磁共振成像对扩张型心肌病转基因模型小鼠左右心室对比分析

目的对cTnTR141W扩张型心肌病转基因模型小鼠左、右心室进行对比分析,研究cTnTR141W转基因小鼠作为右心室心肌病的动物模型的可行性。方法利用7.0 T高场强磁共振成像(MRI)技术,定量分析了2、4、6和8月龄对照组及cTnTR141W转基因模型小鼠左、右心室的舒张末容积(EDV)、收缩末容积(ESV)和射血分数(EF)的变化情况,同时对6月龄对照组cTnTR141W转基因模型小鼠心肌组织进行组织学分析。结果转基因阴性对照小鼠相比,cTnTR141W转基因小鼠左、右心室的容积在2月龄时已有增大趋势,而射血分数有减小趋势。右心室射血分数减小出现最早也最显著(P<0.05)。随年龄增加,cTnTR141W转基因小鼠与转基因阴性对照小鼠相比,右心室的结构和功能的病理生理变化与左心室同时趋于严重。该小鼠左、右心室在4月龄后表现典型的扩张型心肌病表型。结论 cTnTR141W转基因模型小鼠左心室和右心室的扩张性心肌病表型同时出现,该小鼠可作为右室性心肌病等右心室功能下降相关疾病研究的动物模型。     

cTnT^R92Q转基因小鼠肥厚型心肌病模型的建立

目的建立cTnT^R92Q肥厚型心肌病的转基因小鼠模型。方法把cTnT^R92Q基因插入-αMHC启动子下游,构建转基因表达载体,通过显微注射法建立cTnT^R92Q转基因C57BL/6J小鼠。PCR鉴定cTnT^R92Q转基因小鼠的基因表型,RT-PCR检测基因表达,光学显微镜和超声检测cTnT^R92Q转基因小鼠心脏的病理改变。结果建立了3个不同表达水平的cTnT^R92Q转基因小鼠品系。转入的cTnT^R92Q基因在心脏组织的表达水平高于内源性cTnT。组织学分析显示cTnT^R92Q转基因小鼠心脏变大,心室壁肥厚,心腔变小,心肌细胞排列紊乱,心肌间质纤维增多。超声检查显示心室壁变厚,收缩期容积和舒张期容积显著缩小,射血分数、短轴缩短率明显增加。结论cTnT^R92Q转基因小鼠心脏变大,室壁变厚,心腔变小,心肌细胞排列紊乱,间质纤维化以及心肌舒张功能失调,说明成功建立了cTnT^R92Q转基因小鼠肥厚型心肌病模型,为研究肥厚型心肌病发病机制和药物研发提供了有价值的动物模型。     

cTnT^（R141W）转基因小鼠扩张型心肌病模型的建立

目的建立cTnT^R141W扩张型心肌病的转基因小鼠模型。方法把cTnT^R141W基因插入-αMHC启动子下游,构建转基因表达载体,通过显微注射法建立cTnT^R141W转基因C57BL/6J小鼠。PCR鉴定cTnT^R141W转基因小鼠的基因表型,实时PCR检测基因的拷贝数,Northern blotting检测基因表达,光学显微镜和超声检测cTnT^R141W转基因小鼠心脏的病理改变。结果建立了3个系的cTnT^R141W转基因小鼠。3个系的基因拷贝数分别是15、20和59拷贝。cTnT^R141W基因在心脏组织的表达水平高于内源性cTnT。病理分析显示cTnT^R141W转基因小鼠心房心室明显大于野生型,心室壁明显变薄,心肌细胞不均匀肥大,心肌间质纤维增多。超声检查显示心室腔明显扩大,收缩期容积和舒张期容积显著增大,射血分数、短轴缩短率、室壁运动度明显降低。结论cTnT^R141W转基因小鼠的全心扩大,室壁变薄,心肌细胞肥大,间质纤维化以及心肌收缩力下降,说明成功建立了cTnT^R141W转基因小鼠扩张型心肌病模型,为研究扩张型心肌病发病机制和药物研发提供了有价值的动物模型。     

心脏特异表达Calponin 1转基因小鼠的心脏功能分析

目的建立心脏特异表达Calponin 1转基因小鼠,研究Calponin 1对心脏发育及心肌病的调节作用。方法利用心脏特异启动子α-MHC构建转基因表达载体,显微注射法建立Calponin 1转基因小鼠,PCR法鉴定转基因小鼠的基因型,Western Blot检测Calponin 1在心脏组织中的表达,心脏超声检测转基因小鼠的心脏结构和功能,HE染色和Masson染色检测转基因小鼠心脏的病理改变。结果 Calponin 1在野生型小鼠心脏中有表达,在扩张型心肌病小鼠的心脏组织表达降低。通过显微注射法,建立了2个心脏组织Calponin 1基因高表达的转基因小鼠系。与野生型小鼠相比,Calponin 1转基因小鼠收缩期左室内径（LVID,systolic）增加28%（P〈0.01,n=12）,舒张期左室内径（LVID,diastolic）增加16.2%（P〈0.01,n=12）,收缩期左室后壁厚度（LVPW,systolic）减小15.7%（P〈0.01,n=12）,舒张期左室后壁厚度（LVPW,diastolic）减小21%（P〈0.01,n=12）,射血分数（ejection fraction,EF）降低11.5%（P〈0.01,n=12）,短轴内径缩短率（fraction shortening,FS）降低14.6%（P〈0.05,n=12）。转基因小鼠心脏组织病理H＆E染色和Masson染色显示,转基因小鼠心室扩张,心肌细胞不均匀肥大,细胞间隙变大,心肌间质纤维增多。结论 Calponin 1在心脏特异过表达引起转基因小鼠心脏左室内径增加,收缩期容积和舒张期容积显著增大,心室壁变薄,射血分数及短轴缩短率降低等扩张性心肌病表型,推测Calponin 1是参与心肌病病理发生的基因之一。     

心脏特异表达人源FAM55A转基因小鼠的建立

目的建立心脏特异表达的人源FAM55A转基因小鼠,为研究该基因在心肌病发病中的作用提供模型。方法 Western blot检测FAM55A在野生型小鼠与cTnTR141W转基因小鼠心脏组织中的表达变化及其在野生小鼠的组织表达谱。克隆人源FAM55A基因入α-MHC启动子下游构建a-MHC-FAM55A表达载体,显微注射法建立FAM55A转基因小鼠。PCR鉴定转基因首建鼠的基因型。Western blot鉴定人源FAM55A在转基因小鼠心脏中的表达,超声检测转基因小鼠心脏的几何构型和功能。HE染色检测转基因小鼠心脏的病理改变。结果 FAM55A在野生型小鼠心脏中有少量表达,在扩张型心肌病小鼠的心脏中表达增加。建立了1个心脏组织特异表达人源FAM55A转基因小鼠品系。与野生型小鼠相比,FAM55A转基因小鼠的心脏收缩期和舒张期左室前壁从1月龄到5月龄持续增厚,3月龄转基因小鼠心脏射血分数和短轴缩短率稍有增强,1月龄和5月龄转基因小鼠心脏功能则与同龄野生型小鼠相比无变化。组织学检测显示,转基因小鼠心脏左室心肌细胞不均匀肥大,但不发生紊乱。结论 FAM55A在扩张型心肌病小鼠的心脏中表达上调,建立了心脏特异表达的人源FAM55A转基因小鼠,为进一步和心肌病小鼠模型杂交,研究该基因在心肌病发病中的作用提供了工具。     

心脏组织特异性表达 Neuregulin -2转基因小鼠的建立及心脏功能分析

目的：神经调节蛋白2（ neuregulin-2, NRG2）可促进神经系统发育,基因缺失表现早期生长延迟, NRG2在心脏中也有表达,但其在心脏发育尤其是病理刺激时对心脏结构及功能的影响尚未见报道。本文目的是建立心脏组织特异性表达NRG2转基因小鼠,分析其在正常及压力负荷刺激时对心脏结构及功能的影响。方法将人NRG2基因插入到心脏特异性启动子α-MHC下游,构建转基因表达载体,显微注射法建立NRG2转基因小鼠,PCR鉴定转基因小鼠基因型,western blot鉴定NRG2蛋白在心脏中的表达并筛选高表达的转基因品系,主动脉缩窄术（ transverse aortic constriction , TAC）制备压力负荷诱导的心肌肥厚小鼠模型。利用超声影像分析和病理学观察小鼠心脏结构和功能改变。结果建立了心脏组织特异性高表达NRG2转基因小鼠品系。与同窝阴性转基因小鼠相比,转基因小鼠左心室舒张末期后壁厚度（LVPWD）明显增加,3月龄时可达15．6％（P＜0．05）,经压力负荷刺激后,NRG2转基因手术小鼠心室壁增厚程度显著下降,心室腔增大,同时心肌排列紊乱程度和纤维化程度明显比NTG手术小鼠严重。结论在压力负荷下,转基因表达NRG2缩短了肥厚过程,同时加速了心衰进程。     

心脏特异表达LMNA^E82K转基因小鼠的建立

目的建立心脏特异表达LMNAE82K转基因小鼠,为研究LMNAE82K与心肌病发病机制的关系提供工具动物。方法把LMNAE82K基因插入α-MHC启动子下游,构建转基因表达载体,显微注射法建立C57BL/6JLMNAE82K转基因小鼠,PCR鉴定转基因小鼠的基因型,采用Western Blot鉴定LMNAE82K在心脏组织中的表达,H＆E染色和超声检测转基因小鼠心脏的病理改变。结果建立了2个心脏组织特异表达LMNAE82K的转基因小鼠品系。超声检查显示转基因小鼠心室壁变薄,收缩期容积和舒张期容积增加,射血分数及短轴缩短率降低。结论LMNAE82K转基因小鼠具有LMNAE82K引起的家族性扩心病有类似的病理变化,为研究LMNAE82K与心肌病发病机制的关系的研究提供了有价值的疾病动物模型。     

心肌特异性高表达热休克蛋白27转基因鼠建立

目的 建立人热休克蛋白27（heat shock protein 27, Hsp27）基因在小鼠心肌特异性表达的转基因鼠模型。 方法 将人心肌Hsp27cDNA插入含有心肌特异性表达启动子αMHC的pBSⅡ-SK+载体中,限制性内切酶EcoRI酶切、纯化后,获得含有αMHC启动子－Hsp27cDNA－HGH polyA的线性DNA片段,以显微注射法将目的基因导入受精卵, PCR筛选基因型,Western Blot鉴定转移基因的表达和表达的组织特异性。结果和结论 共获得两个转基因系小鼠,均呈心肌组织特异性高表达。     

心脏特异性表达KCNQ1^（V180L）转基因小鼠的建立及表型分析

目的建立心脏特异性表达KCNQ1^V180 L转基因小鼠,为研究KCNQ1基因功能及其突变与心律失常性心脏疾病的关系提供工具动物。方法把KCNQ1^V180 L基因插入α-MHC启动子下游,构建转基因表达载体,显微注射法建立C57BL/6J KCNQ1^V180 L转基因小鼠,PCR鉴定转基因小鼠的基因型,采用Western Blot鉴定KCNQ1^V180 L在心脏组织中的表达,记录转基因小鼠死亡情况,超声分析转基因小鼠心脏结构形态和功能改变,心电分析转基因小鼠心肌电生理变化。结果建立了2个心脏组织特异性表达KCNQ1^V180 L转基因小鼠品系。转基因小鼠离乳前即出现猝死;超声检查显示转基因小鼠左心室内径变短,心室壁变厚,短轴缩短率增加;心电分析显示其心室复极异常。结论 KCNQ1^V180 L转基因小鼠具有临床长QT综合征类似的病理改变,可作为研究KCNQ1基因功能及其突变与心律失常发病机制的疾病动物模型。     

心肌肌钙蛋白Ⅰ基因突变与心肌病的研究进展

心肌肌钙蛋白I(cTnI)是心肌肌钙蛋白复合物的亚单位之一,与心肌肌钙蛋白T和C相互作用,与肌动蛋白-原肌球蛋白结合从而抑制肌动蛋白-肌球蛋白的收缩作用。在肥厚型、扩张型和限制型心肌病中发现30多种cTnI基因的突变,cTnI基因突变转基因小鼠也反映了心肌病的特征。本文总结了cTnI基因突变在心肌病发病机制中的研究情况。     

Left ventricular volume and function in cynomolgus monkeys using real-time three-dimensional echocardiography

BACKGROUND: The purpose of this study was to investigate the feasibility of evaluating cardiac function by real time three-dimensional (RT3D) echocardiography in isoflurane-anesthetized male cynomolgus monkeys. Additionally differences between inhibitory effects of beta-blockers and a Ca channel blocker on left ventricular (LV) function were examined. METHODS AND RESULTS: End-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) in the control (without any drug effect) were not significantly changed by repetitive measurement at a 30-day interval. Propranolol and metoprolol (0.1 and 0.3 mg/kg/10 minutes, i.v.) caused a dose-dependent increase in ESV, but little effect on EDV, resulting in a decrease in EF. Verapamil (0.1 and 0.3 mg/kg/10 minutes, i.v.) increased both EDV and ESV, but decreased EF was noted at 0.3 mg/kg. CONCLUSIONS: These results demonstrate the feasibility of RT3D echocardiography in providing reproducible estimations of LV volume and EF in monkeys when evaluating drugs that may affect cardiac function.     

急性心肌梗死患者早期血浆脑钠肽水平与左室重构及预后关系的评估

目的：探讨急性心肌梗死（AMI）早期脑钠肽（BNP）水平与左室重构及预后的关系。方法：用放射免疫法测定AMI患者早期血浆BNP水平;用超声心动图检查测量左室收缩末容积（ESV）、左室舒张末容积（EDV）、射血分数（EF）并通过计算得左室质量（LVM）。并根据左心室容积指标分组,左心室容积增加率〉20%为左心室重构组,否则为非重构组,比较两组血浆BNP水平。结果：重构组恢复期左心室舒张末期及收缩末期容积指数均高于非重构组（P〈0.01）,亦高于急性期左心室容积（P〈0.01）。重构组早期血浆BNP浓度明显高于非重构组（P〈0.01）,恢复期也较非重构组高（P〈0.01）。重构组早期BNP浓度与恢复期左心室容积及容积变化量之间呈正相关。结论：AMI早期BNP升高与急性期左室重构密切相关,血浆BNP浓度可以作为溶栓治疗再通的观察指标及预后判断依据。     

Determination of the ejection fraction and cardiac volumes using magnetic resonance tomography

The results of NMR-tomography and radiocontrast ventriculography (VG) were compared in 20 CHD patients to determine ejection fraction (EF), and left ventricular (LV) end-diastolic and end-systolic volumes (EDV and ESV). NMR-tomography of the heart was performed at the field power of 0.23 T using the synchronization with ECG. Two methods of orientation of NMP-section on the LV long axis were employed. A sufficiently high correlation of NMR-tomography and VG findings in the determination of EF (r = 0.9) was obtained, low and insignificant--in the determination of EDV and ESV. Possible causes of differences between the results of both methods are under discussion.     

Influence of left bundle branch block on left ventricular volumes, ejection fraction and regional wall motion

Background. Left ventricular volumes, ejection fraction and regional wall motion are cardiac parameters which provide valuable information for patient management in a large variety of cardiac conditions. Differences in regional wall motion are of relevance in the field of cardiac resynchronisation therapy. We quantified three-dimensional echocardiographic measurements of left ventricular volumes, ejection and regional wall motion (e.g. expressed as systolic dyssynchrony index (SDI)) in two patient cohorts: patients with normal conduction and patients with complete left bundle branch block. Methods. Thirty-five patients scheduled for routine cardiac examination underwent three-dimensional echocardiography: 23 patients with normal conduction and 12 patients with a complete left bundle branch block. Full-volume datasets were analysed and end-systolic volume (ESV), end-diastolic volume (EDV) and ejection fraction (EF) were obtained. SDI was derived from the standard deviation of the measured times to reach minimal regional volume for each of the 16 segments of the left ventricle. Results. A significant difference was observed in left ventricular volumes, ejection fraction and SDI between the two groups. Patients with complete left bundle branch block showed higher EDV (p=0.025) and ESV (p<0.01) and a lower EF (p<0.01) than patients with normal conduction. SDI is significantly higher in patients with complete left bundle branch block (p=0.004) expressing a higher amount of ventricular dyssynchrony. Intraobserver variability showed excellent correlation coefficients: r=0.99 for EDV, ESV and SDI and r=0.98 for EF. Conclusion. Three-dimensional echocardiography is a feasible and reproducible method for the quantification of left ventricular volumes, left ventricular ejection fraction and regional wall motion. Differences can be assessed between normal patients and patients with left bundle branch block. (Neth Heart J 2007;15:89-94.)     

Effect of acute high-intensity interval exercise on postexercise biventricular function in mild heart failure

We studied the acute effect of high-intensity interval exercise on biventricular function using cardiac magnetic resonance imaging in nine patients [age: 49 ± 16 yr; left ventricular (LV) ejection fraction (EF): 35.8 ± 7.2%] with nonischemic mild heart failure (HF). We hypothesized that a significant impairment in the immediate postexercise end-systolic volume (ESV) and end-diastolic volume (EDV) would contribute to a reduction in EF. We found that immediately following acute high-intensity interval exercise, LV ESV decreased by 6% and LV systolic annular velocity increased by 21% (both P < 0.05). Thirty minutes following exercise (+30 min), there was an absolute increase in LV EF of 2.4% (P < 0.05). Measures of preload, left atrial volume and LV EDV, were reduced immediately following exercise. Similar responses were observed for right ventricular volumes. Early filling velocity, filling rate, and diastolic annular velocity remained unchanged, while LV untwisting rate increased 24% immediately following exercise (P < 0.05) and remained 18% above baseline at +30 min (P < 0.05). The major novel findings of this investigation are 1) that acute high-intensity interval exercise decreases the immediate postexercise LV ESV and increases LV EF at +30 min in patients with mild HF, and this is associated with a reduction in LV afterload and maintenance of contractility, and 2) that despite a reduction in left atrial volume and LV EDV immediately postexercise, diastolic function is preserved and may be modulated by enhanced LV peak untwisting rate. Acute high-intensity interval exercise does not impair postexercise biventricular function in patients with nonischemic mild HF.     

Darbepoetin-alpha prevents progressive left ventricular dysfunction and remodeling in nonanemic dogs with heart failure

In anemic patients with heart failure (HF), erythropoietin-type drugs can elicit clinical improvement. This study examined the effects of chronic monotherapy with darbepoetin-alpha (DARB) on left ventricular (LV) function and remodeling in nonanemic dogs with advanced HF. HF [LV ejection fraction (EF) approximately 25%] was produced in 14 dogs by intracoronary microembolizations. Dogs were randomized to once a week subcutaneous injection of DARB (1.0 microg/kg, n=7) or to no therapy (HF, n=7). All procedures were performed during cardiac catheterization under general anesthesia and under sterile conditions. LV end-diastolic volume (EDV), end-systolic volume (ESV), and EF were measured before the initiation of therapy and at the end of 3 mo of therapy. mRNA and protein expression of caspase-3, hypoxia inducible factor-1alpha, and the bone marrow-derived stem cell marker c-Kit were determined in LV tissue. In HF dogs, EDV and ESV increased and EF decreased after 3 mo of followup. Treatment with DARB prevented the increase in EDV, decreased ESV, and increased EF. DARB therapy also normalized the expression of HIF-1alpha and active caspase-3 and enhanced the expression of c-Kit. We conclude that chronic monotherapy with DARB prevents progressive LV dysfunction and dilation in nonanemic dogs with advanced HF. These results suggest that DARB elicits beneficial effects in HF that are independent of the presence of anemia.     

Assessing Right Ventricular Function in Patients with Hypertrophic Cardiomyopathy with Cardiac MRI: Correlation with the New York Heart Function Assessment (NYHA) Classification

Purpose

To determine whether 3.0-T magnetic resonance imaging (MRI) could assess right ventricular (RV) function in patients with hypertrophic cardiomyopathy (HCM), and if this assessment is correlated with the New York Heart Function Assessment (NYHA) classification.

Materials and Methods

Forty-six patients with HCM and 23 normal individuals were recruited. Left and right ventricular function parameters including end-diastolic and end-systolic volumes (EDV, ESV), stroke volume (SV) and ejection fraction (EF) and dimensions were measured and compared using 3.0-T MRI. RV function parameters between HCM patients and controls were compared using independent sample t tests. A one way ANOVA test with Bonferroni correction was used to determine significant differences among different NYHA groups. Receiver operating characteristic analyses calculated the sensitivity and specificity of RV dysfunction on MRI for the prediction of HCM severity.

Results

Statistical analysis revealed significant differences of left ventricular (LV) and RV volumetric values and masses between the HCM patients and controls (all p<0.05). Within the HCM group, the simultaneously decreased maximum RVEDD correlated well with the LVEDD (r = 0.53; p<0.001). The function and dimension parameters among Class I to III were not determined to be significantly different (all p>0.05). However, significant differences between the Class IV and I-III groups (all P<0.0167) indicated that the diastolic and systolic function in both the RV and LV were impaired in Class IV patients. ROC analyses identified the EDV, ESV and EDD of both the LV and RV with a high sensitivity cutoff value to predict the HCM patients with severe heart failure (Class IV) with high sensitivity and specificity.

Conclusions

RV involvements were comparable to those of LV global function impairments in patients with HCM. The presence of RV dysfunction and decreased dimension on the MRI helped to predict the severe symptomatic HCM with high sensitivity and specificity.