快速心房起搏引起猪心房颤动时心房结构的变化及替米沙坦的预防作用  

Preventions with telmisartan on atrial remodeling in atrial fibrillation of pig with rapid atrial pacing

作　　者：徐晤[1] 王志荣[1] 李思召[1] 张超群[1] 李飞[1] 周召峰[1] 张卓琦[1] 

机构地区：[1]徐州医学院附属医院心内科,221002

出　　处：《中国介入心脏病学杂志》2012年第6期338-342,共5页Chinese Journal of Interventional Cardiology

基　　金：江苏省兴卫工程医学重点人才资助项目(RC2007089)

摘　　要：目的建立猪实验性心房颤动(atrial fibrillation,AF)模型,观察心房结构重构的变化和替米沙坦(TMST)干预的作用,测定血管紧张素转化酶2(ACE2)和胶原蛋白-Ⅰ的变化。方法将18头猪按随机数字表分为对照组(NC组)、快速心房起搏组(RAP组)、RAP+TMST组。闭胸法建立猪的持续性AF模型,超声测量实验前、后心室收缩末期左、右心房面积(LAESA、RAESA)变化;应用程序刺激检测AF的诱发率和持续时间;通过伊红(HE)染色、Masson染色和蛋白印迹法(Western blot)检测ACE2和胶原蛋白-Ⅰ的变化。结果与RAP组相比,RAP+TMST组LAESA、RAESA扩大减轻,AF诱发率降低、持续时间缩短,胶原蛋白-Ⅰ减少,而ACE2表达明显增加。RAESA与胶原蛋白-Ⅰ呈正相关关系(r1=0.956,P<0.01),RAESE与ACE2、ACE2与胶原蛋白-Ⅰ均呈负相关关系(r2=-0.966,r3=-0.948,P<0.01)。结论猪AF模型心房肌出现结构重构的病理表现,ACE2表达失衡与AF结构重构密切相关;TMST可降低AF的发生率及持续时间,明显改善心房结构重构。Objective To study the atrial structural remodeling, angiotensin-converting enzyme 2 （ACE2） and collagen-I differently expressed in experimental pig atrial fibrillation （AF） model and effect of telmisartan （TMST） on the atrial remodeling. Methods Eighteen healthy pigs were randomly divided into 3 groups which were the control （NC） group,the rapid atrial pacing （RAP） group and the RAP＋TMST group.AF model is established by rapid atrial pacing. Echocardiography is used to measure the Left and Right Atrial End-systolic Aera Atrial area （LAESA, RAESA） before and after the intervention. Electrophysiological stimulation was used to detect the rate and duration of AF. The changes of collagen-I and ACE2 was assessed by HE staining, Masson staining and Western Blotting. Results LAESA, RAESA,the rate and duration of AF and the collagen-Ⅰ expression were significantly reduced （P0.05） in RAP＋TMST group compared with RAP,but the expression of ACE2 increased （P0.05）. RAESA and the collagen-Ⅰ expression were positively correlated （r1=0.956, P0.01） while RAESE with ACE2, ACE2 and collagen-Ⅰ were negative correlated （r2=-0.966, r3=-0.948, P0.01）. ConclusionsStructural remodeling occurs in pigs′ AF model. It is related to ACE2 expression but telmisartan showed reduction in the incidence and duration of AF, and atrial structural remodeling.

关 键 词：心房颤动 起搏 人工 心房重构 肽基二肽酶A 替米沙坦 

分 类 号：R541.75[医药卫生—心血管疾病]