江苏省第二届心脏生理性起搏研讨会在宁召开

由南京大学医学院附属鼓楼医院主办的江苏省第二届心脏生理性起搏研讨会于6月7日在宁召开。中华医学会心电生理和起搏分会主任委员、全国心脏起搏专家张澍教授表示,我国心脏性猝死的年发生率为0．04％,每年死于心脏猝死的人数高达54．4万。由于发病突然、进展迅速,具有无法预测的特点,发生心脏骤停的患者经心肺复苏生存率不到5％。因此心脏性猝死的预防显得非常重要。     

大鼠不同心肌肥厚模型左心室基因表达谱变化的比较

为了解心肌肥厚时基因表达谱的变化规律,本实验复制了三种大鼠心肌肥厚模型：肾上腹主动脉缩窄(suprarenal abdominal aortic stenosis,SRS)、动静脉瘘(arterial-vein fistula,AVF)和去甲。肾上腺素持续静脉输注(jugular vein infusion of norepinephrine,NEi),并应用组织化学方法和超声心动术检测大鼠心脏结构和功能指标,应用cDNA基因芯片技术检测心脏基因表达水平的变化。SRS和NEi引起大鼠向心性心肌肥厚,AVF引起大鼠离心性心肌肥厚,其中NEi大鼠心肌纤维化明显。对不同心肌肥厚模型间大鼠左心室基因表达谱的变化进行两两比较。结果显示,有部分基因在不同模型中表达水平均发生变化,其中多数基因在两种模型中表达水平改变的方向相同,也有少部分基因在两种模型中表达水平改变方向相反。综合比较三种心肌肥厚模型的基因表达谱,各种模型都有特异的基因表达变化,但是有19个基因在三种心肌肥厚模型中表达水平均发生改变。研究结果有可能成为心肌肥厚的标志性基因或治疗靶点,为心肌肥厚发生机制的深入研究提供了新的线索。     

大鼠胸主动脉缩窄诱导心肌肥厚模型的建立

目的建立大鼠胸主动脉部分缩窄诱导心肌肥厚动物模型。方法雄性SD大鼠30只,随机分为两组：胸主动脉缩窄组20只和同期假手术组10只。在右无名动脉和左颈总动脉之间将主动脉结扎于8G针头上,随后将针头退出即可。术后10周,采用超声心动图检测心脏、观察心脏的大体剖面以及HE染色、测量心肌肥厚指数评价心肌肥厚的效果。结果术后10周,肉眼观：模型组心脏体积明显大于对照组。M型超声示：模型组较假手术组缩短分数下降,左室内径和室壁厚度明显增加。超声测量结果示：模型组与假手术组比较：室间隔厚度增加明显（2.527±0.269 vs.1.943±0.1）mm,（P〈0.01）;后壁厚度增加明显（2.492±0.242 vs.1.902±0.076）mm,（P〈0.01）;缩短分数略减小（49±7.681 vs.55.7±9.828）（P〉0.05）;左室舒张末期内径、左室收缩末期内径及射血分数均无明显变化。心脏肥厚指数明显增大（3.196±0.11 vs.1.785±0.099）,P〈0.01。结论胸主动脉缩窄可以导致大鼠心肌肥厚,为研究心室肥厚、心肌功能障碍以及心肌重构提供了一个很好的模型。     

青藤碱对异丙肾上腺素诱导小鼠心肌肥厚的影响

目的：探讨青藤碱（Sin）拮抗异丙肾上腺素（Iso）诱导小鼠心肌肥厚（CH）的作用。方法：健康昆明种小鼠48只,雌雄各半,随机均分为对照组、Iso模型组、Iso+Sin 50 mg/kg组、Iso+Sin 200 mg/kg组。除对照外,其余组小鼠均i.h Iso,逐日一次,当日剂量40 mg/kg,第2日20 mg/kg,第3日10 mg/kg,之后保持10 mg/kg,持续14 d。随意进食、饮水,创建CH模型。给药和造模同时进行,每日上午注射Iso 4 h后,分别给予Sin 50 mg/kg和200 mg/kg灌胃治疗,逐日一次;对照组和模型组等量生理盐水灌胃,持续4周。检测心肌SOD、MDA水平和血清LDH活性;HE及Masson染色检查心肌组织学改变,免疫组化检测心肌NF-κB蛋白表达。结果：与对照组相比,Iso组心重指数和左心室重量指数、心肌纤维化面积明显增长（P<0.01）,NF-κB蛋白水平,LDH、MDA升高,T-SOD下降（P<0.01）。与Iso组相比,Iso+Sin组随剂量增大,心重指数和左心室重量指数明显改善,纤维化面积减小（P<0.01）,NF-κB蛋白,LDH、MDA下降,T-SOD升高（P<0.01）;其中,高剂量Sin组上述作用与低剂量组Sin比较差异明显（P< 0.05）。结论：Sin拮抗Iso诱导小鼠CH,高剂量作用更显著,可能与对抗氧化应激和心肌炎症相关。     

杭白菊提取物对异丙肾上腺素诱导小鼠心肌肥厚的影响*

目的:探讨杭白菊提取物对异丙肾上腺素(Iso)诱导小鼠病理性心肌肥厚(CH)的影响。方法:健康雄性JCR小鼠,随机分为4组(n=12): 对照组、单纯药物处理组(CFE组)、CH模型组(Iso组)和 CH模型+药物处理组 (CFE+Iso 组);Iso 组和CFE+Iso 组每天一次i.h Iso(3 mg/kg),以构建小鼠CH模型,对照组和 CFE组每天一次i.h同体积生理盐水,连续14 d;同时i.h在4 h后,CFE组和 CFE+Iso组每天一次灌胃CFE(200 mg/kg) ,对照组和Iso 组每天灌胃同体积的生理盐水;28 d后取小鼠心脏, 检测全心质量指数(HMI)、左室质量指数(LVMI)、心脏质量/胫骨长度比值(HW/TL)、心肌纤维化程度、心肌SOD、GSH、MDA水平和左心室组织环磷酸腺苷(cAMP)、血管紧张素II(Ang II)水平。结果:与正常组比较, Iso组LVMI、HMI 和 HW/TL升高(P＜ 0.01);与 Iso组相比,CFE＋Iso组HMI、LVMI和HW/TL比值降低(P＜0.01),心肌纤维化减轻(P＜0.01), GSH、T-SOD水平升高(P＜0.05 或P＜0.01),MDA水平下降(P＜0.01);心肌cAMP和Ang II 含量下降(P＜0.01 或P＜0.05)。结论:CFE改善Iso诱导小鼠CH的心脏状况,其机制可能与其抗氧化、抑制心肌纤维化进展、降低心肌cAMP、AngⅡ水平有关。     

ISO和AngⅡ诱导小鼠心脏纤维化模型的表型及机制比较

该文旨在比较异丙肾上腺素(isoprenaline,ISO)和血管紧张素Ⅱ(angiotensin Ⅱ,AngⅡ)诱导的2种小鼠心脏纤维化模型在心功能、心肌纤维化及发生机制等方面的差别。采用C57野生型小鼠随机分为ISO组、AngⅡ组和生理盐水对照组。在背部皮下植入AngⅡ微量泵或者皮下注射ISO,28天后比较各组的心功能、静脉压、心重指数(cardiac weight index,CWI)、心肌组织纤维化程度和纤维化分子表达差异,以及信号通路改变情况。结果显示,ISO组和AngⅡ组在心功能受损方面无显著差异,而在静脉压、CWI方面ISO组都低于AngⅡ组,在心肌组织纤维化程度和纤维化分子表达水平方面,ISO组都高于AngⅡ组。两种模型中纤维化发生的信号通路机制也明显差异。因此,该实验结果表明,ISO模型通过不同于AngⅡ模型的信号通路机制来诱导更为显著的心肌纤维化病理改变。     

小鼠心肌肥厚发展过程中心电图动态变化

目的：探讨小鼠心肌肥厚发展过程中心电图的动态变化。方法：复制小鼠压力超负荷性心肌肥厚模型,连续动态监测小鼠从心肌肥厚早期至心力衰竭发展过程中的不同阶段体表心电图改变。结果：①对照组和模型组术后2周内小鼠未见自发性心律失常,而模型组术后5周、9周和13周小鼠出现自发性心律失常,主要表现为频发的室性早搏以及阵发性室性心动过速,心律失常发生率分别为15％、28％和63％。②与同期对照相比,术后2周、5周、9周和13周组动物伽间期以及帆间期明显延长,分别延长20．4％、32．7％、49．7％、61．0％和27．1％、32．1％、43．9％、59．1％（P〈0．01）。③心肌肥厚小鼠心电图的另一个特征为J波变化。所有对照组动物心电图均为正向J波,而模型组动物从2周开始J波正向值下降,5周逐渐变平,到13周时完全翻转。④与同期对照相比,模型组的PR间期没有改变,但术后2周RR问期轻微缩短。结论：心肌肥厚小鼠自发性心律失常发生率逐渐增加,QT间期进行性延长,J波幅值逐渐降低,表明随着疾病的进展心室复极化异常逐渐加重。     

心脏诱导的研究

对心脏发育调控机制的认识是从观察两栖动物和鸟类的胚胎学过程开始的.心脏的诱导调控一直是人们研究的热点.从心脏的形态发生,心脏诱导和心脏的分子标识等3个方面对最近的一系列研究结果进行了综述.     

利用光遗传学技术构建小鼠光控心脏起搏模型

电刺激是人工控制心脏搏动频率的标准技术,但在实验研究中,这种方法有较大的局限性,如局部电解效应、刺激频率和时长受限、只能对目标范围内的所有细胞进行刺激、不能选择性作用于心肌细胞等。基于光遗传学技术,本研究构建了心肌细胞特异性表达光激活阳离子通道channelrhodopsin-2(ChR2)的转基因小鼠,采用特定频率的蓝光刺激使心肌细胞膜电位去极化,从而引发动作电位并控制心脏起搏。当蓝光刺激频率低于小鼠自发心脏搏动频率时,蓝光刺激造成暂时性的心律失常,去除蓝光照射后小鼠心跳恢复正常;当蓝光刺激频率高于小鼠自发心跳频率时,小鼠的心脏搏动完全由蓝光刺激支配,去除蓝光照射后恢复到自发搏动状态;失去自主搏动能力的小鼠心脏也可由蓝光刺激进行起搏;不表达ChR2的对照小鼠对蓝光刺激没有响应。本研究对基于光遗传学的光控心脏起搏技术进行了实验论证,在心肌电生理学特别是心律失常研究中有着非常重要的应用价值。     

Dietary sodium induced cardiac hypertrophy.

In humans, high sodium intake not only increases the blood pressure, and thus can cause left ventricular hypertrophy (LVH), but also appears to increase LVH independent of this increase in blood pressure. In both normo- and hyper-tensive rats the hypertrophic effect of increased dietary sodium intake on the heart has been clearly established. In normotensive rats, this effect is strain and age dependent, and seems independent of hemodynamic effects of high sodium intake. In both rats and humans, dietary sodium appears to increase wall thickness, resembling pressure overload rather than an increased left ventricular diameter as expected of volume overload. The mechanisms through which high dietary sodium induces hypertrophy are still unknown. It is possible that dietary sodium increases either adrenergic stimulation and (or) enhances sensitivity for adrenergic stimulation and that this hypertrophic response mainly acts via stimulation of alpha 1-adrenergic receptors. Stimulation of the alpha 1-adrenergic receptors will increase the inositol phosphate-diacyl glycerol pathway and enhance the Na+/H+ exchange. The activity of this exchanger might play an important role in the development of dietary sodium induced cardiac hypertrophy.     

Upregulation of eIF6 inhibits cardiac hypertrophy induced by phenylephrine

Cardiac hypertrophy is determined by an increase of cell size in cardiomyocytes (CMCs). Among the cellular processes regulating the growth of cell size, the increase of protein synthesis rate represents a critical event. Most of translational factors promoting protein synthesis stimulate cardiac hypertrophy. In contrast, activity of translational repressor factors, in cardiac hypertrophy, is not fully determined yet. Here we report the effect of a translational modulator, eIF6/p27^BBP in the hypertrophy of neonatal rat CMCs. The increase of eIF6 levels surprisingly prevent the growth of cell size induced by phenylephrine, through a block of protein synthesis without affecting skeletal rearrangement and ANF mRNA expression. Thus, this work uncovers a new translational cardiac regulator independent by other well-known factors such as mTOR signalling or eIF2β.     

Experimental cardiac hypertrophy induced by isoproterenol in the rat.

Isoproterenol (IPR) administered to rats in a dose of 5 mg/kg for seven days induces cardiomegaly. To determine the degree of myocardial enlargement, wet and dry heart weight, myocardial RNA, DNA, protein content and protein synthesis were measured. Wet and dry heart weight, and the level of cardiac RNA, DNA and protein were augmented by IPR treatment, with RNA increasing more than DNA and protein. Incorporation of 14C-leucine into the protein of the heart was enhanced by IPR. Thus the IPR-induced cardiomegaly may serve as a model for studying the development of cardiac hypertrophy under various conditions.     

A mouse prostate cancer model induced by Hedgehog overexpression

Summary Hedgehog is a regulatory protein during embryonic development and its abnormal activation in adult tissues has been implicated in tumorigenesis within sites where epithelial–mesenchymal interactions take place. In the prostate, Hedgehog signaling activation was observed during advanced cancer progression and metastasis, but whether Hedgehog overexpression can initiate prostate tumorigenesis remains unknown. We introduced a Hedgehog-expressing vector by intra-prostate injection and electroporation to address the effects of Hedgehog overexpression. The manipulation caused lesions with characteristic prostatic intraepithelial neoplasia or even prostatic cancer (CaP) phenotypes within 30 days, with Hedgehog overexpression demonstrated by immunohistochemistry and Western blot detections. The tumorigenic phenotypes were confirmed by discontinuity of basal cell marker p63, mix-up of CK-8/CK-18 positive epithelial cells in the stoma as well as absence of α-SMA positive fibro-muscular sheath. Comparable Hedgehog overexpression was found in human CaP specimen. Thus, Hedgehog overexpression induced prostate tumorigenesis starting from the normal status. Furthermore, a mouse prostate cancer model induced by Hedgehog overexpression was established and may be used for testing novel therapeutical approaches targeting at Hedgehog signaling pathway.These authors have contributed equally to this work.     

Intensity-controlled treadmill running in mice: cardiac and skeletal muscle hypertrophy.

Whereas novel pathways of pathological heart enlargement have been unveiled by thoracic aorta constriction in genetically modified mice, the molecular mechanisms of adaptive cardiac hypertrophy remain virtually unexplored and call for an effective and well-characterized model of physiological mechanical loading. Experimental procedures of maximal oxygen consumption (VO(2 max)) and intensity-controlled treadmill running were established in 40 female and 36 male C57BL/6J mice. An inclination-dependent VO(2 max) with 0.98 test-retest correlation was found at 25 degrees treadmill grade. Running for 2 h/day, 5 days/wk, in intervals of 8 min at 85-90% of VO(2 max) and 2 min at 50% (adjusted to weekly VO(2 max) testing) increased VO(2 max) to a plateau 49% above sedentary females and 29% in males. Running economy improved in both sexes, and echocardiography indicated significantly increased left ventricle posterior wall thickness. Ventricular weights increased by 19-29 and 12-17% in females and males, respectively, whereas cardiomyocyte dimensions increased by 20-32, and 17-23% in females and males, respectively; skeletal muscle mass increased by 12-18%. Thus the model mimics human responses to exercise and can be used in future studies of molecular mechanisms underlying these adaptations.     

Mitochondrial functions during experimentally induced cardiac hypertrophy

When the hearts of albino rats are subjected to pressure-induced stress through constriction of ascending aorta, changes in the mitochondrial functions are observed as early as 24 h after the imposition of the stress. These include the abolition of oxidative phosphorylation, decrease in the energy dependent [⁴⁵Ca]-uptake and decrease in the rate of energized swelling. A large influx of calcium ions and an increase in the fluidity of mitochondrial membranes also occur in this period. At later stages of hypertrophy (17, 28, 40%), these mitochondrial functions gradually return to normal levels.     

D-半乳糖诱导建立的小鼠多囊卵巢综合征模型

目的研究D-半乳糖诱导ICR中年雌性小鼠多囊卵巢综合征(PCOS)动物模型的卵巢形态学、性激素以及胰岛素水平变化,并探讨D-半乳糖引致小鼠PCOS的意义。方法以D-半乳糖腹腔注射20周龄ICR雌性小鼠8周,观察卵巢形态的变化,检测血糖值及动情周期排卵情况,并采用ELISA法测定血清胰岛素、雌二醇(E2)、促卵泡生长激素(FSH)、睾酮(T)水平。结果 D-半乳糖处理组小鼠的卵巢重量显著高于对照组(P<0.05),有80%(10/12)的单侧或双侧卵巢呈现多囊性扩张,卵巢闭锁增多及颗粒细胞层数减少,并表现为紊乱的动情周期,提示无排卵;与对照组比较,D-半乳糖组小鼠血清T、E2和空腹血糖水平明显升高(P<0.001),FSH水平下降(P<0.0001),空腹血胰岛素水平显著高于对照组(P<0.01),胰岛素敏感指数显著低于对照组(P<0.05)。结论使用D-半乳糖诱导小鼠PCOS模型,无论在影响血清性激素还是卵巢局部形态学改变方面都与临床表现相似,并存在胰岛素抵抗现象,符合PCOS的典型特征,可作为动物模型用于科学研究。     

A calcium stimulated cysteine protease involved in isoproterenol induced cardiac hypertrophy

The purpose of this study was to test the relationship between biochemical and functional changes accompanying -agonist induced cardiac hypertrophy and the activation of a calcium stimulated cysteine protease. Because the ultrastructural and ionic changes accompanying -agonist induced cardiac hypertrophy are reminiscent of the actions of the calcium activated neutral protease, calpain, it was hypothesized that lowering calpain activity (by the use of an exogenous inhibitor(s)) would reduce the extent of hypertrophy. Rats (275-300 g) were randomly assigned to either a control, -agonist (iso) or cysteine protease inhibitor (E64c) group. Isoproterenol administration (1 mg/kg) resulted in changes for ventricular weight to body weight ratio (19%), ventricular [RNA] (105.6%), rate of pressure development (22% for +dP/dt) and maximum developed left ventricular pressure (19%) (p < 0.05) after 3 days. Calpain-like activity (assessed by microplate method) increased by 45% (p < 0.05), while [cAMP] returned to control levels (following a transient rise at 1 day; 606.03 ± 124.1 pmol/g/wet/wt to 937.9 ± 225 (p < 0.05)). E64c (administered 1 h prior to iso) reduced the extent of hypertrophy, from 19 to 12%, and prevented the increases in; total [RNA], left ventricular function, the initial [cAMP] increase and calpain-like activity. It is concluded that a calcium stimulated cysteine protease(s), such as calpain, may be involved in the biochemical and functional changes associated with isoproterenol induced cardiac hypertrophy.     

Agiotensin II induced cardiac hypertrophy in vivo is inhibited by cyclosporin A in adult rats

Recently, the calciumcalmodulindependent calcineurin pathway has been defined as a central pathway for the induction of cardiac hypertrophy. The purpose of this study was to determine if cardiac hypertrophy in animals chronically treated with angiotensin II (AngII), could be prevented by blocking this pathway with cyclosporin A (CsA). Female Wistar rats were treated with AngII by subcutaneous infusion and injected twice a day with CsA (25 mg/kg) for 7 days. In the AngII treated group there was a 30% increase in the heart/body weight ratio (p < 0.05 vs. control). The increase in heart weight was blocked with CsA. Substantial increases in ANF and MHC gene expression were detected in the AngII treated animals, which were either attenuated or blocked with CsA treatment. Thus, this study demonstrates that CsA does prevent the development of cardiac hypertrophy in Ang II treated rats, suggesting that the calciumcalmodulindependent calcineurin pathway is associated with angiotensin II induced hypertrophy in vivo.