室性早搏对心室肌线粒体超微结构的影响  

Effects of premature ventricular contractions on ultrastructure of ventricular mitochondrial

作　　者：杨曼琪 吴钢[1] 刘韬[1] 崔博[1] 居昊 刘哲宇 任宗力[2] 曹省[3] 颜敏 张帆[1] YANG Man-qi;WU Gang;LIU Tao;CUI Bo;JU Hao;LIU Zhe-yu;REN Zhong-li;CAO Sheng;YAN Min;ZHANG Fan(Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan430060,Hubei,China;Department of Thoracic Surgery,Renmin Hospital of Wuhan University,Wuhan430060,Hubei,China;Department of Ultrasound,Renmin Hospital of Wuhan University,Wuhan430060,Hubei,China)

机构地区：[1]武汉大学人民医院心内科,湖北武汉400060 [2]武汉大学人民医院胸外科,湖北武汉400060 [3]武汉大学人民医院超声科,湖北武汉400060

出　　处：《中国心脏起搏与心电生理杂志》2023年第2期142-145,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金(项目编号:81870301,81800337)。

摘　　要：目的探讨频发性室性早搏(PVC)对线粒体超微结构的影响。方法14只成年比格犬随机分为对照组(CTL,n=7)和模型组(PVC-ICM,n=7)。PVC-ICM组经颈外静脉植入双腔起搏器,心房电极植入右室游离壁,心室电极植入右室心尖部,起搏模式设置为VDD,形成PVC二联律起搏方式,在右室心尖部持续起搏,联律间期设置为350 ms;CTL组植入起搏器不起搏。每隔2周对犬进行心电图及超声心动图检测,通过心电图数据,确认起搏器持续工作。造模12周后关闭起搏器,注射过量戊巴比妥钠将犬处死后取材。利用透射电镜观察心室线粒体超微结构改变。结果造模12周后,与CTL组比较,PVC-ICM组LVEF[(0.40±0.03)vs(0.62±0.03)]和FS[(0.18±0.01)vs(0.33±0.02)]明显降低,LVEDD[(36.4±1.6)mm vs(29.3±1.0)mm]和LVESD[(29.8±1.0)mm vs(19.6±0.5)mm]增厚;线粒体结构紊乱,每个视野下数量减少[(93.29±6.02)个vs(112.43±11.85)个,P<0.001],面积增大[(225.63±18.88)μm^(2)vs(171.37±19.64)μm^(2),P<0.001],体积增大[(2.42±0.18)μm^(2)vs(1.54±0.19)μm^(2),P<0.001]。结论长期频发性PVC可引起心功能障碍和线粒体超微结构改变。Objective To investigate the effect of frequent PVCs on the ultrastructure of mitochondria.Methods Fourteen adult beagles were randomly divided into control group(CTL,n=7)and PVC-ICM group(PVC-ICM,n=7).In the PVC-ICM Group,dual chamber pacemaker was implanted via external jugular vein,atrial electrode was implanted into the free wall of right ventricle,ventricular electrode was implanted into the apex of right ventricle,and the pacing mode was set to VDD to form PVC biphasic pacing mode,continuous pacing was performed in the right ventricular apex with a 350 ms coupling intervals.The control group(CTL,n=7)implanted pacemaker did not beat.Electrocardiogram and echocardiography were performed every 2 weeks to confirm the continuous operation of the pacemaker.After 12 weeks,the pacemaker was turned off and the dogs were euthanized.The ultrastructural changes of ventricular mitochondrial were observed by transmission electron microscopy.Results After 12 weeks,compare with CTLgroup,the LVEF[(0.40±0.03)vs(0.62±0.03)]and FS[(0.18±0.01)vs(0.33±0.02)]of the PVCICM group were obviously decreased;The number[(93.29±6.02)vs(112.43±11.85),P<0.001]of mitochondtrial decreased and area[(225.63±18.88)μm^(2)vs(171.37±19.64)μm,P<0.001]of mitochondrial increased in each fiber field,and volume of mitochondrial were increased[(2.42±0.18)μm^(2)vs(1.54±0.19)μm^(2),P<0.001] in the PVC-ICM Group.Conclusions Long-term frequent PVCs can cause cardiac dysfunction and ultrastructural changes of mitochondria.

关 键 词：心血管病学 病理生理 室性早搏 心肌病 线粒体 超微结构 

分 类 号：R541.7[医药卫生—心血管疾病]