Gao Xiao-Ming, Dilley Rodney J, Samuel Chrishan S, Percy Elodie, Fullerton Meryl J, Dart Anthony M, Du Xiao-Jun
Baker Medical Research Institute, Melbourne, Victoria, Australia.
J Cardiovasc Pharmacol. 2002 Oct;40(4):632-40. doi: 10.1097/00005344-200210000-00018.
This paper addresses whether the enhanced left ventricular (LV) contractility and heart rate, seen in transgenic mice overexpressing beta -adrenergic receptor in the heart, might raise the incidence of LV rupture after myocardial infarct. Transgenic and wild-type mice underwent left coronary artery occlusion. Postinfarct deaths that occurred 1-7 days after surgery were analyzed. Hemodynamics, morphologic parameters, and collagen content in the LV were determined. A significantly lower incidence of LV rupture was observed in transgenic than in wild-type mice 3-5 days after myocardial infarct (2.5 versus 19.7%, p < 0.05), despite a similar infarct size between the two groups and better hemodynamic function in transgenic mouse hearts. Morphologic analysis showed a more severe infarct expansion in wild-type versus transgenic mice or in mice dying of rupture versus those that died of acute heart failure. Collagen content was higher in the LV of sham-operated transgenic than wild-type mice (p < 0.01) with both type I and type III collagen elevated. Such difference in collagen content between transgenic and wild-type mice was maintained in noninfarcted and infarcted LV. In conclusion, transgenic mice overexpressing beta -adrenergic receptor had a lower risk of cardiac rupture during the acute phase after infarction despite the markedly enhanced LV contractility and heart rate. As a hyperdynamic function due to beta-adrenergic activation would likely increase the risk of cardiac rupture and infarct expansion, the lack of rupture in this transgenic mouse model suggests that the interstitial collagen level is a more important factor than functional status in the pathogenesis of rupture and infarct expansion.
本文探讨了在心脏中过表达β-肾上腺素能受体的转基因小鼠中所观察到的左心室(LV)收缩力和心率增强,是否会增加心肌梗死后LV破裂的发生率。对转基因小鼠和野生型小鼠进行左冠状动脉闭塞手术。分析术后1-7天发生的梗死相关死亡情况。测定LV的血流动力学、形态学参数和胶原含量。尽管两组梗死面积相似且转基因小鼠心脏的血流动力学功能更好,但在心肌梗死后3-5天,转基因小鼠LV破裂的发生率显著低于野生型小鼠(2.5%对19.7%,p<0.05)。形态学分析显示,野生型小鼠比转基因小鼠梗死扩展更严重,死于破裂的小鼠比死于急性心力衰竭的小鼠梗死扩展更严重。假手术转基因小鼠LV中的胶原含量高于野生型小鼠(p<0.01),I型和III型胶原均升高。转基因小鼠和野生型小鼠之间的这种胶原含量差异在未梗死和梗死的LV中均保持。总之,尽管LV收缩力和心率明显增强,但过表达β-肾上腺素能受体的转基因小鼠在梗死后急性期心脏破裂的风险较低。由于β-肾上腺素能激活导致的高动力功能可能会增加心脏破裂和梗死扩展的风险,该转基因小鼠模型中未出现破裂表明,在破裂和梗死扩展的发病机制中,间质胶原水平比功能状态更重要。