卡维地洛对家兔心肌梗死边缘区Cx43的影响及与室性心律失常的关系  

Carvedilol reduces ventricular arrhythmia by altered expression of connexin43 in infarct border zone

作　　者：陈葵[1] 黄从新[1] 曲哲[1] 唐艳红[1] 王晞[1] 包明威[1] 邓汉华[1] 胡曙萍[1] 葛建[1] 

机构地区：[1]武汉大学人民医院心内科心电图室,博士研究生430060

出　　处：《中华心律失常学杂志》2006年第6期443-446,共4页Chinese Journal of Cardiac Arrhythmias

基　　金：湖北省科技攻关项目(2006A301A04)

摘　　要：目的卡维地洛是一种新型的抗心律失常药物,对β1、β2、α1受体都有阻滞作用,而Cx43是心室肌心电传导的基础,本组观察卡维地洛对心肌梗死边缘区Cx43分布的影响及与室性心律失常的关系。方法家兔随机分为梗死组、卡维地洛组、假手术组,每组12只。梗死组和卡维地洛组开胸结扎冠状动脉左前降支,假手术组不结扎。所有家兔普通饲料喂养,卡维地洛组另给予卡维地洛5 mg·kg-1·d-1。12周后观察:(1)动态心电图记录自发性室性心律失常的情况;(2)快速心室连续电刺激诱发的室性心律失常;(3)共聚焦激光显微镜观察梗死边缘区Cx43的分布。结果(1)动态心电图记录显示梗死组和卡维地洛组的偶发和频发室性早搏(室早)明显多于假手术组。与梗死组对比,卡维地洛组发生频发室早和室性心动过速(室速)的家兔数显著降低(分别为2 vs 6,P<0．05;3 vs 6,P< 0．05);(2)心肌梗死组比卡维地洛组更易被连续心室电刺激诱发室速(7 vs 3,P<0．01),而假手术组仅有1只家兔被诱发出室速;(3)共聚焦激光显微镜下观察梗死组的Cx43相对密度显著低于卡维地洛组,分别为0．32％±0．11％,0．16％±0．06％,P<0．05。结论卡维地洛可以减少心肌梗死后自发的和诱发的室性心律失常,这可能与卡维地洛引起Cx43的再分布有关。Objective This study is to observe the effect of carvedilol on Cx43 of infarcted rabbits and its relationship with ventricular arrhythmia. Methods Rabbits were randomly divided into 3 groups （ n = 12/ group）. Both infarcted group and carvedilol group underwent open-chest left anterior coronary artery occlusion but the sham group underwent open chest surgery occlusion with sham operation. After the surgery all rabbits were raised for 3 months and carvedilol 5 mg · kg^-1· d^-1 were added to rabbits in carvedilol group. The spontaneous ventricular arrhythmia was monitored by Hoher for 5 hours. The burst stimulation was applied to induce the ventricular tachycardia. The density of Cx43 was observed by quantitative immunoconfocal laser scanning microscope and PC image software from epicardial border zone. Results （ 1 ） According to Holter recording, occasional and frequent ventricular premature beats （VPB） and ventricular tachycardia （VT） in infarcted group and carvedilol group are much more than in sham group. Compared with infarcted group, rabbits with frequent VPB （2 vs 6, P 〈 0. 05 ） and VT （3 vs 6, P 〈 0.05 ） are less in carvedilol group significantly. （2） VT is easier to be induced in infarcted group though burst pacing than in carvedilol group （7 vs 3, P 〈 0. 05 ）. In control group only 1 rabbit is induced VT, less than both above groups （ P 〈 0. 05 ）. （3） Under immunoconfocal laser microscape, the relative density of Cx43 in infarcted group （0. 32% ± 0. 11%, P 〈 0. 05 ） and carvedilol group （0. 16% ±0.06%, P 〈0.05） are less than in sham group （0.68% ±0. 15% ） and carvedilol group is higher than infarcted group significantly （ P 〈 0. 05 ）. Conclusion Carvedilol can reduce spontaneous and induced ventricular arrhythmia, and this effect may due to Cx43 distribution.

关 键 词：卡维地洛 心肌梗死 CX43 室性心律失常 

分 类 号：R542.22[医药卫生—心血管疾病] R541.7[医药卫生—内科学]