心肌干细胞移植心肌梗死区12周后的心电生理稳定性及室颤阈值改善效应  

Long-term effects of cardiac stem cells transplantation to improve the electrophysiological stability and ventricular fibrillation threshold after myocardial infarction

作　　者：陈立朋 晏平[2] 郭天柱[3] 侯婧瑛[3] 郑韶欣[3] 周长青[3] 龙会宝[3] 钟婷婷[3] 王彤[3] 

机构地区：[1]广东省中山市西区医院,广东省中山市528400 [2]广州医科大学附属第一医院急诊科,广东省广州市510120 [3]中山大学孙逸仙纪念医院急诊科,广东省广州市510120

出　　处：《中国组织工程研究》2015年第10期1516-1522,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81270213)"ANGⅡ/AT1/SMAD/CX43通路在心肌干细胞提高心梗大鼠心电生理学稳定性和室颤阈值的作用机制研究";国家自然科学基金(81070125)"抗凋亡与促血管生成miRNA-378干预MSCs治疗心梗后心衰的机制研究";广东省科技计划项目(2010B031600032)"抗凋亡与促血管生成miRNA-378干预MSCs治疗心梗后心衰的机制研究";高校基本科研业务费中山大学青年教师重点培育项目(13ykzd16)"PPAR-γ/TGF-β1/Smad/CX43通路在PPAR-γ干预MSCs治疗心梗后心衰的疗效及机制研究"~~

摘　　要：背景:课题组前期研究证实心肌干细胞治疗心肌梗死后短中期(6周)能明显改善心电生理学稳定性和室颤阈值。目的:观察心肌干细胞对心力衰竭大鼠室颤阈值和心电生理稳定性的长期影响。方法:开胸结扎20只SD大鼠左前降支冠状动脉,2周后其中10只大鼠局部梗死心肌内注射PKH26荧光标记的由PBS悬浮的心肌干细胞,另10只大鼠局部梗死心肌内注射等量PBS。治疗12周后,再次开胸检测梗死区、梗死边缘区和非梗死区的心电生理特性和室颤阈值。实验结束后,摘取心脏行病理切片,检查PHK26标记的心肌干细胞是否在梗死区内生存并表达连接蛋白43及α-肌动蛋白。结果与结论:与对照组相比,心肌干细胞移植12周后其梗死区、梗死边缘区和非梗死区的单极电图激动恢复时间、纠正的激动恢复时间差异无显著性意义(P>0.05);单极电图纠正的激动恢复时间离散度、电刺激所激发的恶性心律失常差异无显著性意义(P>0.05);室颤阈值方面,实验组梗死区和梗死边缘区与对照组相比差异无显著性意义(P>0.05),非梗死区与对照组相比差异有显著性意义(P<0.05)。PHK26标记的心肌干细胞在梗死边缘区内被发现并表达连接蛋白43和α-肌动蛋白。以上结果提示心肌干细胞移植后12周其心电生理的稳定性和室颤阈值的改善效应已逐渐消失,但机制未明。BACKGROUND： Our previous work has demonstrated that the electrophysiological stability and ventricular fibrillation threshold were distinctly improved in rats with myocardial infarction 6 weeks after cardiac stem cells transplantation（short- to mid-term）.OBJECTIVE： To observe the long-term effects of cardiac stem cells transplantation on the ventricular fibrillation threshold and electrophysiological stability in rats with heart failure post myocardial infarction.METHODS： Twenty Sprague-Dawley rats with myocardial infarction were induced by the left anterior descending coronary artery ligation. Two weeks later, animals were randomized to receive the injection of cardiac stem cells labeled with PKH26 in PBS or PBS alone into the local infarct zone. Twelve weeks after the cardiac stem cells or PBS injection,the electrophysiological characteristics and ventricular fibrillation threshold were measured at the infarct zone, the infarct marginal zone and the non-infarct zone. Labeled cardiac stem cells were detected and the expression of connexin-43 and α-sarcomeric actin was examined in cryostat sections from each harvested heart.RESULTS AND CONCLUSION： Compared with the PBS group, no significant differences were revealed in the unipolar electrogram activation recovery time and the correct activation recovery time in the infarct zone, the infarct marginal zone and the non-infarct zone in the cardiac stem cells group at 12 weeks post the cell transplantation（P〉0.05）. There were no remarkable differences in the correct activation recovery time dispersion and induced malignant ventricular arrhythmias between the two groups（P〉0.05）. No obvious differences were discovered in the ventricular fibrillation threshold in the infarct zone and infarct marginal zone in the cardiac stem cells group in contrast to the PBS group（P〉0.05）, though a statistical significance could be found in the non-infarct zone between the two groups（P〉0.05）. Labeled cardiac stem cells were identified in the infarct

关 键 词：肌细胞 心脏 心力衰竭 心脏电生理学 心室颤动 干细胞 移植 心肌干细胞 心律失常 心电生理学特性 室颤阈值 心肌梗死 国家自然科学基金 

分 类 号：R394.2[医药卫生—医学遗传学]