左心室重建术对左心室重构的影响

白向锋; 陶杰; 蒙俊; 杨伟

左心室重建术对左心室重构的影响

1. 昆明医科大学第一附属医院心脏外科
2. 昆明医科大学第一附属医院麻醉科

基金项目:

基金：云南省教育厅科学研究基金资助项目 (5J0347C);

计量
- 文章访问数: 2152
- HTML全文浏览量: 787
- PDF下载量: 48
- 被引次数: 0
出版历程
- 收稿日期: 2017-05-22

Effect of Left Ventricle Reconstruction on Left Ventricular Remolding

Funds:

基金：云南省教育厅科学研究基金资助项目 (5J0347C);

摘要

摘要: 目的探讨左心室重建术对左心室重构的影响.方法结扎14只普通级杂种犬冠状动脉, 建立左心室室壁瘤模型, 取犬正常心肌组织作为正常组;建模评估后将建模成功的犬平均分为2组, 实验组犬通过左心室重建术 (闭式折叠术) 折叠室壁瘤、重建左心室, 对照组犬则只进行开胸手术;6周后, 采集对照组、实验组犬的非手术区心肌组织, 使用实时荧光定量RT-PCR检测已采集的3个组的心肌组织AT1RmRNA、AT2RmRNA含量, 并通过透射电镜观察各组心肌组织的超微结构.结果与正常组相比, 实验组和对照组非手术区心肌组织中AT2R mRNA表达显著更高 (P<0.05) , AT1R mRNA的表达显著更低 (P<0.05) , AT2R mRNA/AT1R mRNA比值显著更高 (P<0.05) .相较于对照组, 实验组非手术区心肌组织中AT2R mRNA的表达显著更低 (P<0.05) , AT1R mRNA的表达显著更高 (P<0.05) , AT2R mRNA/AT1R mRNA的比值显著更低 (P<0.05) ;与正常组相比, 实验组和对照组非手术区心肌组织电镜下都有心室重构 (心肌间质内可见胶原蛋白沉着明显, 胶原纤维明显增多) 和心肌损害 (心肌细胞内肌原纤维间隙增大, 细胞质水肿, 线粒体部分嵴断裂) 的超微结构表现;与对照组相比, 实验组的非手术区心肌组织电镜下心室重构和心肌损害程度小于对照组.结论左心室重建术在一定程度上可以延缓左心室重构的发生, 降低心肌组织的损害程度, 有助于预防心室重构的发生及改善心室重构的预后.
- 左心室重建 /
- 左心室重构 /
- 实时荧光定量RT-PCR /
- 超微结构
Abstract: Objective To investigate the effect of left ventricular reconstruction on left ventricular remolding.Methods We selected twelve common dogs as experimental animals.We ligated the aeteria coronaria and established the model of ventricular aneurysm.We seleced the normal cardiac muscle as common group.After modelling and evaluating, the dogs of successful modelling were divided into two groups.The experimental group was rebuilt by the operation of left ventricular reconstruction (linear closure operation) .The control group was disclosed chest, yet it was not rebuilt by the operation of left ventricular (linear closure operation) ;after six weeks of the operation of left ventricular reconstruction, we obtained the cardiac muscle of nonoperating field in every group.Then we detected the content of AT1R mRNA, AT2Rm RNA of the cardiac muscle of every group by RT-PCR and observed ultrastructure of the cardiac muscle of every group by electron microscope.Results Compared with normal group, the expression of AT2R mRNA was significantly higher (P<0.05) , the expression of AT1R mRNA was significantly lower (P<0.05) , and AT2R mRNA/AT1R mRNA ratio was significantly higher (P<0.05) in experimental group and the control group.Compared with control group, the expression of AT2R mRNAwas significantly lower (P<0.05) , the expression of AT1R mRNA was significantly higher (P<0.05) , and AT2R mRNA/AT1R mRNA ratio was significantly lower (P<0.05) in experimental group;Compared with the common group, ventricular remolding (collagen protein obviously deposited in the mesenchyme of cardiac muscle, collagen fibers became obviously larger) and cardiac damage (the gap of myofibrilla became larger in myocardial cell, cytoplasm dropsy, the part of mitochondria cristas was broken) ultramicrostructure took place in the cardiac muscle of the experimental group and the control group;compared with the control group, the extent of ventricular remolding and Cardiac damage of experimental group was less than the control group in the electron microscope.Conclusion Left ventricular reconstruction (linear closure operation) can delay the process of left ventricular remolding to a certain extent, lower the extent of cardiac damage and help to prevent the development of ventricular remolding and improve the prognosis of ventricular remolding.
- Left ventricular reconstruction /
- Left ventricular remolding /
- Real-time reverse transcription quantitative polymerase chain reaction /
- Ultrastructure

HTML全文

参考文献(20)

[1]	[1]LASSEN T R, NIELSEN J M, JOHNSEN J, et al.Effect of paroxetine on left ventricular remodeling in an in vivo rat model of myocardial infarction[J].Basic Research in Cardiology, 2017, 112 (3) :26.
[2]	[2]ZHANG Y, YAN H, GUANG G C, et al.Overexpressed connective tissue growth factor in cardiomyocytes attenuates left ventricular remodeling induced by angiotensin II perfusion[J].Clinical&Experimental Hypertension, 2017, 39 (2) :168-174.
[3]贺延法, 李强, 孟自力, 等.左心室重建术对非手术区心肌组织超微结构的影响[J].河北医药, 2011, 33 (13) :1978-1979.
[4]	[4]MAO S, ZHANG X, SHAO B, et al.Baduanjin exercise prevents post-myocardial infarction left ventricular remodeling (BE-PREMIER trial) :design and rationale of a pragmatic randomized controlled Trial[J].Cardiovascular Drugs&Therapy, 2016, 30 (3) :315-322.
[5]李彬, 王永霞, 谢世阳, 等.心肌梗死后心室重构的中医药治疗实验研究进展[J].中西医结合心脑血管病杂志, 2014, 12 (7) :876-878.
[6]吴洁, 尹涛, 邹庆华, 等.红景天苷对慢性心力衰竭大鼠心室重构及肾素血管紧张素醛固酮系统的影响[J].中国老年学, 2016, 36 (19) :4728-4730.
[7]张波, 范晋奇, 张全军, 等.血管紧张素转化酶2过表达对大鼠心肌梗死后心室重构的影响[J].第二军医大学学报, 2013, 34 (12) :1291-1298.
[8]	[8]HIGAKI J, AOKI M R, KIDA I, et al.In vivo evidence of the importance of cardiac angiotensin-converting enzyme in the pathogenesis of cardiac hypertrophy[J].Arteriosclerosis Thrombosis&Vascular Biology, 2000, 20 (2) :428-434.
[9]	[9]YOON N, KIM K H, PARK K H, et al.Preventive effects of the angiotensin-II receptor blocker on atrial remodeling in an ischemic heart gailure model of rats[J].Korean Circulation Journal, 2013, 43 (10) :686.
[10]余良主, 韩璐, 孟巍, 等.人参皂苷Rg1对血管紧张素Ⅱ诱导心肌细胞肥大的影响[J].湖北科技学报 (医学版) , 2013, 27 (4) :277-280.
[11]崔欣欣.卡维地洛对高血压大鼠左心室重构的影响[J].解放军医药杂志, 2011, 23 (2) :12-14.
[12]	[12]NAGATA Y, KONNO T, HAYASHI K, et al.Myocardial tissue characterization of left ventricular reverse remodeling in ischemic cardiomyopathy[J].Circulation Journal, 2016, 80 (12) :2427-2428.
[13]符宇, 谈智, 吴涛, 等.α7n ACh R激动剂对血管紧张素Ⅱ诱导的心肌成纤维细胞增殖和胶原合成的影响及其分子机制[J].中山大学学报 (医学科学版) , 2016, 37 (1) :23-28.
[14]刘源, 唐其柱, 李利娜, 等.橙皮素对血管紧张素Ⅱ诱导的心肌成纤维细胞增殖及胶原蛋白合成的抑制作用[J].中华医学杂志, 2014, 94 (36) :2852-2856.
[15]	[15]PUNTMANN V O, ARROYO U E, HINOJAR B R, et al.Aortic stiffness and interstitial myocardial fibrosis by native T1 are independently associated with left ventricular remodeling in patients with dilated cardiomyopathy[J].Hypertension, 2014, 64 (4) :762-768.
[16]	[16]HURTADO-DE-MENDOZA D, CORONA-VILLALOBOS C P, POZIOS I, et al.Diffuse interstitial fibrosis assessed by cardiac magnetic resonance is associated with dispersion of ventricular repolarization in patients with hypertrophic cardiomyopathy[J].Journal of Arrhythmia, 2016, 33 (3) :201-207.
[17]赵庆斌, 刘丹丹, 李超.糖尿病兔心肌缺血早期心肌细胞超微结构和心肌组织中肿瘤坏死因子α表达水平及其意义[J].吉林大学学报 (医学版) , 2017, 43 (3) :463-467.
[18]王振涛, 常红波, 吴鸿, 等.抗纤益心浓缩丸对扩张型心肌病大鼠心功能及心室重构的影响[J].中国中医急症, 2017, 26 (3) :394-396.
[19]朴丽贞, 尹永日.甲醛对大鼠胚胎心脏的毒性作用研究[J].中国妇幼保健, 2016, 31 (18) :3833-3835.
[20]何炜, 李玉明, 周欣, 等.短时高强度间歇运动训练心肌梗死模型大鼠心室重构及线粒体变化[J].中国组织工程研究, 2016, 20 (40) :5986-5993.

相关文章(20)

[1]	李啟堂, 代兴飞, 张清东, 严荣爽, 潘呈, 费德锐, 马裕俭, 徐世鑫, 张颖. 早发性脊柱侧弯合并胸廓发育不良综合征幼猪模型肺组织学及超微结构, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240504
[2]	代华磊, 胡成成, 张桂敏, 陶四明, 陈建昆. 基于网络药理学和分子对接筛选黄芪治疗高血压心室重构的生物标记物, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230819
[3]	龙佑玲, 潘登, 熊田珍, 潘月, 苏勇, 熊霖, 吴彦, 栗莹. 心电向量图诊断高血压病左心室异常的临床应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210421
[4]	李云玲, 鲍天昊, 张亚洲, 田伟盟, 毛文文, 胡晓云, 李华, 顾俊. 左心室射血分数<45%的老年慢性心衰患者合并认知功能障碍的影响因素, 昆明医科大学学报.
[5]	杜飞, 李榕, 何睿, 曾水芹, 段开文, 李承文. 实时定量PCR检测白色念珠菌方法学的建立, 昆明医科大学学报.
[6]	原斌. 缺血性心肌病经皮冠状动脉介入治疗对改善左心室功能、降低心血管事件发生率的作用, 昆明医科大学学报.
[7]	李浩. 系统性缺氧导致新生大鼠脑损伤及远期行为异常, 昆明医科大学学报.
[8]	罗庆祎. 单心动周期实时三维超声心动图对房间隔缺损患者右心室功能的研究, 昆明医科大学学报.
[9]	龙琼华. 2型糖尿病对老年高血压患者颈动脉内膜中层厚度与左心室质量指数的影响及相关性, 昆明医科大学学报.
[10]	张瑜. 血流向量成像定量评价正常成人左心室涡流特征, 昆明医科大学学报.
[11]	王天阳. 洛铂对人胆管癌RBE细胞凋亡显微结构及超微结构的作用观察, 昆明医科大学学报.
[12]	白向锋. 脑钠素（BNP）评价左心室重建术对急性心肌梗死后左心室重构的影响, 昆明医科大学学报.
[13]	吴云鼎. 实时定量PCR的数据归一化方法, 昆明医科大学学报.
[14]	陈丽星. 血管紧张素-(1-7)对野百合碱诱导的肺动脉高压及右心室重构的影响, 昆明医科大学学报.
[15]	罗庆祎. 单心动周期全容积成像评价心肌梗死患者左心室收缩功能收缩同步性, 昆明医科大学学报.
[16]	王庆慧. 三维斑点追踪成像技术评价房间隔缺损患者左心室扭转的临床应用, 昆明医科大学学报.
[17]	景舒南. 急性心肌梗死直接PCI术后NT-proBNP与左室重构的变化, 昆明医科大学学报.
[18]	. 二维应变超声心动图对评价2型糖尿病患者左心室纵向收缩功能的作用, 昆明医科大学学报.
[19]	. 吗啡诱导CPP建立和消退大鼠海马CA1区超微结构变化的研究, 昆明医科大学学报.
[20]	. 缺血心肌早期超微结构观察, 昆明医科大学学报.