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慢性非闭塞性冠状动脉狭窄会损害大鼠的心室功能、心肌结构和心脏收缩蛋白酶活性。

Chronic nonocclusive coronary artery constriction impairs ventricular function, myocardial structure, and cardiac contractile protein enzyme activity in rats.

作者信息

Capasso J M, Malhotra A, Li P, Zhang X, Scheuer J, Anversa P

机构信息

Department of Medicine, New York Medical College, Valhalla 10595.

出版信息

Circ Res. 1992 Jan;70(1):148-62. doi: 10.1161/01.res.70.1.148.

Abstract

To determine the effects of chronic nonocclusive coronary constriction on cardiac hemodynamics, structural integrity, and contractile protein enzyme activity, the left coronary artery was narrowed in rats, and measurements of ventricular performance, magnitude, and distribution of tissue damage and myofibrillar Mg2+ and Ca2+ myosin ATPase activities were evaluated 1 month later. In the presence of coronary artery stenosis averaging 58%, three levels of involvement of global cardiac performance were identified, and the rats were divided accordingly. In the first group, only left ventricular end-diastolic pressure (LVEDP) was increased; in the second group, LVEDP and left ventricular +dP/dt and/or -dP/dt were affected; and in the third group, LVEDP, left ventricular +dP/dt and -dP/dt, and right ventricular end-diastolic pressure were impaired. Thus, left ventricular moderate dysfunction, severe dysfunction, and failure occurred with coronary narrowing. On a structural basis, coronary constriction resulted in an ongoing process characterized by acute myocytolytic necrosis and foci of replacement fibrosis in different stages of healing. The number of these lesion profiles in the left ventricular myocardium increased 4.7-, 4.4-, and 8.3-fold in rats with moderate dysfunction, severe dysfunction, and failure, respectively. Biochemically, Mg(2+)-ATPase activity of myofibrils increased biventricularly when moderate dysfunction was present. However, this parameter decreased with the appearance of severe dysfunction, reaching control values in ventricular failure. Ca2+ myosin ATPase activity was reduced in the left ventricle of rats with severe dysfunction and failure, whereas it was elevated in the right ventricle of rats with severe dysfunction. In conclusion, a fixed lesion of the left main coronary artery with a modest reduction in vessel luminal diameter generates a conditioned state of the heart characterized by a continuous loss of myocytes and replacement scarring, which, in combination with alterations in contractile protein enzyme activity, may be responsible for a number of abnormalities in cardiac dynamics ranging from moderate dysfunction to pump failure.

摘要

为了确定慢性非闭塞性冠状动脉狭窄对心脏血流动力学、结构完整性和收缩蛋白酶活性的影响,对大鼠的左冠状动脉进行缩窄,并在1个月后评估心室功能、组织损伤的程度和分布以及肌原纤维Mg2+和Ca2+肌球蛋白ATP酶活性。在平均冠状动脉狭窄率为58%的情况下,确定了全球心脏功能受累的三个水平,并据此将大鼠进行分组。在第一组中,仅左心室舒张末期压力(LVEDP)升高;在第二组中,LVEDP以及左心室 +dP/dt 和/或 -dP/dt 受到影响;在第三组中,LVEDP、左心室 +dP/dt 和 -dP/dt 以及右心室舒张末期压力均受损。因此,随着冠状动脉狭窄,左心室出现中度功能障碍、严重功能障碍和衰竭。在结构基础上,冠状动脉缩窄导致一个持续的过程,其特征是急性肌溶解坏死和处于不同愈合阶段的替代性纤维化灶。在左心室心肌中,这些病变特征的数量在中度功能障碍、严重功能障碍和衰竭的大鼠中分别增加了4.7倍、4.4倍和8.3倍。在生化方面,当存在中度功能障碍时,肌原纤维的Mg(2+)-ATP酶活性在双心室均升高。然而,随着严重功能障碍的出现,该参数下降,在心室衰竭时达到对照值。在严重功能障碍和衰竭的大鼠左心室中,Ca2+肌球蛋白ATP酶活性降低,而在严重功能障碍的大鼠右心室中则升高。总之,左主冠状动脉的固定病变伴血管腔直径适度减小会导致心脏的一种状态,其特征是心肌细胞持续丢失和替代性瘢痕形成,这与收缩蛋白酶活性的改变相结合,可能是导致从中度功能障碍到泵衰竭等多种心脏动力学异常的原因。

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