急性实验中用长度计对狗在位心脏局部心肌功能的评定

本文用自制充水银硅胶管长度计记录了开胸狗左心室局部心肌的长度和压力-长度环。观察到(1)局部心肌的搏功对应心室舒张末期压所绘制的局部心肌功能曲线,与心室功能曲线两者形态相似,均为拋物线升支,回归方程分别为:(?)=-1413.9860 25.9511X-0.1128X~2和(?)=-271.5947 207.4281X-5.0468X~2;(2)心室舒张末期压对应局部心肌舒张末期长度构成的舒张末期压力-长度关系,呈指数曲线。同一条狗,在对照、收缩性能增加和后负荷增加等情况下,回归方程式分別为(?)=e~(0.1356g-1.3706)、(?)=e~(0.0465x-3.9856)和(?)=e~(0.1127x-9.5596)。本文结果表明,局部心肌的长度、压力一长度环,以及由此推导的局部心肌搏功、功能曲线和舒张末期压力-长度关系,可以作为评定局部心肌功能,Frank-Starling 效应、收缩性能和舒张顺应性的有效指标。     

白细胞介素-2对大鼠心肌收缩功能的影响涉及一氧化氮机制

为深入研究细胞因子白细胞介素-2(interleukin-2,IL-2)对心肌收缩功能的影响及其可能机制,本实验采用酶解分离成年大鼠心室肌细胞模型,用视频跟踪计算机系统记录测定单个心室肌细胞收缩反应并用双波长荧光系统检测细胞[Ca2+]i.心肌细胞收缩参数包括最大收缩幅度(dL)、细胞最大收缩速度(+dL/dtmax)、细胞最大舒张速度(-dL/dtmax)和舒张末期细胞长度.结果显示,IL-2(2-1000U/ml)浓度依赖性地抑制心肌细胞dL、±dL/dtmax和舒张末期细胞长度;用一氧化氮(ni-tric oxide,NO)合酶抑制剂L-NAME(100mmol/L)和可溶性鸟苷酸环化酶(sGC)抑制剂ODQ(10mmol/L)可减弱IL-2对心肌细胞收缩的抑制作用,iNOS抑制剂Aminoguanidine(100mmol/L)对IL-2的作用则无明显影响.200 U/ml的IL-2可降低单个心室肌细胞电刺激诱导的钙瞬变幅度;ODQ(10mmol/L)可明显抑制IL-2对心肌细胞钙瞬变的作用.以上结果提示IL-2对大鼠心肌细胞收缩功能具有直接抑制作用,其机制可能通过刺激NOS活性,增加NO的生成,激活可溶性鸟苷酸环化酶(sGC)从而导致细胞内Ca2+含量降低所致.     

关于左室等容收缩相心肌收缩性能指标的实验研究

实验在麻醉开胸狗身上进行。用装有微分器的八道生理功能记录仪测取左室肌收缩性能的等容收缩相指标:(1)左室内压最大变化速率(dP/dt max)和(2)心肌收缩成分缩短速度(V_(CE)):包括 V_(CE)的生理最大值(V_(pm))、同最高等容收缩压时的 V_(CE)(V_(CE)-cpip)和 V_(CE)的最大值(V_(max))等。同时,利用示波摄影装置摄制左室内压-压力变化速率环(P-dP/dt 环)和左室内压-压力对数值变化速率环(P-(dP/dt)/P 环)。讨论了两环的形态特征以及干扰两环图形的方法学因素。本文认为,摄制 P-dP/dt 环和 P-(dP/dt)/P 环的优点在于:可以在两环上分析心动周期中任一瞬间 P 与 dP/dt 以及 P 与(dP/dt)/P 的对应关系;依据这两项对应的压力-速率关系,可以方便且准确地在同一个 P-(dP/dt)/P 环上测取 V_(pm)、V_(CE)-(CPiP)和 V_(max)等一系列 V_(CE)指标。实验结果表明,dP/dt max 和 V_(CE)这两类指标对正性变力性干预都比较敏感,受负荷状态的影响较小,因而,对评定心肌收缩性能的急性改变,有较高价值。两类指标相比较,V_(CE)类对变力性干预的敏感性低于 dP/dt max,但对负荷状态的依赖性较小。因此,采用多个指标综合评定心脏功能,较单一指标为宜。     

心室压力瞬时加速度的测定及其意义

本工作对国产SJ-42型四道生理记录仪进行改进,增加了记录压力二阶微分曲线的功能。经比较研究家兔左心室压力一阶微分与二阶微分指标后发现,(d~2p/dt~2)max对心肌变力作用的敏感性比(dp/dt)max高出1/3左右,两项指标对心脏前后负荷和心率均具有一定的依赖性,但两者间无明显差异,提示用心室压力瞬时加速度指标评价心脏收缩性能比用压力瞬时速率指标更为灵敏可靠。     

犬双心室多点组合同步起搏的心肌力学效应研究

目的 :探讨多点组合同步心室起搏对犬心肌收缩 /舒张力学效应和心脏作功的影响。方法 :12只犬 ,随机进行 5种组合模式的双心室同步起搏 ,并以自身窦性心律状态 (SNR )作为对照。记录各起搏状态下 :左室内压上升和下降最大数率 (±dp/dtmax)、左室松弛时间常数 (τ)、左 /右室游离壁室壁肌张力 (L/RV tensileforce ,L/RV TF)、每搏量 (SV )、左室每搏功 (LVSW )和右室每搏功 (RVSW )等心肌收缩 /舒张力学和心脏作功参数。结果 :双室cHisB LVPL起搏和RVA LVPL起搏的心肌收缩力学参数 +dp/dtmax和L/RV TF较右室双点cHisB RVA起搏增加 ,前两组的心肌舒张力学参数 dp/dtmax也较cHisB RVA起搏增加 ,而τ值较后者缩短。双室三点cHisB RVA LVPL起搏和cHisB RVA LVA起搏的上述各参数均优于双室cHisB LVPL起搏和RVA LVPL起搏。而cHisB RVA LVPL起搏的 +dp/dtmax和L/RV TF均较cHisB RVA LVA起搏增加。cHisB RVA LVPL起搏 dp/dtmax较cHisB RVA LVA起搏提高 6.0 % ,τ值缩短 3 .7%。cHisB LVPL起搏和RVA LVPL起搏的SV、LVSW和RVSW等心室作功参数均较cHisB RVA起搏增加 ,而HisB RVA LVPL起搏的上述心脏作功各参数 ,亦分别较cHisB RVA LVA起搏和cHisB LVPL起搏有不同程度的增加。结论 :双室三点cHisB RVA LVPL组合同     

家兔急性缺血早期心室肌细胞跨膜电位的变化及迷走神经的保护作用

以在体家兔的心脏为对象,应用浮置微电极技术研究了急性缺血早期心室肌细胞跨膜电位的变化及迷走神经的保护作用。 冠状动脉的一个分支阻断后 1—5min,静息电位(RP)、动作电位振幅(APA)和 0相最大上升速率(dv/dt)_(max)均减小(P<0.01)。动作电位时程APD_(30)、APD_(50)和APD_(90)均缩短(P<0.01)。反映 2相平台时程的 APD_(30)和 APD_(50)缩短较总时程 APD_(90)的缩短更明显。 在自然心率的条件下,左颈迷走神经电刺激,可使急性缺血的心肌电位的变化有所恢复:RP、APA、(dv/dt)_(max)均增加,APD_(30)、APD_(50)、APD_(90)延长(P_均<0.01)。刺激迷走神经时缺血的心室肌细胞跨膜电位有所恢复,对防止缺血早期的室性心律失常可能具有重要作用。     

氨甲酰胆碱(Carbamylcholine)对大鼠缺血心室致颤阈值的影响及其与cAMP、cGMP的关系

本实验以心室颤动阈(VFT)作为心室易颤性的指标,观察胆碱类物质氨甲酰胆碱对大鼠缺血心室 VFT 的影响及其与心肌 cAMP 和 cGMP 水平的关系。实验结果表明,氨甲酰胆碱可提高正常心脏和急性局部缺血心脏的 VFT,提高缺血和未缺血心肌的 cGMP 水平,但明显降低缺血心肌 cAMP 水平,使缺血和未缺血心肌的 cAMP/cGMP 比值显著降低,其作用与肾上腺素正好相反。实验结果还表明,急性局部缺血心脏的 VFT 与缺血心肌 cAMP/cGMP 比值之间有密切的负相关关系,相关系数 r=-0.905(n=22,P<0.001)。上述结果提示缺血心肌 cAMP/cGMP 比值的提高可能是急性心肌梗塞早期发生心室纤维性颤动的重要因素。     

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.     

缺氧对离体猫心乳头肌力学的影响

本文研究缺氧对离体猫心乳头肌力学的影响,以探讨缺血性心肌损伤中缺氧这一因素所起的作用。结果表明:①-dT/dt max/Tmax(舒张指标之一)在缺氧 lmin 时明显降低(P<0.05),而所有收缩指标无变化。②缺氧4min 时,-dT/dt max 降低16.7%(P<0.01),而 dT/dt max 在缺氧7min 时才降低16.6%(P<0.05)。③在缺氧4min 时,所有舒张指标已发生显著的变化,而所有收缩指标在缺氧7min 时才有明显改变。缺氧对离体猫心乳头肌的收缩过程和舒张过程都有影响,但是舒张过程的变化较之收缩过程出现更早,且较明显。     

清醒狗短暂缺血心肌复灌注时舒缩功能的变化

在狗的心脏上装入微超声探头和高精度微压力传感器,手术后两星期,在清醒状态下给予左冠状动脉旋支阻断三分钟。在复灌注过程中,观察到血液动力学指标与收缩期心室壁厚度(WT)迅速恢复正常;但在 dWT/dt—WT 环形图上出现舒张早期异常相,其形状与缺血过程不同。低氧和急遽冠状动脉过度充盈可以产生此种异常图形。我们推测,心肌缺血可能促使一些产物的形成,复灌注时它使冠脉过度舒张,冠脉灌注增加,从而造成舒张早期急遽充盈而形成了此种异常的形图。     

Hyperbaric oxygen preconditioning alleviates myocardial ischemic injury in rats

It has been shown that after ischemia-reperfusion, application of hyperbaric oxygen (HBO) reduces cardiac injury. In this study we tested the hypothesis that HBO preconditioning reduces injury to the ischemic myocardium. One hundred and eight adult male Sprague-Dawley rats (250-280 g) were randomly divided into four groups: normoxia + sham surgery (CS), normoxia + permanent occlusion of the left anterior descending (LAD) coronary artery (CMI), HBO preconditioning + sham surgery (HS), and HBO preconditioning + permanent LAD occlusion (HMI). Rats receiving HBO preconditioning were intermittently exposed to 100% O(2) at 2.5 atmosphere absolute (ATA) for 60 min, twice daily for 2 days followed by 12 hrs of recovery in room air prior to the myocardial ischemic insult induced by LAD ligation. Rats in the normoxia group were time-matched with the HBO group and maintained under normoxic conditions prior to LAD occlusion. At 3 and 7 days after LAD occlusion, heart function parameters were measured by inserting a catheter into the left ventricle, infarct size was calculated using the method of TTC staining, myocardial capillary density was determined by immunohistochemical staining with a monoclonal anti-CD(31)/PECAM-1 antibody, and VEGF protein level was determined by Western blot analysis. At 3 days after LAD ligation, the infarct size of the HMI group was significantly smaller than that of the CMI group (26 +/- 2.5% vs. 38 +/- 3%, P < 0.05). The heart function parameters including left ventricular systolic pressure (LVSP), +dP/dt(max) and -dP/dt(max) were significantly improved in the HMI group compared to the CMI group at 3 and 7 days after LAD occlusion. Capillary density and VEGF protein levels were significantly increased in the ischemic myocardium pre-exposed to HBO. We conclude that HBO preconditioning alleviates myocardial ischemia in rat model.     

Role of nucleoside transport and purine release in a rabbit model of myocardial stunning

Previously, we have demonstrated the role of nucleoside transport and purine release in post-ischemic reperfusion injury (myocardial stunning) in several canine models of ischemia. Since rabbits are deficient of xanthine oxidase, it is not known whether selective blockade of purine release is beneficial in a rabbit model of coronary artery occlusion and reperfusion (stunning). Therefore, we determined the hemodynamic and metabolic correlates in response to myocardial stunning in the presence or absence of selective nucleoside transport blocker (p-nitrobenzylthioinosine, NBMPR) and adenosine deaminase inhibitor (erythro-9-(2-hydroxy-3-nonyl)adenine, EHNA).Sixty adult anaesthetized rabbits were surgically prepared for hemodynamic measurements. After stabilization period, the left anterior descending coronary artery was occluded for 15 min and reperfused for 30 min. Transmural myocardial biopsies were obtained from the ischemic LAD area and from the non-ischemic posterior (circumflex, CFX) segment of the myocardium.Rabbits (n = 60) were randomly assigned to either the control or the EHNA/NBMPR-treated group (n = 30 each). Each group was further divided to either functional or metabolic groups (n = 15 each subgroup). Each animal received intravenously 30 ml of either a vehicle solution or 100 M EHNA and 25 M NBMPR 10 min before ischemia.Although administration of EHNA/NBMPR did not affect the heart rate, it did cause mild hypotension (about 20-30%). Fifteen minutes of LAD occlusion resulted in significant ATP depletion and concomitant accumulation of nucleosides in both groups (p < 0.05 vs. baseline and non-ischemic CFX segment). AMP was higher in the LAD compared to the CFX segment. Significant accumulation of adenosine was observed in the treated group compared to the control group.It is concluded that EHNA/NBMPR induced site specific entrapment of adenosine of nucleoside transport in the rabbit heart, in vivo.     

Non-ischemic myocardial preconditioning

The reduction of infarct size produced by brief ischemic episodes prior to a sustained occlusion of a coronary artery, called ischemic preconditioning, is a well known phenomenon that occurs in several species, but its mechanism is still under investigation. Recent reports support the idea that this protection can also be obtained by non-ischemic maneuvers like distention of the left ventricle and metabolic stimulation of myocardial cells. The features of non-ischemic preconditioning (temporal limitation, second window, tolerance development, remote preconditioning and efficiency of the protection), as opposed to those of ischemic preconditioning, are still to be determined. Neither is it known if non-ischemic preconditioning occurs in humans. From a physiological point of view the protective effect of an increase in metabolic rate of the heart means a constant feed-back mechanism in the myocardial cell that counteracts the presumptive damage consequent to the increase in metabolism. Therefore, in the presence of a sudden coronary occlusion the metabolic rate of the heart immediately before the occlusion would have a dual role of increasing the degree of ischemia and of protecting against it.     

Effect of ethanol on myocardial infarct size in a canine model of coronary artery occlusion-reperfusion

This study was conducted to determine if elevated blood alcohol prior to acute coronary artery occlusion affects myocardial infarct size in an in vivo canine model. Seven pentobarbital anesthetized open-chest dogs received 10 min Iv infusion of ethanol (0.08 g/kg/min). Ten min after ethanol, the left anterior descending coronary artery (LAD) was occluded distal to its first major branch for 60 min. The LAD was then reperfused for 5 h. Following electrically induced ventricular fibrillation, the area at risk of infarction was delineated with dye. The area of infarction was identified by staining with triphenyl tetrazolium chloride. Eleven untreated control experiments were also conducted. Mean blood ethanol concentration was 155 ± 26 mg/dl just prior to LAD occlusion and 47 ± 3 mg/dl after 4 h reperfusion. Ethanol infusion had no effect on systemic hemodynamic variables during ischemia. In ethanol treated animals, the area at risk was 19.7 ± 3.0% of the left ventricle, and the infarct size was 20.9 ± 4.8% of the area at risk. In control experiments, the area at risk was 23.0 ± 4.1% of the left ventricle (p > 0.05), and the infarct size was 21.6 ± 3.8% of the area at risk (p > 0.05). Collateral blood flow to ischemic region did not differ between the two groups, and the relationships between infarct size and collateral flow were similar for control and untreated hearts. Acute ethanol exposure prior to coronary artery occlusion and subsequent reperfusion does not affect myocardial infarct size in the heart of the anesthetized dog.     

Development of a preclinical model of ischemic cardiomyopathy in swine

A number of promising therapies for ischemic cardiomyopathy are emerging, and the role of translational research in testing the efficacy and safety of these agents in relevant clinical models has become important. The goal of this study was to develop a chronic model of ischemic cardiomyopathy in a large animal model. In this study, 40 consecutive pigs were initially enrolled. To induce progressive stenosis, a plastic occluder with a fixed diameter of 1.0 mm fitted with an 18-gauge copper wire was placed around the proximal left anterior descending (LAD) coronary artery. Coronary angiography, hemodynamic measurements, and echocardiography were performed at 2 wk and 1, 2, and 3 mo. Overall mortality was 26% at 3 mo, and up to 80% of the pigs showed total occlusion of LAD at 1 mo. A significant depression of peak LV pressure rate of rise (+dP/dt(max)) was observed in the animals showing total artery occlusion throughout the study. Left ventricular ejection fraction was also impaired, and the left ventricular volumes tended to be larger in the pigs with occlusion. Approximately 10% of scar tissue was found in the LAD occluded pigs, whereas the coronary flow pattern in the rest of the area took the pattern of hibernating myocardium. At the same time, histological and protein analysis established the presence of fibrosis and ongoing apoptosis in the ischemic area. In this model, the timing and incidence of total occlusion and low mortality offer significant advantages over other ischemic cardiomyopathy models in conducting preclinical studies.     

Differing cardioprotective efficacy of the Na+/Ca2+ exchanger inhibitors SEA0400 and KB-R7943

KB-R7943 and SEA0400 are Na(+)/Ca(2+) exchanger (NCX) inhibitors with differing potency and selectivity. The cardioprotective efficacy of these NCX inhibitors was examined in isolated rabbit hearts (Langendorff perfused) subjected to regional ischemia (coronary artery ligation) and reperfusion. KB-R7943 and SEA0400 elicited concentration-dependent reductions in infarct size (SEA0400 EC(50): 5.7 nM). SEA0400 was more efficacious than KB-R7943 (reduction in infarct size at 1 microM: SEA0400, 75%; KB-R7943, 40%). Treatment with either inhibitor yielded similar reductions in infarct size whether administered before or after regional ischemia. SEA0400 (1 microM) improved postischemic recovery of function (+/-dP/dt), whereas KB-R7943 impaired cardiac function at >/=1 microM. At 5-20 microM, KBR-7943 elicited rapid and profound depressions of heart rate, left ventricular developed pressure, and +/-dP/dt. Thus the ability of KB-R7943 to provide cardioprotection is modest and limited by negative effects on cardiac function, whereas the more selective NCX inhibitor SEA0400 elicits marked reductions in myocardial ischemic injury and improved +/-dP/dt. NCX inhibition represents an attractive approach for achieving clinical cardioprotection.     

Effects of yohimbine and desipramine on cardiac noradrenaline release and ventricular arrhythmias during acute coronary artery occlusion and reperfusion in anesthetized dogs

Effects of yohimbine (YHMB, an alpha 2-antagonist) and desipramine (DMI, a neuronal uptake inhibitor) were compared on cardiac noradrenaline (NA) release either upon left ansa subclavia nerve stimulation during acute occlusion of the left anterior descending coronary artery (LAD) or upon subsequent LAD reperfusion without stimulation in anesthetized dogs. In control dogs, before LAD occlusion, coronary sinus (CS) NA output increased from 5.4 +/- 1.0 to 26.8 +/- 4.0 ng/min (p less than 0.05) upon stimulation (2 Hz, 30 s). The response to stimulation remained unchanged 25 min after LAD occlusion. During reperfusion 60 min after occlusion, the output of CS-NA and lactate increased from 6.1 +/- 0.8 to 51.3 +/- 19.4 ng/min (p less than 0.05) and from 2.7 +/- 0.5 to 6.7 +/- 1.3 mg/min (p less than 0.05), respectively. In dogs treated with YHMB, the stimulation-induced increase in NA output was potentiated at least fourfold (p less than 0.05) either before or during LAD occlusion, but not during reperfusion. In dogs receiving DMI, stimulation-induced CS-NA output was enhanced to a similar extent (approximately twofold, p less than 0.05) either before or during occlusion, while reperfusion-induced NA output was markedly potentiated by approximately ninefold (p less than 0.05). Maximum dP/dt of left ventricular pressure remained unchanged upon reperfusion in all groups. The total arrhythmic ratio in the drug-treated groups did not significantly differ from the ratio in control dogs upon either stimulation or reperfusion. The data suggest that an abrupt increase in NA output upon reperfusion may result from a washout of NA locally accumulated in the ischemic and (or) peri-ischemic region during the preceding occlusion period, and that NA thus released does not have substantial hemodynamic effects. The results indicate that in the presence of YHMB or DMI, the potentiated increase in NA release in response to either nerve stimulation during LAD occlusion or to reperfusion without stimulation did not aggravate ventricular arrhythmia, most probably owing to the antiarrhythmic properties of these substances.     

Short-term exercise improves myocardial tolerance to in vivo ischemia-reperfusion in the rat.

These experiments examined the independent effects of short-term exercise and heat stress on myocardial responses during in vivo ischemia-reperfusion (I/R). Female Sprague-Dawley rats (4 mo old) were randomly assigned to one of four experimental groups: 1) control, 2) 3 consecutive days of treadmill exercise [60 min/day at 60-70% maximal O2 uptake (VO2 max)], 3) 5 consecutive days of treadmill exercise (60 min/day at 60-70% VO2 max), and 4) whole body heat stress (15 min at 42 degrees C). Twenty-four hours after heat stress or exercise, animals were anesthetized and mechanically ventilated, and the chest was opened by thoracotomy. Coronary occlusion was maintained for 30-min followed by a 30-min period of reperfusion. Compared with control, both heat-stressed animals and exercised animals (3 and 5 days) maintained higher (P < 0.05) left ventricular developed pressure (LVDP), maximum rate of left ventricular pressure development (+dP/dt), and maximum rate of left ventricular pressure decline (-dP/dt) at all measurement periods during both ischemia and reperfusion. No differences existed between heat-stressed and exercise groups in LVDP, +dP/dt, and -dP/dt at any time during ischemia or reperfusion. Both heat stress and exercise resulted in an increase (P < 0.05) in the relative levels of left ventricular heat shock protein 72 (HSP72). Furthermore, exercise (3 and 5 days) increased (P < 0.05) myocardial glutathione levels and manganese superoxide dismutase activity. These data indicate that 3-5 consecutive days of exercise improves myocardial contractile performance during in vivo I/R and that this exercise-induced myocardial protection is associated with an increase in both myocardial HSP72 and cardiac antioxidant defenses.     

小型猪急性心肌梗死后心力衰竭模型的构建

目的应用选择性冠状动脉前降支(LAD)球囊闭塞结合微血栓微球混悬液灌注方法造成心肌缺血坏死,探索建立稳定存活的小型猪急性心肌梗死(AMI)后心力衰竭(HF)动物模型。方法选择中国五指山小型猪18头,行冠脉造影后沿血管送球囊至LAD中段,依次扩张球囊阻断前向血流1、2、5 min,每次间隔60 s,然后扩张球囊堵闭血流120 min。再以4F导管超选LAD,行微血栓微球混悬液分次注入,间隔10 min重复注射,TIMI心肌灌注分级(TMPG)2级和左室舒张末压(LVEDP)15 mm Hg时停止注射,同时监测心电图及应用漂浮导管监测有创血流动力学参数。并行pigtail导管测量(LVEDP)的变化,待LVEDP稳定在15~18 mm Hg之间后结扎血管,并加压包扎。监测心肌坏死标志物(cTnI和CK-MB)变化。分别于制模前,制模后第1天、7天、14天行心脏超声检查,制模第14天复查有创血流动力学检查,并行心脏病理检查,认定和评价模型的成功率、稳定性和可重复性。结果制模14 d后共有15头小型猪成活,心电图、心肌坏死标记物、病理检查均符合AMI病理生理过程。其中14头小型猪达到动物模型标准【肺毛细血管楔压(PCWP)18 mmHg和心输出量(CO)下降30%以上】,模型成功率为77.78%。制模后第14天PCWP明显升高(P0.01),CO平均下降50.76%;左室射血分数(LVEF)明显降低(P0.01)。病理检查显示心肌梗死面积占左心室面积的25.4%~34.9%。结论球囊闭塞结合微血栓微球混悬液灌注构建小型猪急性心肌梗死后心力衰竭模型具有闭胸、高成功率、稳定和重复性好等优点,较药物、冠状动脉结扎和起搏诱导的心力衰竭模型更接近临床病理生理学特点。     

Cardioprotective effects of stretch are mediated by activation of sarcolemmal, not mitochondrial, ATP-sensitive potassium channels

To determine whether sarcolemmal and/or mitochondrial ATP-sensitive potassium (K(ATP)) channels (sarcK(ATP), mitoK(ATP)) are involved in stretch-induced protection, isolated isovolumic rat hearts were assigned to the following protocols: nonstretched hearts were subjected to 20 min of global ischemia (Is) and 30 min of reperfusion, and before Is stretched hearts received 5 min of stretch + 10 min of no intervention. Stretch was induced by a transient increase in left ventricular end-diastolic pressure (LVEDP) from 10 to 40 mmHg. Other hearts received 5-hydroxydecanoate (5-HD; 100 microM), a selective inhibitor of mitoK(ATP), or HMR-1098 (20 microM), a selective inhibitor of sarcK(ATP), before the stretch protocol. Systolic function was assessed through left ventricular developed pressure (LVDP) and maximal rise in velocity of left ventricular pressure (+dP/dt(max)) and diastolic function through maximal decrease in velocity of left ventricular pressure (-dP/dt(max)) and LVEDP. Lactate dehydrogenase (LDH) release and ATP content were also measured. Stretch resulted in a significant increase of postischemic recovery and attenuation of diastolic stiffness. At 30 min of reperfusion LVDP and +dP/dt(max) were 87 +/- 4% and 92 +/- 6% and -dP/dt(max) and LVEDP were 95 +/- 9% and 10 +/- 4 mmHg vs. 57 +/- 6%, 53 +/- 6%, 57 +/- 10%, and 28 +/- 5 mmHg, respectively, in nonstretched hearts. Stretch increased ATP content and did not produce LDH release. 5-HD did not modify and HMR-1098 prevented the protection achieved by stretch. Our results show that the beneficial effects of stretch on postischemic myocardial dysfunction, cellular damage, and energetic state involve the participation of sarcK(ATP) but not mitoK(ATP).