频发室性早搏对犬心房重构的影响及其机制研究  

Effect of premature ventricular contraction on atrial remodeling in dogs

作　　者：居昊 吴钢[1] 刘韬[1] 崔博[1] 杨曼琪 刘哲宇 任宗力[2] 曹省[3] 颜敏 张帆[1] Ju Hao;Wu Gang;Liu Tao;Cui Bo;Yang Manqi;Liu Zheyu;Ren Zongli;Cao Sheng;Yan Min;Zhang Fan(Department of Cardiology,Renmin Hospital of Wuhan University,Cardiovascular Research Institute,Wuhan University,Hubei Key Laboratory of Cardiology,Wuhan 430060,China;Department of Thoracic Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Ultrasound,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院心内科、武汉大学心血管病研究所、心血管病湖北重点实验室,武汉430060 [2]武汉大学人民医院胸外科,武汉430060 [3]武汉大学人民医院超声科,武汉430060

出　　处：《中华心律失常学杂志》2024年第3期249-256,共8页Chinese Journal of Cardiac Arrhythmias

基　　金：国家自然科学基金(82270243,82270365)。

摘　　要：目的探讨频发室性早搏(PVC)对犬心房重构的影响及其机制。方法选择健康的雄性比格犬14只(体重10~12 kg),采用随机数字表法分为对照组和建立频发PVC犬模型的PVC组,每组7只。每隔2周对犬进行心电图检查确认起搏器正常工作。造模12周后,检测各组犬的超声心动图、心房电生理相关指标。处死犬后取左心房组织使用Masson染色分析进行组织学检测。提取左心房组织蛋白,采用Western blot法检测钙循环蛋白表达。使用ELISA法检测血浆中去甲肾上腺素(NE)和血管紧张素Ⅱ(AngⅡ)的表达。结果与基线相比,12周后对照组犬各超声心动图指标无明显变化,PVC组犬心房扩大[(18.30±1.25)mm对(27.88±1.52)mm,P<0.001],左心室射血分数下降(62.59%±1.35%对41.59%±2.32%,P<0.001),左心房射血分数下降(57.69%±2.95%对38.44%±6.08%,P=0.001)。两组犬的电生理特性,与对照组比较,PVC组犬心房有效不应期离散度(COV-ERP)增加(0.048±0.011对0.065±0.012,P=0.026),心房动作电位恢复时限离散度(COV-APD90)增加(0.047±0.005对0.057±0.008,P=0.027)。与对照组比较,PVC组心房颤动(房颤)诱发率上升(0对71.4%,P=0.021)。Masson染色显示,左心房胶原容积分数增加(3.49%±0.64%对8.31%±3.00%,P=0.002)。与对照组相比,PVC组钙循环蛋白表达异常。PVC组血浆中NE和的表达水平均高于对照组。结论PVC二联律可使心房功能降低,也能加重心房纤维化导致心房电重构,其机制可能是钙循环蛋白的异常表达,干扰了心房肌钙稳态。Objective To explore the effects and mechanisms of frequent premature ventricular contractions(PVC)on canines′atrial remodeling.Methods Fourteen healthy male beagles(0-12 kg)were divided into control group and PVC group by random number table,with 7 dogs in each group.The models of frequent PVC were established in PVC group dogs.Electrocardiogram(ECG)was performed on the canines every 2 weeks to confirm that the pacemaker was working properly.After pacing for 12 weeks,the echocardiography and atrial electrophysiological examination of the dogs in each group were detected.After being euthanized,the left atrium tissues were collected and analyzed by Masson staining for histological analysis.Left atrium tissues were extracted,and the expressions of calcium handling proteins was detected by Western blot.Use ELISA method to detect the expression of norepinephrine(NE)and angiotensinogenⅡ(AngⅡ)in plasma.Results Compared with the baseline,there was no significant change in the ultrasound indexes of the control group dogs after 12 weeks.Compared with the baseline and 12 weeks after pacing,left atrium in the PVC group was enlarged[(18.30±1.25)mm vs.(27.88±1.52)mm,P<0.001].And left ventricular ejection fraction was decreased(62.59%±1.35%vs.41.59%±2.32%,P<0.001).Left atrial ejection fraction was decreased(57.69%±2.95%vs.38.44%±6.08%,P=0.001).In terms of the electrophysiological characteristics,compared with the control group,the dispersion of atrial effective refractory period(COV-ERP)in the PVC group was increased(0.048±0.011 vs.0.065±0.012,P=0.026).And the dispersion of atrial action potential duration(COV-APD90)were also higher than that in the control group(0.047±0.005 vs.0.057±0.008,P=0.027).Compared with the control group,atrial fibrillation induction rate was significantly higher(0 vs.71.4%,P=0.021)in PVC group.Masson staining showed that left atrial collagen volume fraction in PVC group was significantly higher than that in control group(3.49%±0.64%vs.8.31%±3.00%,P=0.002).Compared with the control g

关 键 词：室性早搏复合征 心房重构 超声心动图 电生理 钙稳态 

分 类 号：R541.7[医药卫生—心血管疾病]