol group was slightly increased after stretching compared with the normal control group (P>0.05). However, taxol reduced MAPD₉₀ in infarcted myocardium (P<0.05 at ΔV=0.3 mL). The incidences of PVB and VT in the MI group were higher than in the normal control group (both P<0.01). Taxol had no effect on the occurrence of arrhythmias in normal myocardium, but it inhibited PVB and VT in infarcted hearts (both P<0.01). Thus changes in MAPD and the occurrence of arrhythmias caused by mechanical stretching of the myocardium could be inhibited by taxol in isolated rat hearts during AMI, indicating the involvement of tubulin in mechanoelectric feedback in AMI.     

犬心右室,左室大面积梗塞时的容量负荷评价

在１２只犬,结扎四支冠脉,造成犬心右室、左室大面积梗塞和心源性休克时,左室收缩压（ＬＶＳＰ）及最大正负压力阶差（±ｄｐ／ｄｔｍａｘ．）分别下降５４％、５１％和４７％,而右室收缩压（ＲＶＳＰ）及±ｄｐ／ｄｔｍａｘ．仅降低９％、２５％和２７％。组Ⅰ（６只犬）快速扩容（低分子右旋糖酐３０ｍｌ／ｋｇ,２０ｍｉｎ内静脉输入）,结果右室反向搏动增强,双心室±ｄｐ／ｄｔｍａｘ．进一步降低,右房压（ＲＡＰ）及左室舒张末压（ＬＶＥＤＰ）极度升高达２．９±０．２ｋＰａ和５．０±０．３ｋＰａ（Ｐ均＜０．０１）,甚至诱发室颤。组Ⅱ缓慢静点多巴胺（１０μｇ／ｋｇ·ｍｉｎ）和硝酸甘油（１μｇ／ｋｇ·ｍｉｎ）３０ｍｉｎ,有效提高了动脉压（ＡＰ）,心输出量（ＣＯ）,ＬＶＳＰ及左室±ｄｐ／ｄｔｍａｘ．使休克逆转。结果表明,大面积左、右室梗塞伴休克时,右室残余心肌的代偿性收缩仍能造成ＲＶＳＰ与右室泵功能呈分离状态;此时快速扩容将进一步损害左、右室功能,而联合使用硝酸甘油和多巴胺能有效纠正休克同时不造成ＲＡＰ和ＬＶＥＤＰ的升高。     

共载体AAV-PR39-ADM治疗缺血性心脏病

目的:探讨共载体AAV-PR39-ADM分泌表达血管生成肽(PR39)与血管扩张肽(ADM)对SD大鼠心肌缺血再灌注损伤的作用。方法:选健康成年雄性SD大鼠36只,体重平均为280 g±20 g,随机分为假手术组(SO)、治疗组(TR)与对照组(I/R),每组各12只。治疗组大鼠心肌注射共载体AAV-PR39-ADM感染心肌7天后行B超检查,测量记录左室壁厚度及射血分数(EF%),左室收缩末压(LVSP),左室内压最大上升下降速率(±dp/dt max)评价作为心脏功能指标。对照组建立缺血再灌注损伤模型,假手术组只穿线不结扎且两组行相同检测。速取处死大鼠心肌行masson染色测量心肌梗死面积。结果:治疗组明显高于对照组,其射血分数、左室内收缩末压、最大上升速率,最大下降速率、梗死面积分别为:EF%(50.4±6.3),(29.8±10.5),P0.05;LVSP:(116±4.2),(101±3.7),P0.05;+dp/dt max:(2859±365),(2137±191),P0.05;-dp/dtmax:(2186±107),(1886±124),P0.05;IS%:(29.3±4.6),(24.6±2.2),P0.05。结论:共载体AAV-PR39-ADM能够显著恢复心肌缺血损伤引起的左室内压下降,提高心肌收缩能力,提高射血分数并明显缩小心肌梗死范围。     

The cardioprotective effect of isosteviol on rats with heart ischemia-reperfusion injury

This study was designed to assess the cardioprotective effect of isosteviol on rats with heart ischemia-reperfusion (IR) injury and to explore the mechanism of action of the compound. Sprague Dawley rats were divided into 8 groups (n=10-12): a sham-operated control and 7 ischemia-reperfusion groups (IR control, 3 isosteviol pre-treated (0.5, 1.0 and 2.0 mg kg(-1)), ligustrazine pre-treated, 5-hydroxydecanoate (5-HD) pre-treated and 5-HD+ isosteviol pre-treated groups). IR was produced by occluding the left coronary artery for 30 min followed by re-opening the artery for 90 min. The compounds under investigation were administered intravenously 10 min prior to occluding the artery. Hemodynamic parameters (+/-dp/dt(max), LVSP, LVDevP, MAP), heart rate, ventricular tachycardia (VT) and ventricular fibrillation (VF) were determined during the IR period. The myocardial infarct size, activities of serum lactate dehydrogenase and creatine kinase were determined at the end of the experiment. In the isosteviol pre-treated groups, the hemodynamic parameters were improved and the myocardial infarct size, the activities of serum enzymes, and the incidences of VT and VF were all decreased when compared to the control group. These effects of isosteviol were similar to that of a traditional cardioprotective agent, ligustrazine. The 5-HD+ isosteviol group displayed parameters that were between those in the equivalent isosteviol pre-treated group and the IR control group. In conclusion, damage due to a standard rat heart IR injury was reduced by pretreatment with intravenous isosteviol, and this effect was partly attenuated by a mitochondrial ATP-sensitive potassium channel blocker, 5-HD.     

基于三维超声心动图对比分析扩张型心肌病与二尖瓣关闭不全左室构型和收缩功能的研究

摘要 目的：基于三维超声心动图对比分析扩张型心肌病（DCM）与二尖瓣关闭不全（MI）左室构型和收缩功能的研究。方法：收集我院2018年1月至2021年7月就诊患有左心室（LV）扩张的患者100例,其中DCM患者57例,MI患者43例。LV大小大致相仿,DCM组（43±5）mm/m²,MI组（42±5）mm/m²。另选取同时期50例健康受试者作为对照组。所有患者均进行常规超声心动图及三维超声心动图检查,测量指标主要包括左室大小（LVID）、左室后壁厚度（PWT）、左室舒张末期内径（LVEDD）、左室舒张末期室间间隔厚度（IVS）、左室舒张末期容积（LVEDV）、收缩末期容积（LVESV）、相对室壁厚度（RWT）、LV质量指数（LVMI）、三维左室射血分数（3D-LVEF）、三维舒张末期血流速度（3D-EDV）、二维或三维超声心动图球形指数（2D-SI/3D-SI）。结果：DCM组和MI组LVEDD均大于对照组,差异有统计学意义（P＜0.05）。DCM组比MI组患者心功能分级III/IV和心力衰竭的发生率更高,差异有统计学意义（P＜0.05）。DCM组和MI组患者的LVEDD、LVEDD指数、LVEDV、LVEDV指数、3D-EDV、3D-EDV指数均高于对照组,差异有统计学意义（P＜0.05）;但DCM组和MI组对比差异无统计学意义（P＞0.05）。DCM组和MI组患者的LV长度、LV长度指数、LVMI均高于对照组,差异有统计学意义（P＜0.05）;且MI组高于DCM组,差异有统计学意义（P＜0.05）。DCM组和MI组患者的LVESV、LVESV指数、2D-SI、3D-SI均高于对照组,差异有统计学意义（P＜0.05）;且DCM组高于MI组,差异有统计学意义（P＜0.05）。DCM组3D-LVEF、RWT均低于对照组和MI组,差异有统计学意义（P＜0.05）。ROC分析显示,3D-SI在评估左室扩大患者的左室重构方面优于其他变量,3D-SI的ROC曲线下面积为0.875,95%CI为0.816-0.920,3D-SI>0.62对于DCM和MI区分左室构型的特异性（81.66%）和敏感性（92.09%）较高。DCM和MI患者的3D-LVEF和3D-SI均呈线性负相关（r=-0.719,P=0.000;r=-0.682,P=0.000）。DCM和MI患者3D-SI检测心力衰竭的ROC曲线下面积均大于3D-LVEF的ROC曲线下面积,差异有统计学意义（P=0.000）。结论：与MI患者相比,尽管LV大小大致相仿,但DCM患者的左室几何形状更接近球形,且收缩功能更差。收缩功能与3D-SI显著相关,3D-SI较好地描述了左室重构,可能是LV扩张患者心力衰竭的较强指标。     

Preserved ventricular contractility in infarcted mouse heart overexpressing beta(2)-adrenergic receptors

Effects of cardiac specific overexpression of beta(2)-adrenergic receptors (beta(2)-AR) on the development of heart failure (HF) were studied in wild-type (WT) and transgenic (TG) mice following myocardial infarction (MI) by coronary artery occlusion. Animals were studied by echocardiography at weeks 7 to 8 and by catheterization at week 9 after surgery. Post-infarct mortality, due to HF or cardiac rupture, was not different among WT mice, and there was no difference in infarct size (IS). Compared with the sham-operated group (all P < 0.01), WT mice with moderate (<36%) and large (>36%) IS developed lung congestion, cardiac hypertrophy, left ventricular (LV) dilatation, elevated LV end-diastolic pressure (LVEDP), and suppressed maximal rate of increase of LV pressure (LV dP/dt(max)) and fractional shortening (FS). Whereas changes in organ weights and echo parameters were similar to those in infarcted WT groups, TG mice had significantly higher levels of LV contractility in both moderate (dP/dt(max) 4,862 +/- 133 vs. 3,694 +/- 191 mmHg/s) and large IS groups (dP/dt(max) 4,556 +/- 252 vs. 3,145 +/- 312 mmHg/s, both P < 0.01). Incidence of pleural effusion (36% vs. 85%, P < 0.05) and LVEDP levels (6 +/- 0.3 vs. 9 +/- 0.8 mmHg, P < 0.05) were also lower in TG than in WT mice with large IS. Thus beta(2)-AR overexpression preserved LV contractility following MI without adverse consequence.     

Actin cytoskeletons regulate the stretch-induced increase of Ca2+ current in human gastric myocytes

Using the whole-cell and single channel recording techniques, the influence of actin cytoskeletons on L-type Ca2+ current was investigated in human gastric smooth muscle cells. In isotonic condition, an actin depolymerizer cytochalasin D (Cyt-D) markedly decreased the whole-cell current (I(Ba)) without changing steady-state voltage dependency and single channel conductance. Intracellular dialysis of phalloidin, an actin polymerizer, significantly increased the I(Ba). Hypotonic stretch (222 mOsm/L) of the myocytes increased the I(Ba), and Cyt-D significantly inhibited the I(Ba) increase by the stretch. Phalloidin was without effect on the I(Ba) increase by the stretch. Phalloidin antagonized the Cyt-D inhibition of the stretch-induced I(Ba) increase. Neither heterotrimeric G protein modifiers (GTPgammaS and GDPbetaS) nor rho GTPase inhibitor (C3 exoenzyme) influenced the stretch-induced responses. These results reveal that the integrity of the actin cytoskeleton is an important factor which determines the activity of L-type Ca2+ channels and a response to stretch.     

人参皂苷Rg2对异丙肾上腺素诱导的大鼠心室重构的保护作用

目的：探讨人参皂苷Rg2对异丙肾上腺素诱导的心室重构模型大鼠的保护作用。方法：将60只雄性Wistar大鼠随机分为对照组、心室重构模型组、人参皂苷Rg2（20、40、80 mg/kg）组和普萘洛尔（propranolol,15 mg/kg）组,n=10。采用多点皮下注射异丙肾上腺素85 mg/（kg·d）,连续7 d,建立大鼠心室重构模型;对照组皮下注射等体积的生理盐水。此后按分组灌胃给药,每天1次,连续给药6 w后,使用八道生理记录仪测定血流动力学参数,并测定心脏重量和左心室重构指数。结果：与对照组相比,注射异丙肾上腺素后第7周时模型组大鼠颈动脉收缩压、舒张压、平均动脉压、心率、LVSP、+dp/dt_max、-dp/dt_max显著降低（P<0.01）;而HW/BW和LVW/BW、LVDP显著升高（P<0.01）。与模型组相比,人参皂苷Rg2低、中、高剂量组和普萘洛尔组大鼠颈动脉收缩压、舒张压、平均动脉压、心率、LVSP、+dp/dt_max、-dp/dt_max显著升高（P<0.05,P<0.01）;LVDP显著降低（P<0.01）,而人参皂苷Rg2中、高剂量组和普萘洛尔组大鼠HW/BW和LVW/BW显著降低（P<0.01）。与普萘洛尔组相比,人参皂苷Rg2低剂量组收缩压、舒张压、平均动脉压显著降低（P<0.05,P<0.01）;人参皂苷Rg2低剂量组LVDP和高剂量组LVSP和+dp/dt_max显著升高（P<0.05,P<0.01）。结论：人参皂苷Rg2对异丙肾上腺素所致的心室重构模型大鼠具有改善作用。     

Cardiac adrenomedullin gene expression and peptide accumulation after acute myocardial infarction in rats

Plasma adrenomedullin (AM) has been shown to increase in the early phase of acute myocardial infarction (MI). However, little information is available regarding cardiac AM synthesis after MI. Accordingly, we examined the time course of ventricular AM production and potential stimulation of AM in the infarcted and noninfarcted regions in MI rats produced by coronary artery ligation. Compared with sham-operated rats, the ventricular AM peptide level 6 h after MI increased 1.5-fold in the infarcted region and 1.7-fold in the noninfarcted region in association with increased left ventricular end-diastolic pressure (EDP). Northern blot analysis also showed marked induction of AM gene expression in the infarcted region (11-fold) and the noninfarcted region (6-fold) 6 h after MI. The AM peptide level in the infarcted region reached its peak (2. 6-fold) 1 wk postinfarction and thereafter decreased to normal. In the noninfarcted region, however, the AM level remained elevated for at least 4 wk. Immunohistochemical studies demonstrated that intense immunostaining for AM was limited to myocytes in both the infarcted and noninfarcted regions. Interestingly, the AM level in the noninfarcted region correlated positively with infarct size (r = 0. 40, P < 0.01) and EDP (r = 0.52, P < 0.001). An oral angiotensin-converting enzyme inhibitor suppressed the overproduction of AM 1 wk postinfarction in association with decreases in EDP and mean arterial pressure. In summary, cardiac AM synthesis was rapidly induced in both the infarcted and noninfarcted regions after MI. The subsequent ventricular AM in the two regions demonstrated different time-concentration curves during 4 wk after MI. AM may be synthesized predominantly by cardiac myocytes, but not by fibroblasts, at least in part, in association with increased ventricular load after MI.     

Canine model of paroxysmal atrial fibrillation and paroxysmal atrial tachycardia

Both autonomic nerve activity and electrical remodeling are important in atrial arrhythmogenesis. Therefore, dogs with sympathetic hyperinnervation, myocardial infarction (MI), and complete atrioventricular block (CAVB) may have a high incidence of atrial arrhythmias. We studied eight dogs (experimental group) with MI, CAVB, and sympathetic hyperinnervation induced either by nerve growth factor infusion (n = 4 dogs) or subthreshold electrical stimulation (n = 4 dogs) of the left stellate ganglion. Cardiac rhythm was continuously monitored by a Data Sciences International transmitter for 48 (SD 27) days. Three normal control dogs were also monitored. Six additional normal dogs were used for histology control. Paroxysmal atrial fibrillation (PAF) and paroxysmal atrial tachycardia (PAT) were documented in all dogs in the experimental group, with an average of 3.8 (SD 3) episodes/day, including 1.3 (SD 1.6) episodes of PAF and 2.5 (SD 2.2) episodes of PAT. The duration averaged 298 (SD 745) s (range, 7-4,000 s). There was a circadian pattern of arrhythmia onset (P < 0.01). Of 576 episodes of PAF and PAT, 236 (41%) episodes occurred during either sustained or nonsustained ventricular tachycardia (VT). Among these 236 episodes, 53% started before VT, whereas 47% started after the onset of VT. Normal dogs did not have either PAF or PAT. The hearts from the experimental group had a higher density of nerve structures immunopositive (P < 0.01) for three different nerve specific markers in both right and left atria than those of the control dogs. We conclude that the induction of nerve sprouting and sympathetic hyperinnervation in dogs with CAVB and MI creates a high yield model of PAF and PAT.