维拉帕米对家兔快速心房起搏所致心房结构和电重构的影响  

Effect of verapamil on the structural and electrical remodeling of atria reduced by rapid intra-atrial pacing in rabbits

作　　者：孙娟[1] 侯月梅[1] 张玲[1] 刘政疆[1] 

机构地区：[1]新疆医科大学第一附属医院心脏中心,830054

出　　处：《国际心血管病杂志》2009年第4期236-239,共4页International Journal of Cardiovascular Disease

基　　金：国家自然科学基金(30560050)

摘　　要：目的:观察L-钙离子通道阻断剂维拉帕米对家兔快速心房起搏所致结构和电重构的作用。方法:将24只家兔随机分为:对照组、快速起搏组和维拉帕米组。经颈内静脉将电极置入兔右心房。分别测定各组在0、2、4、6和8h(记为P0、P2、P4、P6、P8)时的心房有效不应期(AERP200和AERP150)。左心房和肺静脉心肌袖组织行HE染色观察组织学改变。结果:快速心房起搏组在不同基础刺激作用下AERP缩短,AERP200-AERP150的频率适应性不良,P8与起搏前P0比较差异显著(P<0.05)。左心房和肺静脉心肌袖组织学改变明显。维拉帕米组AERP基本无改变(P>0.05),AERP200-150频率适应性维持。左心房和肺静脉心肌袖与起搏组相比组织学改变较轻。结论:维拉帕米可以抑制快速心房起搏所致电重构,但不能逆转结构重构。Objective： To investigate the effects of L-type Ca^2＋ -channel blocker verapamil on atrial structural and electrical remodeling induced by rapid intra-atrial pacing in rabbits and to explore the mechanism by which verapamil exerts therapeutic effect on atrial fibrillation （AF）. Methods：A cohort of 24 rabbits were randomly assigned into 3 groups： control group （n = 8）, rapid pacing group （n =8） and Verapamil group （n = 8）. Atrial effective refractory period （AERP） was measured by programmed electrical stimulation before pacing and 0, 2, 4, 6, and 8 hours after the onset of the pacing. Morphological characteristics revealed by HE staining of the left atrial tissues and pulmonary vein sleeves were detected with light microscope. Results： The AERP was shortened and the adaptability to the frequency of AERP disappeared during pacing compared with those before pacing （P〈0. 05）. The morphology of the tissues from above-mentioned regions changed more significantly in rapid pacing group than that in control group. The shortening of AERP was reversed, the adaptability to frequence was maintained （P〉0.05）, and morphological changes in tissues in verapamil group was less than those in rapid pacing group. Conclusion： Verapamil can inhibit the atrial electrical remodeling, but can not reverse structural remodeling of atria and pulmonary vein sleeves reduced by rapid intra-atrial pacing.

关 键 词：心房颤动 起搏 电重构 结构重构 维拉帕米 

分 类 号：R541.75[医药卫生—心血管疾病] R972[医药卫生—内科学]