Huwer H, Rissland J, Vollmar B, Nikoloudakis N, Welter C, Menger M D, Schäfers H J
Department of Thoracic and Cardiovascular Surgery, University of Saarland, Homburg/Saar, Germany.
Basic Res Cardiol. 1999 Apr;94(2):85-93. doi: 10.1007/s003950050130.
Microvascularization of infarcted myocardial tissue may be a prerequisite for successful therapeutic interventions, including cardiomyoblast or satellite cell transplantation. Because little is known on microvascular restitution within infarcted tissue, we studied angiogenesis and microvascularization after cryothermia-induced myocardial infarction using intravital fluorescence microscopic techniques.
In anesthetized, orally intubated and ventilated Sprague-Dawley rats (n = 20), a sternotomy was performed and a standardized cryolesion was induced to the right ventricle by freezing for 5 min to -160 degrees C. Myocardial angiogenesis and microvascularization were analyzed quantitatively after rethoracotomy on days 7 (n = 6) or 28 (n = 8). Sham-operated animals (n = 6) served as controls.
Seven days after cryothermia, the central tissue area of the injured myocardium (28.4 +/- 9.2 mm2) was characterized by complete lack of capillary perfusion, while the periphery of the cryolesion (27.6 +/- 5.7 mm2) revealed a heterogeneous capillary perfusion pattern with a density of 300.9 +/- 38.9 cm-1. Adjacent myocardial tissue showed intact capillary perfusion (density: 563.0 +/- 44.4 cm-1) comparable with that of sham-operated controls. After 28 d the area with lack of capillary perfusion was found significantly reduced to 7.3 +/- 3.7 mm2 (P < 0.05); however, it was still surrounded by a heterogeneously perfused area of myocardial tissue of 57.7 +/- 19.2 mm2 (density: 271.1 +/- 52.7 cm-1), indicating partial restitution of capillary perfusion. Although at day 7 within the central zone of the cryolesions, capillary perfusion was completely shut down, perfusion of microvessels larger than capillaries, i.e., arterioles and venules, were found maintained, however, with a density markedly lower (1.96 +/- 1.04 mm-1) when compared with that of sham-controls (4.28 +/- 1.52 mm-1). After 28 d the number of these larger-sized microvessels increased significantly with values of density even higher compared with those observed in controls (6.89 +/- 1.71 mm-1; P < 0.05), indicating new vessel formation.
Our study indicates partial restitution and function of the microvascular network within infarcted myocardial tissue, which may serve as an appropriate prerequisite for successful application of novel therapeutic strategies to improve myocardial function.
梗死心肌组织的微血管化可能是包括心肌母细胞或卫星细胞移植在内的成功治疗干预的前提条件。由于对梗死组织内微血管修复的了解甚少,我们使用活体荧光显微镜技术研究了低温诱导心肌梗死后的血管生成和微血管化。
在麻醉、经口插管并通气的Sprague-Dawley大鼠(n = 20)中,进行胸骨切开术,并通过冷冻至-160℃ 5分钟,在右心室诱导标准化的冷冻损伤。在第7天(n = 6)或第28天(n = 8)再次开胸后,对心肌血管生成和微血管化进行定量分析。假手术动物(n = 6)作为对照。
低温治疗7天后,受损心肌的中央组织区域(28.4±9.2平方毫米)的特征是完全缺乏毛细血管灌注,而冷冻损伤的周边区域(27.6±5.7平方毫米)显示出异质性的毛细血管灌注模式,密度为300.9±38.9每厘米。相邻心肌组织显示出完整的毛细血管灌注(密度:563.0±44.4每厘米),与假手术对照组相当。28天后,发现缺乏毛细血管灌注的区域显著减少至7.3±3.7平方毫米(P < 0.05);然而,它仍然被一个57.7±19.2平方毫米的心肌组织异质性灌注区域(密度:271.1±52.7每厘米)包围,表明毛细血管灌注部分恢复。尽管在第7天,在冷冻损伤的中央区域内,毛细血管灌注完全停止,但发现大于毛细血管的微血管,即小动脉和小静脉的灌注得以维持,然而,与假手术对照组(4.28±1.52每毫米)相比,其密度明显较低(1.96±1.04每毫米)。28天后,这些较大尺寸微血管的数量显著增加,密度值甚至高于对照组(6.89±1.71每毫米;P < 0.05),表明有新血管形成。
我们的研究表明梗死心肌组织内微血管网络部分恢复并具有功能,这可能是成功应用新型治疗策略改善心肌功能的合适前提条件。