白藜芦醇对快速起搏右心房诱发的持续性心房颤动猪心房结构重构的影响

目的 观察快速起搏猪右心房制备持续性心房颤动（AF）的效果,探讨白藜芦醇（RES）干预对持续性AF猪的心房结构重构的影响.方法 18只小家猪（雌雄不拘）按完全随机设计的分组方法（采用动物编号和随机分组表）分为起搏组（ATP组）、假手术组（Sham组）和RES干预组各6只,采用Seldinger血管穿刺技术送入双极电极至右心房并连接实验用起搏器（AOO）,ATP组和RES干预组的右心房快速起搏（500次/min）2周,制备持续性AF实验模型.3组猪分别于起搏前和起搏2周后进行电生理和经胸壁超声心动图检查,以检测AF的持续时间、左右心房大小及左心房收缩末面积.RES干预组猪于起搏前1周开始服用RES（2.5 mg·kg-1·d-1）.起搏2周后取各组猪的左右心房组织标本,观察心房组织形态学和间质纤维化的改变,用免疫组织化学分析软件计算胶原容积分数（CVF）来反映间质纤维化程度.结果 （1）起搏2周后,ATP组AF的发生率较RES干预组明显升高（100％比66.7％,x2=10,P＜0.01）、持续时间延长[（26.41±9.89）min比（9.56±1.36） min,F=10.7,P=0.01].（2）起搏2周后,ATP组和RES干预组猪的左右心房明显比起搏前增大;但RES干预组的左心房收缩末面积明显低于ATP组[（599.2±8.7） mm2比（744.3±29.9） mm2,F=130.61,P＜0.01].（3）RES干预组左右心房组织CVF明显低于ATP组（56％±6％比73％±7％;59％±6％比75％±7％,均为P＜0.01）.结论 快速起搏猪右心房可成功制备持续性AF模型;RES干预可以明显抑制快速起搏右心房诱发的持续性AF猪的心房结构重构,减少AF的发生.

Effect of resveratrol on atrial structural remodeling in sustained atrial fibrillation pigs induced by right atrial rapid pacing

Objective To investigate the feasibility of right atrial rapid pacing in inducing sustained atrial fibrillation pig model and the effect of resveratrol on atrial structural remodeling.Methods Eighteen pigs were randomly divided into three groups,right atrial rapid pacing （ATP） group （n =6）,resveratrol-intervened group （n =6） and sham group （n =6）.A bipolar electrode was inserted through jugular veins into the right atrial （RA） appendage under fluoroscopic guidance and connected to pacemakers （AOO） in subcutaneous pockets in the neck.Pigs in ATP group and resveratrol-intervened group were paced at 500 beats per minute for 2 weeks.Electrophysiological study and transthoracic echocardiography were performed at baseline and the end of study to measure atrial fibrillation duration time and left atrial end-systolic area （LAESA）.Resveratrol was given orally 2.5 mg· kg-1· d-1 only in the resveratrol-intervened group a week before pacing.Pathohistological changes were tested to observe the degree of atrial interstitial fibrosis in all Pigs.Microscopic images were quantified by Image-Pro Plus image analysis system.Results （1）The mean duration of induced AF was significantly longer in ATP group than in resveratrol-intervened group[（26.41 ± 9.89） minvs.（9.56±1.36） min,F=10.7,P=0.01].（2） LAESA was increased in both ATP group and resveratrol-intervened group.At the end of study,LAESA in resveratrol-intervened group was significantly lower than that in ATP group [（599.2 ±8.7） mm2 vs.（744.3 ±29.9） mm2,F =130.61,P 〈 0.01].（3） The percentage of fibrosis in left and right atria in resveratrol-intervened group was markedly lower than in ATP group （56% ±6% vs.73% ±7% and 59% ±6% vs.75% ±7%,respectively,both P 〈 0.01].Conclusions Right atrial rapid pacing can successfully induce sustained atrial fibrillation in pigs.Resveratrol can significantly inhibit atrial structural remodeling in sustained atrial fibrillation induced by right atrial rapid pacing in pigs.