压力超负荷致心肌肥大过程中心肌内分泌因子活化

目的探讨急性压力超负荷心肌肥大的跨膜信号传递机制.方法分别利用放射免疫法、分光光度法、免疫组化及原位杂交法动态观察压力超负荷后大鼠心肌组织血管紧张素转换酶(ACE)活性、血管紧张素Ⅱ(Ang Ⅱ)、一氧化氮含量和碱性成纤维细胞生长因子(bFGF)表达的变化,并观察它们与压力超负荷心肌肥大的关系.结果随大鼠血压升高,心肌组织中ACE活性及AngⅡ含量均迅速升高(P＜0.05),并持续保持高水平,bFGF表达先升高(P＜0.05)后又恢复到正常水平;AngⅡ含量升高早于bFGF表达升高;而一氧化氮含量迅速降低并持续受抑(P＜0.05).结论心肌内分泌活化可能是介导压力超负荷致心肌肥大的重要机制.     

一氧化氮在压力超负荷心肌肥大作用中的定量分析

目的：探讨一气化氮（NO）在压力超负荷心肌肥大反应过程中的作用。方法：建立腹主动脉缩窄性高血压大鼠模型,测定平均动脉压（MAP）和左心室／体重比值（LVW／BW）;测量大鼠心肌的体积密度（Vv）、表面积密度（Sv）、比表面（S／V）及平均自由程（λ）等。结果：高血压大鼠的MAP、LVW／Bw、心肌横断面积、平均直径、Vv、Sv明显增大、入显著减小;加L-Arg组的MAP、LVW／BW值大致恢复至正常水平,心肌横断面积及平均直径、Vv、Sv等明显小于高血压组,S／V及入则增大;加L-NAME组的MAP、LVW／BW、心肌横断面积及平均直径、Vv、Sv等持续加大,而S／V及入则变小。结论：NO可明显改变体视学各项参数,对压力超负荷引起的高血压和心肌肥大具有明显的抑制作用。     

压力超负荷大鼠心肌胶原代谢的动态变化

目的:探讨压力超负荷大鼠心肌胶原代谢的动态变化。方法:采用腹主动脉缩窄法制备压力超负荷大鼠模型,并以假手术组为对照,分别于术后第3周、4周、8周和12周取材,称量大鼠体质量、心脏质量和左心室质量,计算心脏质量指数(heart mass index,HMI)和左心室质量指数(left ventricle mass index,LVMI);心肌组织Masson染色观察心肌胶原纤维沉积情况;样本碱水解法检测心肌组织羟脯氨酸(hydroxyproline,HYP)含量;ELISA法检测血清Ⅰ型前胶原羧基端肽(procollagen typeⅠcarboxy-terminal peptide,PⅠCP)、Ⅲ型前胶原氨基端肽(procollagen typeⅢamino-terminal peptide,PⅢNT)和Ⅰ型胶原C端肽(collagen C telopeptide typeⅠ,CTX-Ⅰ)水平。结果:与假手术组相比,模型组大鼠心肌血管周围及间质可见胶原纤维沉积,心肌胶原容积分数明显增高(P0.01),且随时间延长胶原沉积明显增多;模型组大鼠HMI、LVMI和HYP均明显增加(P0.05),且随时间延长大鼠HYP有升高的趋势;模型组大鼠血清PⅠCP浓度显著升高,在第4、8和12周时差异有统计学意义(P0.05);模型组大鼠血清PⅢNP浓度显著升高,CTX-Ⅰ浓度显著降低,差异均有统计学意义(P0.01)。结论:压力超负荷状态下,心肌胶原代谢紊乱,且随时间的延长心肌呈不同程度的纤维化表现。     

丝裂素活化蛋白激酶与心肌重构

心肌重构主要指心肌细胞肥大和间质增生。丝裂素活化蛋白激酶（ＭＡＰＫ）是一类重要的细胞内信息传递物质。研究发现ＭＡＰＫ是原核细胞和真核细胞生长与分化的细胞内信号传导的共同通路。心室肌、心房肌和心脏间质成纤维细胞中均有ＭＡＰＫ存在，而且许多外界刺激因素如牵张作用、某些血管活性肽和生长因子均可激活ＭＡＰＫ导致心肌重构。因此ＭＡＰＫ在心肌重构的发生中具有重要的地位     

Neuregulin-1β对压力超负荷心肌肥大大鼠治疗作用及机制的研究

 目的：研究神经调节蛋白 1β（NRG-1β）对压力超负荷所致大鼠心肌肥大的治疗作用并探讨其机制。方法：Wistar雄性大鼠采用腹主动脉缩窄的方法复制心肌肥大模型。术后8周,将模型动物随机分成模型（model）组、NRG-1β治疗组（尾静脉注射NRG-1β,10 μg·kg-1·d-1）和NRG-1β+赫赛汀(Herceptin, HERCE)治疗组（尾静脉注射NRG-1β的同时给予注射HERCE 10 μg·kg-1·d-1）。假手术（sham）组除不以银夹缩窄腹主动脉外,其余操作同腹主动脉缩窄组。7　d后分别采用心动超声、血流动力学评价心功能;Masson染色观察心肌组织的超微结构;放射免疫法检测心肌组织中血管紧张素II（Ang II）,酶联免疫吸附法测定心肌组织中肿瘤坏死因子 α（TNF-α）的变化;RT-PCR法检测心肌中bcl-2和bax mRMA表达的改变。结果：（1）心动超声显示,和模型组比较,NRG-1β组左室射血分数(LVEF)及短轴缩短率(LVFS)升高,左室收缩末内径(LVESD)及舒张末内径(LVEDD)减小（P<0.01）。（2）血流动力学检测显示,NRG-1β治疗组左室收缩末压(LVESP)和左室内压最大上升和下降速率(±dp/dtmax)均明显高于模型组（P<0.01）;左室舒张末压(LVEDP)低于模型组（P<0.01）。（3）与模型组比较,NRG-1β组心肌胶原容积分数（CVF）下降,心肌中Ang II和TNF-α明显减少,bcl-2 mRNA表达显著升高,而bax mRNA表达下降（P<0.01）。（4）NRG-1β+ HERCE治疗组与模型组相比各项指标无明显改变（P>0.05）。结论：NRG-1可以减少压力超负荷大鼠心肌Ang II和TNF-α的生成,从而减轻Ang II和TNF-α介导的心肌间质重构; NRG-1可通过上调bcl-2 mRNA表达、下调bax mRNA表达,抑制心肌细胞的凋亡,改善压力超负荷大鼠的心功能,进而在心肌肥大的过程中发挥作用。     

miR-20a调控压力超负荷型心肌肥大

背景：心肌肥大是心脏对压力超负荷等生理和病理刺激所做出的适应性反应,早期具有代偿意义,若刺激持续进行可引起心肌病变导致心力衰竭。micro RNAs参与调控了心肌肥大的发生发展,然而mi R-20a在压力超负荷所致心肌肥大中的作用尚未见报道。目的：探究mi R-20a在压力超负荷所致心肌肥大中的作用及其机制。方法：横向主动脉缩窄术诱导心肌肥大小鼠模型,使用血管紧张素Ⅱ诱导心肌肥大H9c2细胞模型。体内实验在小鼠心脏原位注射mi R-20a过表达腺病毒,体外实验将mi R-20a mimic转染至H9c2细胞。通过检测心质量/体质量比值、细胞表面积、心肌纤维化等指标评估心肌肥大,实时荧光定量PCR法检测心房利钠肽、脑利钠肽、β-肌球蛋白重链和mi R-20a的表达水平,Mito Tracker法检测线粒体分裂情况,RNAhybrid软件预测miR-20a的下游靶基因。结果与结论：(1)在心肌肥大细胞模型和动物模型中,mi R-20a的表达水平均显著降低(P<0.05);(2)在动物水平,过表达miR-20a显著抑制了横向主动脉缩窄手术诱导的心肌肥大,包括抑制了肥大标志基因表达水平的...     

压力超负荷性心肌肥厚发病机制的研究

目的:探讨α1、β受体阻断剂派唑嗪(Prazosin,Pra)、心得安(Propra-nolol,Pro)及钙离子拮抗剂尼群地平(Nitrendipine,Nit)在压力超负荷性心肌肥厚发病学中的意义。方法:采用Pra、Pro和Nit治疗大鼠腹主动脉缩窄所致左室肥厚(LVH)。结果:Pra和Nit能抑制早期肥厚心肌c-fosmRNA表达,6周后Pra组和Nit组较LVH组之BP,LVW/BW均显著下降,同时心脏舒张功能改善,Na+-K+ATPase活性增强;而Pro不能有效改善LVH。结论:Pra和Nit治疗成功预防了心肌肥厚的发生,而Pro不能。提示儿茶酚胺参与压力超负荷性心肌肥厚的形成,其效应不仅涉及后负荷的高低,也可通过α1肾上腺素能受体而不是β肾上腺素能受体对心肌产生直接性致肥大作用,同时钙离子可作为第二信使参与引起心肌细胞肥大的信息传递。     

Akta和FoxO1在超负荷性心肌肥大时大鼠心肌的表达

目的 通过检测Akt和FoxO1基因在大鼠超负荷性心肌肥大过程中的表达,探讨心肌肥大时的细胞周期调控机制.方法 采用升主动脉缩窄的方法制作大鼠超负荷心肌肥大动物模型,通过三维彩色超声技术评价心肌肥大程度,采用RT-PCR技术检测心肌组织Akt和FoxO1的mRNA表达,用Western blots方法检测Akt磷酸化水平.结果 与假手术组相比,模型组的左室后壁厚度(LVPW)、室间隔厚度(IVS)增加(P<0.01),左室舒张末内径(LVDD)减小(P<0.01).模型组心肌组织中FoxO1的mRNA表达下调(P<0.01).Akt的基因表达没有明显变化但蛋白的磷酸化水平显著增加(P<0.01).结论 大鼠超负荷性心肌肥大时Akt激活,同时FoxO1的表达下调.     

大鼠压力超负荷早期心肌收缩功能和环核苷酸的动态反应

目的：探讨大鼠压力超负荷后心肌力学及环核苷酸的变化规律。方法：颈总动脉插管法动态测定腹主动脉部分缩窄大鼠心肌力学及环核苷酸含量（放免法）的变化。结果：伴随动脉血压的升高,手术组大鼠心肌收缩功能于术后４ｈ暂时性增强（与对照组比较,Ｐ＜００１）,之后逐渐降低,术后第５ｄ降至最低,其后逐渐恢复正常。心肌ｃＡＭＰ含量于术后３０ｍｉｎ显著升高（Ｐ＜００５）,第５ｄ时达最高（Ｐ＜００１）,之后逐渐下降,第３０ｄ时恢复正常,而ｃＧＭＰ变化正相反。小剂量巯甲丙脯酸可减轻手术大鼠早期及此后的心肌收缩功能受抑,但对环核苷酸含量无显著影响。结论：大鼠压力超负荷早期心肌收缩功能受抑,心肌ｃＡＭＰ浓度呈急性代偿性升高后逐渐恢复正常,而ｃＧＭＰ变化相反。     

大鼠压力负荷性肥大心肌中TNF-α mRNA表达变化

目的：探讨大鼠压力负荷性肥大心肌中TNF-α mRNA表达的变化及卡托普利（captopril）对其的影响。方法：采用腹主动脉缩窄法复制压力超负荷心肌肥大模型，于术后42 d采血、摘取心脏，测定心肌肥大指数并采用酶联免疫法测定血清及左心室肌TNF-α含量；应用心肌原位杂交法结合图像分析系统检测心肌组织中TNF-α mRNA表达的变化，并观测TNF-α mRNA在心肌组织中的定位。结果：术后42 d心肌明显肥大，以左心室为主；主动脉缩窄（aorta-constriction, AC）组心室肌TNF-α含量比假手术（sham-operation, SO）组高98%（P<0.01）；卡托普利干预使心室肌TNF-α含量比AC组低64.14%（P<0.01），但未达到对照水平；心肌组织原位杂交显示TNF-α mRNA表达主要在心肌间质部位，假手术组心肌TNF-α mRNA表达水平极低，明显低于AC术后（P<0.01），captopril干预虽明显抑制AC术后心肌组织中TNF-α mRNA表达，但并未使其达到SO组水平。结论：心肌组织内源性TNF-α的表达增加在压力负荷性心肌肥大中具有重要的调控作用，其过表达可能与RAS激活促心肌间质TNF-α mRNA表达上调有关。     

急性桐油中毒导致大鼠心肌损伤的酶组织化学及超微结构观察

目的：探讨急性桐油中毒对心肌的损伤机制。方法：模拟人体桐油中毒方式灌喂大鼠,复制大鼠急性桐油中毒模型。采用光镜、电镜及组织化学方法,观察急性桐油中毒对大鼠心肌的影响。结果：急性桐油中毒心肌明显受损,光镜下细胞及间质水肿,电镜下心肌线粒体肿胀,空泡样变,并有髓样小体形成。组化观察心肌琥珀酸脱氢酶（SDH）活性显著下降,乳酸脱氢酶（LDH）活性有增强趋势。结论：急性桐油中毒通过对心肌细胞线粒体的直接损伤以及对能量代谢的影响而引起心脏功能的明显损害。     

心肌L型钙通道/电流及其在心肌肥大和心力衰竭时的变化

心肌细胞电活动的基础就是各种通道的离子流。有两类离子流左右心肌细胞的电活动 :一类是内向离子流 ,包括Ｉｎａ、Ｉｎａ-ｂ、Ｉｆ、Ｉｃａ-Ｌ、Ｉｃａ-Ｔ;另一类是外向离子流 ,包括Ｉｔｏ(Ｉｔｏ1 、Ｉｔｏ2 )、ＩＫ(ＩＫｒ、ＩＫｓ、Ｉｋｐ)、ＩＫ1 、ＩＫ -ＡＴＰ、ＩＫ -Ａｃｈ等。心肌细胞的钙通道 /电流属内向电流 ,可分为两大类 :(1 )Ｌ型Ｃａ2 通道 /电流(ＩＣａ-Ｌ) ,它在决定心肌细胞动作电位平台期的内向电流和启动心肌细胞兴奋 -收缩耦联都发挥极其重要的作用。 (2 )Ｔ型Ｃａ2 通道 /电流 (Ｉｃａ-Ｔ) ,它可能在心脏起搏细胞…     

Calcium homeostasis behavior and cardiac function on left ventricular remodeling by pressure overload

Sarcoplasmic reticulum Ca²⁺-ATPase (SERCA2a) and sarcolemmal Na⁺/Ca²⁺ exchanger (NCX1) structures are involved in heart cell Ca²⁺ homeostasis. Previous studies have shown discrepancies in their function and expression in heart failure. The goal of this study was to evaluate heart function and hypertrophied muscle Ca²⁺-handling protein behavior under pressure overload. Twenty male Wistar rats were divided into two groups: Aortic stenosis (AoS), induced by a clip placed at the beginning of the aorta, and Control (Sham). After 18 weeks, heart function and structure were evaluated by echocardiogram. Myocardial function was analyzed by isolated papillary muscle (IPM) at basal condition and Ca²⁺ protein functions were evaluated after post-pause contraction and blockage with cyclopiazonic acid in IPM. Ca²⁺-handling protein expression was studied by western blot (WB). Echocardiogram showed that AoS caused concentric hypertrophy with enhanced ejection fraction and diastolic dysfunction inferred by dilated left atrium and increased relative wall thickness. IPM study showed developed tension was the same in both groups. AoS showed increased stiffness revealed by enhanced resting tension, and changes in Ca²⁺ homeostasis shown by calcium elevation and SERCA2a blockage maneuvers. WB revealed decreased NCX1, SERCA2a, and phosphorylated phospholambam (PLB) on serine-16 in AoS. AoS had left ventricular hypertrophy and diastolic dysfunction compared to Sham; this could be related to our findings regarding calcium homeostasis behavior: deficit in NCX1, SERCA2a, and phosphorylated PLB on serine-16.     

心肌肽素对大鼠心脏缺血-再灌注损伤的治疗作用

目的:研究多肽类物质心肌肽素对大鼠心脏缺血-再灌注损伤的治疗作用。方法:在大鼠冠脉结扎致心肌缺血-再灌注损伤模型上,观察心肌肽素治疗性给药对缺血大鼠血浆中肌酸磷酸激酶(CPK)、乳酸脱氢酶(LDH)活性及脂质过氧化终产物(MDA)含量的影响。结果:心肌肽素治疗性给药能明显降低血浆CPK、LDH的活性与MDA含量,其作用具有明显的量效关系。结论:心肌肽素对心脏缺血-再灌注损伤有治疗作用,提示可能与其抗脂质过氧化和影响心肌酶的活性有关。     

促红细胞生成素对压力超负荷大鼠心肌NADPH氧化酶表达的影响

 目的:探讨促红细胞生成素(EPO)对压力超负荷大鼠心肌NADPH氧化酶的影响。方法:36只SD雄性大鼠,腹主动脉结扎复制压力超负荷心肌肥大模型。动物随机分成3组：模型组;假手术组： 除不缩窄腹主动脉外,其余操作同腹主动脉缩窄组;重组人促红细胞生成素（rhEPO）治疗组（EPO治疗组）：术后给予rhEPO,腹腔注射4 000 U/kg,每周2次。8周后采用心动超声和血流动力学评价心功能; Masson染色观察心肌纤维化程度;实时定量PCR法和Western blotting法检测NADPH氧化酶2（Nox2）和Nox4 mRNA及蛋白表达的变化;Western blotting法观察心肌炎症因子CD45、F4/80和转化生长因子β（TGF-β）的表达变化。结果:与模型组比较,EPO治疗组左室射血分数（LVEF）、左室短轴缩短率（LVFS）、左室收缩末压（LVESP）及左室内压最大上升和下降速率（±dp/dtmax）明显升高( P<0.01),左室收缩末内径（LVESD）、舒张末内径（LVEDD）及左室舒张末压（LVEDP）下降(P<0.01);同时,EPO可降低压力超负荷所致的心肌纤维化程度 (P<0.01),降低心室肌中 Nox2、Nox4 mRNA和蛋白的表达 (P<0.05 或 P<0.01)及心肌炎症因子CD45、F4/80、TGF-β蛋白的表达。结论: EPO可抑制压力超负荷所致大鼠的心肌纤维化,改善心功能,其机制可能与降低NADPH氧化酶活性,抑制心肌氧化应激水平,减少心肌炎症反应有关。     

The autoregulation of the heart work by the coronary perfusion pressure

Summary In 9 dog hearts (coronary arteries cannulated, aortic blood pressure allowed to change) an increase in coronary perfusion pressure raised the peak pressure in the left ventricle and the maximum ofdp/dt, while the left ventricular enddiastolic pressure decreased.An enhancement of coronary perfusion pressure in 6 dog hearts (coronary arteries cannulated, aortic blood pressure kept constant) increased the peak pressure in the left ventricle and the maximum ofdp/dt; the left ventricular enddiastolic filling pressure decreased.This coronary perfusion pressure-induced increase in heart performance can also be shown by ventricular function curves. These are relatively flat at low coronary pressures. Therefore, even large changes in left ventricular enddiastolic pressure bring about only a small increase in stroke work. Heart failure could not be observed at low coronary perfusion pressures. An increase in coronary perfusion pressure shifted the ventricular function curves to the left, so that even a small change in enddiastolic filling pressure had a great effect on strokework.The homeometric autoregulation of the heart can be explained to a certain part by the coronary perfusion pressure.There is no explanation of the effect of the coronary perfusion pressure on heart performance. Based on our findings it must be concluded that an increased coronary perfusion pressure distends the coronary arteries (garden-hose-effect), which increases myocardial fiber tension and heart performance.Supported by the Deutsche Forschungsgemeinschaft (Sonderforschungsbereich Cardiologie Düsseldorf).     

Sex-specific pathways in early cardiac response to pressure overload in mice

Pressure overload (PO) first causes cardiac hypertrophy and then heart failure (HF), which are associated with sex differences in cardiac morphology and function. We aimed to identify genes that may cause HF-related sex differences. We used a transverse aortic constriction (TAC) mouse model leading to hypertrophy without sex differences in cardiac function after 2 weeks, but with sex differences in hypertrophy 6 and 9 weeks after TAC. Cardiac gene expression was analyzed 2 weeks after surgery. Deregulated genes were classified into functional gene ontology (GO) categories and used for pathway analysis. Classical marker genes of hypertrophy were similarly upregulated in both sexes (alpha-actin, ANP, BNP, CTGF). Thirty-five genes controlling mitochondrial function (PGC-1, cytochrome oxidase, carnitine palmitoyl transferase, acyl-CoA dehydrogenase, pyruvate dehydrogenase kinase) had lower expression in males compared to females after TAC. Genes encoding ribosomal proteins and genes associated with extracellular matrix remodeling exhibited relative higher expression in males (collagen 3, matrix metalloproteinase 2, TIMP2, and TGFbeta2, all about twofold) after TAC. We confirmed 87% of the gene expression by real-time polymerase chain reaction. By GO classification, female-specific genes were related to mitochondria and metabolism and males to matrix and biosynthesis. Promoter studies confirmed the upregulation of PGC-1 by E2. Less downregulation of metabolic genes in female hearts and increased protein synthesis capacity and deregulation of matrix remodeling in male hearts characterize the sex-specific early response to PO. These differences could contribute to subsequent sex differences in cardiac function and HF.     

Cytochrome c mRNA levels decrease in senescent rat heart.

The concentration of mitochondria decrease in the heart as rodents age from maturity to senescence. The reason for this change is not known. One purpose of the present study was to determine if cytochrome c mRNA, representative of proteins of the inner mitochondrial membrane, decreased in the hearts of Fischer 344 rats as they aged from 12 to 24 months. Twenty-two percent less cytochrome c mRNA existed per given quantity of extracted RNA from the heart in 24-month-old rats as compared with the 12-month-old group. No change in the quantities of cardiac -actin mRNA, Ca²⁺/calmodulin protein kinase II mRNA or 18S rRNA was noted between 12- und 24-month-old hearts. Thus, the decrease in cytochrome c mRNA suggests that decreased in mRNAs for proteins of the inner mitochondrial membrane could play some role in the diminished concentration of mitochondria that exists in the senescent heart.