大鼠异位心脏移植对心脏减负荷模型制作的价值

目的 探讨大鼠心脏减负荷模型的制作要点,为心力衰竭患者使用左心室辅助装置恢复机制提供实用模型。方法 同系29只Lewis成年大鼠,通过结扎冠状动脉前降支形成缺血性心肌病,用UCG筛选符合心力衰竭条件的大鼠。将24只心力衰竭大鼠随机分为2组：减负荷组（n = 14）与心衰组（n = 10）。心衰组不进行心脏移植。减负荷组对心力衰竭大鼠心脏作为供体异位移植于受体腹部下腔静脉及腹主动脉,形成左心室减负荷模型。另设空白对照组（n = 8）,这些大鼠仅仅接受开胸手术,而不实施冠状动脉前降支的结扎,其它处理方式同以上2组。实施心脏移植2周后,分别对3组小鼠进行检测。检测指标包括测量左室舒张末压、最大压力上升速率（+dp/dt_max）及左室收缩压,并作心脏病理切片检测组织学改变。结果 缺血性心肌病心力衰竭动物模型成功率为 82.76 %（24/29）,心力衰竭大鼠进行心脏减负荷后的存活率是 71.43%（10/14）。与心衰组相比,减负荷组左心室发展压升高（47.85±0.94 vs. 35.94±0.95,F = 250.993,P < 0.05）,左心室+dp/dt_max升高（1177.85±61.03 vs. 841.64±40.26,F = 942.304,P < 0.05）。结论 利用大鼠作为实验动物,通过先制作心肌梗死心力衰竭模型,再对其进行异位心脏移植,可作为经济、可重复的心室减负荷模型。

Role of heterotopic heart transplantation in establishment of rat models with unloading the infarcted hearts

Objective To investigate the highlights of establishing a rat model of mimicking left venticular assist device （LVAD） by unloading rat infarcted hearts. Methods 29 adult Lewis rats were ligated the left anterior discending arteries to shut the blood supply of myocardium to establish the infarcted heart failure rat models. Electrocardiogram （ECG） was performed to screen the rat models with heart failure. 24 heart failure rats were randomly divided into the unloading group （n = 14） and heart failure group （n = 10）. Heart transplantation was not performed in the heart failure group. In the unloading group, the hearts of heart failure rats were prepared for heterotopic cardiac transplantation into the inferior vena cava and abdominal aorta of the recipient rats to establish the left ventricular unloading models. In the blank control group （n = 8）, the rats were intervened with open surgery alone. The remaining interventions were similar to those in the other two groups. At 2 weeks after cardiac transplantation, the left ventricular end-diastolic pressure （LVEDP）, maximum left ventricular pressure rising/falling rate （±dp/dt_max） and left ventricular systolic pressure （LVSP） were measured. Histological changes of the rat hearts were observed. Results The success rate of heart failure rat models after ischemic cardiomyopathy was 82.76% （24/29）. The survival rate of heart failure rats after cardiac unloading was 71.43% （10/14）. Compared with the heart failure group, the left ventricular developed pressure （LVDP） was significantly elevated （47.85±0.94 vs. 35.94±0.95,F = 250.993, P < 0.05） and the ±dp/dt_max was significantly increased （1177.85±61.03 vs. 841.64±40.26,F = 942.304,P < 0.05） in the unloading group. Conclusion The rat models with heart failure can be established by myocardial infarction and subsequently receive heterotopic heart transplantation, which offers an economical and reproducible model of ventricular unloading.