改良的乳鼠原代心房肌细胞的培养及鉴定方法

目的:主要探讨原代心房肌细胞的培养及鉴定方法,为进一步研究心房颤动的重构机制及治疗方法奠定基础。方法:选取1-3 d的SD乳鼠40只,雌雄不限,分离心房、心室肌,胰酶联合EDTA充分消化心房肌细胞,利用心房肌与成纤维细胞的差速贴壁及细胞传代方法纯化心房肌细胞,免疫细胞化学染色鉴定心房肌细胞。结果:心房肌细胞培养至第3天,可见心房肌细胞覆盖率高达90%,并出现波动性,免疫细胞化学染色可见90%的心房肌细胞肌经α-肌动蛋白抗体染色阳性。结论:经酶化学消化法可成功培养出原代心房肌细胞,是一种较好的培养及鉴定乳鼠心房肌细胞的方法。     

心房重构与心房纤颤的病理学机制研究进展

目前,发生率最高的心率失常被认为是心房纤颤,且该病的发生率随着年龄的增长而上升。伴随着我国人口年龄结构的变化,心房纤颤在我国的发病率逐渐增加。了解该病的发生和发展的机制十分迫切。已经证明,心房重构是该病的重要发生机制。随着研究的加深,研究人员对心房重构与该病的病理学机制有了更加深刻的了解。现就心房纤颤和重构在发病中的机制进行回顾。     

原代培养的大鼠心房肌细胞间隙连接的超微结构研究

用原位包埋超薄切片技术,研究了原代培养的大鼠心房心肌细胞的间隙连接(gap junction)的超微结构。观察到一种GJ结合的小泡(GJ—associated vesicle,GJAV)和一种质膜包绕的颗粒群体,其中某些较大的群体内含环状GJAV复合体(concatenate GJAV complexes,CGJAVC)。我们发现,这两种结构都紧邻细胞质膜,位于细胞间隙区域,同时又常伴随已组装好的GJ。因此,我们推测GJAV和CGJAVC是GJ的前体或中间产物。文章分析了观察结果,并进一步探讨了心肌细胞GJ的形成过程。     

糖尿病大鼠心房肌细胞心房特殊颗粒和心房肽免疫反应强度的观察

本研究运用透射电镜及立体计量学方法结合免疫组化技术对糖尿病大鼠右心耳肌细胞心房特殊颗粒(ASG)和心房肽(ANP)免疫反应强度进行了观察和定量研究.实验动物为体重150～250克之间的SD大鼠,糖尿病的诱导采用四氧嘧啶(150mg/kg)右腹股沟区皮下注射.电镜超微结构发现糖尿病未治疗组均出现线粒体肿胀、肌原纤维缩短等病理性改变.ASG膜溶解、排空等现象多见,ASG体密度明显减少.免疫组化分析表明糖尿病未治疗组心肌细胞ANP免疫反应强度减弱.胰岛素治疗组各指标与对照组相比均无显著差别.     

氧化应激对原代培养乳鼠心房肌细胞中内质网应激及凋亡因子的影响

目的：研究氧化应激对原代培养乳鼠心房肌细胞凋亡、内质网应激及凋亡因子的影响。方法：实验分2组：对照组、氧化应激组。原代培养乳鼠心房肌细胞,氧化应激组在培养的原代心房肌细胞中加入终浓度为100μmol/L的H₂O₂培养2 h,检测氧化和抗氧化指标超氧化物歧化酶（SOD）活力、丙二醛（MDA）及还原型谷胱甘肽（GSH）含量;检测细胞凋亡、细胞GRP78、GRP94及chop、bax、bcl-2 mRNA表达。结果：与对照组相比较,氧化应激组心房肌细胞SOD活力和GSH含量下降、MDA含量增加（P < 0.01）,细胞凋亡增加（P < 0.01）,细胞GRP78、GRP94、chop、bax mRNA表达增加、bcl-2 mRNA表达减少（P < 0.01）。结论：氧化应激反应可能介导内质网应激反应并激活促凋亡因子表达,抑制抗凋亡因子表达,引起心房肌细胞凋亡增加。这可能与心房纤颤的发生有一定关联性。     

心房肌胞内钙浓度变化对心房颤动患者小电导钙激活钾通道电流的影响

目的：SK通道存在于心肌细胞上,其中SK2亚型主要表达在心房。SK2通道对胞内游离钙离子高度敏感,可快速将钙离子浓度的变化转换成细胞膜电位变化。本实验应用穿孔膜片钳技术记录人心肌细胞SK2电流,观察心房肌细胞SK2电流在窦性患者和心房颤动患者之间的差别,以及电极液中不同的钙浓度对两组细胞SK2电流的影响。方法：将接受体外循环手术的患者分为两组：心房颤动组和窦性心律组。以心房肌细胞为研究对象,用穿孔膜片钳技术记录人心肌细胞电流,观察窦性组与房颤组SK2通道电流的差异以及两组细胞SK2电流对电极液中钙敏感性的不同。结果：在全细胞穿孔膜片钳模式下,电极液中游离钙离子浓度为5×10-7mol/L时,记录到房颤组SK2通道电流明显大于窦性组,尤其是在超极化水平。膜电位在-130 mV时,窦性组与房颤组的SK2通道电流密度分别为（-2.92±0.35）pA/pF（n=6）,（-6.83±0.19）pA/pF（n=3,P〈0.05）。在电极液游离钙离子浓度分别为0 mol/L、5×10-7mol/L、10-6mol/L,膜电位为-130 mV时,窦性组SK2通道电流密度分别为（-1.43±0.33）pA/pF（n=7）,（-2.92±0.35）pA/pF（n=6）,（-10.11±2.15）pA/pF（n=8,P〈0.05）;房颤组SK2通道电流密度分别为（-2.17±0.40）pA/pF（n=4）（-6.83±0.19）pA/pF（n=3）（-14.47±2.89）pA/pF（n=4）（P〈0.05）。结论：人心房肌细胞SK2通道具有电压不敏感、内向整流、apamin敏感的特性。电极液中钙浓度相同的情况下,房颤组的SK2电流密度明显大于窦性组,SK2通道电流对钙离子的敏感性高于窦性组,提示SK2通道钙敏感性增加可能与心房颤动的发生发展密切相关。     

氯化钠对培养的大鼠主动脉平滑肌细胞的心房钠尿肽受体的调节

培养的卒中型自发性高血压大鼠(SHR_(sp))及其对照 WKY 大鼠主动脉平滑肌细胞(VSMC)上存在心房钠尿肽(ANP)的特异性受体,它们与~(125)I-ANP 的最大结合量(B_(max))是:SHR_(sp)3.65±0.13和 WKY 1.89±0.09 pmol/mg pr(P<0.01);解离平衡常数(Kd)值分别是72.6±10.2和42.0±4.8×10~(-12)mol/L(P<0.01)。 两种细胞内介导舒血管作用的第二信使、环磷酸乌苷(cGMP)的基础浓度无显著差异,对相同剂量 ANP 刺激引起 cGMP 分别增加139(SHRsp)和271(WKY)倍。可见 SHRsp 的 VSMC ANP 受体数量虽比 WKY大鼠增多,但对相同剂量 ANP 引起的 cGMP 增加反应及 ANP 受体的亲和力均显著降低。高盐培养液孵育24h 后,细胞表面 ANP 受体的亲和力改变不明显,但受体数量下调,SHRsp 和 WKY 大鼠分别降至对照的34.8±8.2%和38.6±9.4%,细胞对 ANP 引起的 cGMP增加反应明显降低,且均以 SHR_(sp)较显著。提示后两种变化可能在高盐促进血压升高的机制中起作用。     

汉坦病毒在原代人胚肾与人胚肺细胞中增殖及其特性的研究

近年来研究发现,汉坦病毒能在多种细胞株及人体细胞中增殖、适应.国内学者用人胚肺二倍体细胞(2BS)体外适应该病毒成功,但有关原代人胚肺、肾细胞的报道尚少.作者选用两株病毒及两种原代人胚细胞用于体外感染、观察,应用免疫荧光间接法及胶体金包埋前染色电镜技术对宿主细胞中增殖的病毒进行了动态观察及特异性定位研究,现报告如下.1 材料和方法1.1 细胞的分离和培养1.1.1 人胚细胞:取正常孕妇5—7个月水囊引产胚肾及肺组织,按常规方法分散细胞,5—7天后长满单层.1.1.2 非洲绿猴肾上皮细胞(VeroE6):由安徽省医学科学研究所倪大石惠赠.1.2     

敬钊毒素-XI与突变体R3A-JZTX-XI的合成、复性及其药理活性鉴定

表达于b-胰岛细胞上的Kv2.1钾通道电流负责动作电位的复极化,从而调节胰岛素的分泌,是治疗2型糖尿病的有效作用靶点。敬钊毒素-XI(JZTX-XI) 是从敬钊缨毛蛛Chilobrachys jingzhao粗毒中分离纯化到的一种新型的肽类神经毒素,能够抑制非洲爪蟾卵母细胞上表达的Kv2.1钾通道电流。为了研究JZTX-XI的结构与功能关系,用芴甲氧羰基 (Fomc) 固相多肽合成方法合成了野生型JZTX-XI和突变体R3A-JZTX-XI,结合反相HPLC和质谱对不同条件下的氧化复性结果进行检测,从而得     

副流感病毒5包膜糖蛋白的结构与功能

副流感病毒5(Parainfluenza virus 5,PIV5)属于单股负链不分节段的RNA病毒,迄今尚未发现PIV5与人类已知的疾病有关,主要被用作疫苗载体。其包膜上存在三种糖蛋白:融合(Fusion,F)蛋白、血凝素-神经氨酸酶(Hemaggulatinin-neuraminidase,HN)蛋白、小疏水性(Small hydrophobic,SH)蛋白。F蛋白能在同源性HN蛋白的协助下介导膜融合,HN蛋白具有受体识别、神经氨酸酶活性和促细胞融合活性,SH蛋白则在病毒致病机制中起作用。本文主要阐述了三种包膜糖蛋白的结构和功能,旨在为PIV5的研究提供一些参考。     

Plasma Digoxin Concentrations in Patients with Atrial Fibrillation

Plasma digoxin concentrations were measured by radioimmunoassay in 116 patients with atrial fibrillation on long-term oral treatment with the drug, and in 23 patients with digoxin toxicity. The mean concentrations were 1·4 ng./ml. and 3·1 ng./ml., respectively. Though an overlap occurred between the therapeutic and toxic ranges, toxicity is unlikely to occur below a level of 2 ng./ml. Plasma concentration showed a poor correlation with resting heart rate during atrial fibrillation. In patients with good renal function, however, a significant correlation was found between oral dose and plasma concentration. No evidence was obtained for increased sensitivity to therapeutic concentrations of the drug in elderly subjects, but the doses required to achieve these concentrations tended to be less than in younger patients.     

Primary Culture of Adult Rat Heart Myocytes

Cultured primary adult rodent heart cells are an important model system for cardiovascular research. Nevertheless, establishment of robust, viable cultured adult myocytes can be a technically challenging, rate-limiting step for many researchers. Here we described a protocol to obtain a high yield of adult rat heart myocytes that remain viable in culture for several days. The heart is isolated and perfused with collagenase and protease under low Ca²⁺ conditions to recover single myocytes. Ca²⁺-tolerant cells are obtained by stepwise increases in extracellular Ca²⁺ concentration in three subsequent wash steps. Cells are filtered, resuspended in culture medium, and plated on laminin coated slips. Cultured myocytes obtained using this protocol are viable for up to four days and are suitable for most experiments including electrophysiology, biochemistry, imaging and molecular biology.Open in a separate windowClick here to view.^{(71M, flv)}     

胺碘酮联合厄贝沙坦治疗阵发性心房颤动的疗效观察

目的:探讨胺碘酮与厄贝沙坦联合治疗阵发性心房颤动的临床疗效。方法:将我院收治的97例阵发性心房颤动患者,随机分为观察组(N=49)和对照组(N=48)。对照组单纯服用胺碘酮,治疗组在此基础上加用厄贝沙坦。治疗随访12个月,一级观测终点为房颤复发。结果:治疗后12个月,观察组左心房内径显著小于对照组(P>0.05);治疗后6、12个月,观察组窦性维持率分别为89.8%、81.6%,对照组分别为72.9%、62.5%,两组均有统计学差异(P<0.05);治疗期间,观察组房颤复发率24.5%,显著低于对照组47.9%(P<0.05)。结论:胺碘酮联合厄贝沙坦治疗阵发性心房颤动于窦性心律的维持优于单用胺碘酮,且减少房颤复发,抑制左心房扩大。     

Effect of Propranolol on Exercise Tolerance of Patients with Atrial Fibrillation

Six patients with atrial fibrillation who were taking digitalis were exercised before and after 30 mg. of propranolol twice daily. Though there was a lower pulse rate at rest and on exercise in all patients, three suffered deterioration of exercise tolerance. It is concluded that propranolol does not improve the exercise tolerance of patients with atrial fibrillation whose resting ventricular rate is controlled with digitalis.     

Left Atrial Appendage Morphology in Patients with Suspected Cardiogenic Stroke without Known Atrial Fibrillation

The left atrial appendage (LAA) is the typical origin for intracardiac thrombus formation. Whether LAA morphology is associated with increased stroke/TIA risk is controversial and, if it does, which morphological type most predisposes to thrombus formation. We assessed LAA morphology in stroke patients with cryptogenic or suspected cardiogenic etiology and in age- and gender-matched healthy controls. LAA morphology and volume were analyzed by cardiac computed tomography in 111 patients (74 males; mean age 60 ± 11 years) with acute ischemic stroke of cryptogenic or suspected cardiogenic etiology other than known atrial fibrillation (AF). A subgroup of 40 patients was compared to an age- and gender-matched control group of 40 healthy individuals (21 males in each; mean age 54 ± 9 years). LAA was classified into four morphology types (Cactus, ChickenWing, WindSock, CauliFlower) modified with a quantitative qualifier. The proportions of LAA morphology types in the main stroke group, matched stroke subgroup, and control group were as follows: Cactus (9.0%, 5.0%, 20.0%), ChickenWing (23.4%, 37.5%, 10.0%), WindSock (47.7%, 35.0%, 67.5%), and CauliFlower (19.8%, 22.5%, 2.5%). The distribution of morphology types differed significantly (P<0.001) between the matched stroke subgroup and control group. The proportion of single-lobed LAA was significantly higher (P<0.001) in the matched stroke subgroup (55%) than the control group (6%). LAA volumes were significantly larger (P<0.001) in both stroke study groups compared to controls patients. To conclude, LAA morphology differed significantly between stroke patients and controls, and single-lobed LAAs were overrepresented and LAA volume was larger in patients with acute ischemic stroke of cryptogenic or suspected cardiogenic etiology.     

胺碘酮对急诊老年快速心房颤动患者的疗效观察

目的:通过与传统控制心室率的药物去乙酰毛花苷注射液进行对比,探讨胺碘酮注射液对老年快速型心房颤动患者的临床疗效.方法:选择2010年5月～2012年6月我院急诊科收治的老年快速房颤患者60例,按就诊先后顺序随机分为对照组与胺碘酮治疗组,每组30例.胺碘酮治疗组患者先给予胺碘酮注射液150 mg以生理盐水稀释后缓慢静脉注射,继以0.5 mg/min静滴;对照组患者先予去乙酰毛花苷注射液0.2 mg稀释后缓慢静脉推注,若20 min无效则再次给药,两组患者的院内观察周期均为24h,患者在观察过程中行全程心电监护,观察不同时间段(用药后0、0.5、2、12、24 h)患者的心室率,血压的变化;比较两种治疗方法的临床疗效及对患者复律情况的影响.结果:治疗前,两组患者的心室率比较无显著性差异(P＞0.05);第一次用药后0.5h,两组患者的心室率都较治疗前显著下降(P＜0.01),且用乙酰毛花苷注射液治疗的对照组显著低于胺碘酮治疗组(P＜0.05);用药后2和12h,两组患者的心室率比较均无显著性差异(P＞0.05);用药后24h,胺碘酮治疗组患者的心室率较对照组显著降低(P＜0.01).对照组的临床有效率为40.0％,复律率为l6.7％;而胺碘酮治疗组的临床有效率为73.3％,复律率为43.3％,分别显著高于对照组(P＜0.01).与用药前比较,用药后0.5、2、12和24h患者的收缩压略有下降,但差异均无统计学意义(P＞0.05).结论:与去乙酰毛花苷注射液比较,胺碘酮注射液可更有效地降低老年患者24h心室率,复律率和有效率更高,但在应用过程中需注意其不良反应.     

Galectin-3 in Patients with Atrial Fibrillation Undergoing Radiofrequency Catheter Ablation

Background

Galectin-3 (Gal-3) is an emerging biomarker in heart failure that is involved in fibrosis and inflammation. However, its potential value as a prognostic marker in atrial fibrillation (AF) is unknown. The aim of this study was to assess the impact of AF catheter ablation on Gal-3 and evaluate its prognostic impact for predicting rhythm outcome after catheter ablation.

Methods

Gal-3 was measured at baseline and after 6 months using specific ELISA. AF recurrences were defined as any atrial arrhythmia lasting longer than 30 sec within 6 months after ablation.

Results

In 105 AF patients (65% males, age 62±9 years, 52% paroxysmal AF) undergoing catheter ablation, Gal-3 was measured at baseline and after 6 months and compared with an AF-free control cohort (n=14, 50 % males, age 58±11 years). Gal-3 was higher in AF patients compared with AF-free controls (7.8±2.9 vs. 5.8±1.8, ng/mL, p=0.013). However, on multivariable analysis, BMI (p=0.007) but not AF (p=0.068) was associated with Gal-3. In the AF cohort, on univariable analysis higher Gal-3 levels were associated with female gender (p=0.028), higher BMI (p=0.005) and both CHADS2 (p=0.008) and CHA2DS2-VASC (p=0.016) scores, however, on multivariable analysis only BMI remained significantly associated with baseline Gal-3 (p=0.016). Gal-3 was similar 6 months after AF catheter ablation and was not associated with sinus rhythm maintenance.

Conclusions

Although galectin-3 levels are higher in AF patients, this is driven by cardiometabolic co-morbidities and not heart rhythm. Gal-3 is not useful for predicting rhythm outcome of catheter ablation.     

The Prevalence and Incidence of Atrial Fibrillation in Patients with Acute Pulmonary Embolism

Background

Symptomatic pulmonary embolism (PE) is a major cause of cardiovascular death and morbidity. Estimated prevalence and incidence of atrial fibrillation (AF) in developed countries are between 388–661 per 100,000, and 90–123 per 100,000 person-years respectively. However, the prevalence and incidence of AF in patients presenting with an acute PE and its predictors are not clear.

Methods

Individual patient clinical details were retrieved from a database containing all confirmed acute PE presentations to a tertiary institution from 2001–2012. Prevalence and incidence of AF was tracked from a population registry by systematically searching for AF during any hospital admission (2000–2013) based on International Classification of Disease (ICD-10) code.

Results

Of the 1,142 patients included in this study, 935 (81.9%) had no AF during index PE admission whilst 207 patients had documented baseline AF (prevalence rate 18,126 per 100,000; age-adjusted 4,672 per 100,000). Of the 935 patients without AF, 126 developed AF post-PE (incidence rate 2,778 per 100,000 person-years; age-adjusted 984 per 100,000 person-years). Mean time from PE to subsequent AF was 3.4 ± 2.9 years. Total mortality (mean follow-up 5.0 ± 3.7 years) was 42% (n = 478): 35% (n = 283), 59% (n = 119) and 60% (n = 76) in the no AF, baseline AF and subsequent AF cohorts respectively. Independent predictors for subsequent AF after acute PE include age (hazard ratio [HR] 1.06, 95% confidence interval [CI] 1.04–1.08, p<0.001), history of congestive cardiac failure (HR 1.88, 95% CI 1.12–3.16, p = 0.02), diabetes (HR 1.72, 95% CI 1.07–2.77, p = 0.02), obstructive sleep apnea (HR 4.83, 1.48–15.8, p = 0.009) and day-1 serum sodium level during index PE admission (HR 0.94, 95% CI 0.90–0.98, p = 0.002).

Conclusions

Patients presenting with acute PE have a markedly increased age-adjusted prevalence and subsequent incidence of AF. Screening for AF may be of importance post-PE.     

Beta1-Adrenoceptor Polymorphism Predicts Flecainide Action in Patients with Atrial Fibrillation

Background

Antiarrhythmic action of flecainide is based on sodium channel blockade. Beta₁-adrenoceptor (β₁AR) activation induces sodium channel inhibition, too. The aim of the present study was to evaluate the impact of different β₁AR genotypes on antiarrhythmic action of flecainide in patients with structural heart disease and atrial fibrillation.

Methodology/Principal Findings

In 145 subjects, 87 with atrial fibrillation, genotyping was performed to identify the individual β₁AR Arg389Gly and Ser49Gly polymorphism. Resting heart rate during atrial fibrillation and success of flecainide-induced cardioversion were correlated with β₁AR genotype. The overall cardioversion rate with flecainide was 39%. The Arg389Arg genotype was associated with the highest cardioversion rate (55.5%; OR 3.30; 95% CI; 1.34–8.13; p = 0.003) compared to patients with Arg389Gly (29.5%; OR 0.44; 95% CI; 0.18–1.06; p = 0.066) and Gly389Gly (14%; OR 0.24; 95% CI 0.03–2.07; p = 0.17) variants. The single Ser49Gly polymorphism did not influence the conversion rate. In combination, patients with Arg389Gly-Ser49Gly genotype displayed the lowest conversion rate with 20.8% (OR 0.31; 95% CI; 0.10–0.93; p = 0.03). In patients with Arg389Arg variants the heart rate during atrial fibrillation was significantly higher (110±2.7 bpm; p = 0.03 vs. other variants) compared to Arg389Gly (104.8±2.4 bpm) and Gly389Gly (96.9±5.8 bpm) carriers. The Arg389Gly-Ser49Gly genotype was more common in patients with atrial fibrillation compared to patients without atrial fibrillation (27.6% vs. 5.2%; HR 6.98; 95% CI; 1.99–24.46; p<0.001).

Conclusions

The β₁AR Arg389Arg genotype is associated with increased flecainide potency and higher heart rate during atrial fibrillation. The Arg389Gly-Ser49Gly genotype might be of predictive value for atrial fibrillation.