Gray C C, Amrani M, Smolenski R T, Nakamura K, Yacoub M H
Department of Cardiothoracic Surgery, National Heart and Lung Institute, Imperial College, Harefield Hospital, Harefield, Middlesex, UB9 6JH, United Kingdom.
J Thorac Cardiovasc Surg. 2001 Jun;121(6):1130-6. doi: 10.1067/mtc.2001.113934.
Myocardial content of the 70-kd heat shock protein has been found to correlate with improved cardiac recovery after ischemia, but the mechanisms and conditions that regulate its level, particularly under clinical conditions, are unclear. The aim of this study was to assess the effect of hypothermic cardioplegic arrest and reperfusion on the expression of 70-kd heat shock protein in a protocol mimicking conditions of preservation for cardiac transplantation.
Heat-shocked and control hearts were subjected to 4 hours of cardioplegic arrest and global ischemia at 4 degrees C and then to 20 minutes of reperfusion. Hearts were freeze clamped at different time points-after 15 minutes of Langendorff perfusion, at the end of ischemia, and after 20 minutes of reperfusion, and analyzed for heat shock protein 70 content by Western blotting. Another set of hearts was subjected to 10 minutes of normothermic ischemia and 20 minutes of reperfusion followed by freeze clamping and analysis of heat shock protein 70 content as in cardioplegic arrest protocol. Cardiac function was measured by means of a left ventricular balloon at the end of reperfusion.
Preischemic concentration of 70-kd heat shock protein was increased in heat-shocked hearts compared with control hearts. The content of 70-kd heat shock protein in heat-shocked hearts was further increased from 5.0 +/- 2.4 ng/microg at the end of ischemia to 11.0 +/- 4.9 ng/microg (n = 8, mean +/- SD; P <.05) at 20 minutes of reperfusion after cold cardioplegic arrest. No further rise in 70-kd heat shock protein of the heat-shocked hearts was observed after normothermic ischemia. Maximal developed pressure was 120.8 +/- 13.4 mm Hg in control hearts compared with 164.7 +/- 22.5 mm Hg in heat-shocked hearts (n = 5, mean +/- SD; P =.037) after cardioplegic arrest. By contrast, after normothermic ischemia, maximum developed pressure was 111.2 +/- 10.9 mm Hg in control hearts compared with 139.2 +/- 11.0 mm Hg in heat-shocked hearts (n = 4, mean +/- SD; P =.031).
Hypothermic cardioplegic arrest but not short normothermic ischemia triggered a further increase in the level of 70-kd heat shock protein in heat-shocked rat hearts, which may enhance endogenous cardiac protection.
已发现70-kd热休克蛋白的心肌含量与缺血后心脏恢复的改善相关,但调节其水平的机制和条件,尤其是在临床情况下,尚不清楚。本研究的目的是在模拟心脏移植保存条件的方案中,评估低温心脏停搏和再灌注对70-kd热休克蛋白表达的影响。
对热休克心脏和对照心脏在4℃下进行4小时的心脏停搏和全心缺血,然后进行20分钟的再灌注。在不同时间点(Langendorff灌注15分钟后、缺血结束时和再灌注20分钟后)对心脏进行冷冻钳夹,并通过蛋白质印迹法分析热休克蛋白70的含量。另一组心脏进行10分钟的常温缺血和20分钟的再灌注,然后进行冷冻钳夹并如心脏停搏方案那样分析热休克蛋白70的含量。在再灌注结束时通过左心室球囊测量心脏功能。
与对照心脏相比,热休克心脏中缺血前70-kd热休克蛋白的浓度增加。热休克心脏中70-kd热休克蛋白的含量在冷心脏停搏后缺血结束时从5.0±2.4 ng/μg进一步增加至再灌注20分钟时的11.0±4.9 ng/μg(n = 8,平均值±标准差;P <.05)。常温缺血后未观察到热休克心脏中70-kd热休克蛋白的进一步升高。心脏停搏后,对照心脏的最大收缩压为120.8±13.4 mmHg,而热休克心脏为164.7±22.5 mmHg(n = 5,平均值±标准差;P =.037)。相比之下,常温缺血后,对照心脏的最大收缩压为111.2±10.9 mmHg,而热休克心脏为139.2±11.0 mmHg(n = 4,平均值±标准差;P =.031)。
低温心脏停搏而非短暂的常温缺血可引发热休克大鼠心脏中70-kd热休克蛋白水平的进一步升高,这可能增强内源性心脏保护作用。