左心室辅助装置支持对心肌胶原含量的心脏恢复影响。
The implications for cardiac recovery of left ventricular assist device support on myocardial collagen content.
作者信息
Bruckner B A, Stetson S J, Farmer J A, Radovancevic B, Frazier O H, Noon G P, Entman M L, Torre-Amione G, Youker K A
机构信息
Department of Surgery, Baylor College of Medicine and DeBakey Heart Center, and the Texas Heart Institute, Houston, Texas, USA.
出版信息
Am J Surg. 2000 Dec;180(6):498-501; discussion 501-2. doi: 10.1016/s0002-9610(00)00553-5.
BACKGROUND
To define the beneficial cellular changes that occur with chronic ventricular unloading, we determined the effect of left ventricular assist device (LVAD) placement on myocardial fibrosis.
METHODS
We obtained paired myocardial samples (before and after LVAD implantation) from 10 patients (aged 43 to 64 years) with end-stage cardiomyopathy. We first determined regional collagen expression of an explanted heart by a computerized semiquantitative analysis of positive picro-sirius red stained areas.
RESULTS
We found that there was no statistically significant difference in collagen content between regions of the failed heart studied. Next we determined collagen content in these paired myocardial biopsies pre- and post-LVAD implantation. All 10 patients had significant reductions in collagen content after LVAD placement with a mean reduction of 82% (percent of tissue area stained decreased from 32% +/- 4% to 4% +/- 0.8%, P < 0.001).
CONCLUSION
In summary, these data demonstrate that chronic mechanical circulatory support significantly reduces fibrosis in the failing myocardium.
背景
为了明确慢性心室减负所带来的有益细胞变化，我们确定了植入左心室辅助装置（LVAD）对心肌纤维化的影响。
方法
我们从10例（年龄43至64岁）终末期心肌病患者获取了配对的心肌样本（LVAD植入前后）。我们首先通过对苦味酸天狼星红染色阳性区域进行计算机化半定量分析，确定了切除心脏的局部胶原表达。
结果
我们发现所研究的衰竭心脏各区域之间的胶原含量无统计学显著差异。接下来，我们确定了这些配对心肌活检样本在LVAD植入前后的胶原含量。所有10例患者在LVAD植入后胶原含量均显著降低，平均降低82%（染色组织面积百分比从32%±4%降至4%±0.8%，P<0.001）。
结论
总之，这些数据表明慢性机械循环支持可显著降低衰竭心肌的纤维化程度。
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