Anversa P, Zhang X, Li P, Capasso J M
Department of Medicine, New York Medical College, Valhalla 10595.
J Clin Invest. 1992 Feb;89(2):618-29. doi: 10.1172/JCI115628.
Coronary artery narrowing, ranging from 19% to 61%, was induced in rats and ventricular performance, myocardial damage, and myocyte hypertrophy were examined 1 mo later. Animals were separated into two groups, exhibiting ventricular dysfunction and failure, respectively. Dysfunction consisted of a 2.4-fold increase in left ventricular end diastolic pressure (LVEDP), 15% decrease in left ventricular peak systolic pressure (LVPSP), 24% reduction in developed pressure (DP), and a 16% depression in-dP/dt. Failure was defined on the basis of a 4.7-fold elevation in LVEDP, and a 26%, 47%, 45%, and 41% decrease in LVPSP, DP, +dP/dt, and -dP/dt. Moreover, in this group, right ventricular end diastolic and systolic pressures increased 5.5- and 1.2-fold. Left and right ventricular weights expanded 23% and 51% with dysfunction and 30% and 56% with failure. Left ventricular hypertrophy was characterized by ventricular dilation and wall thinning which were more severe in the failing animals. Foci of damage were found in both groups but tissue injury was more prominent in the endomyocardium and in failing rats. Finally, myocyte loss in the ventricle was 10% and 20% with dysfunction and failure whereas the corresponding enlargements of the unaffected myocytes were 34% and 53%. Thus, coronary narrowing led to abnormalities in cardiac dynamics with an increase in diastolic wall stress and extensive ventricular remodeling in spite of a moderate loss of myocytes and compensatory reactive hypertrophy of the viable cells.
在大鼠中诱导冠状动脉狭窄,狭窄范围为19%至61%,1个月后检测心室功能、心肌损伤和心肌细胞肥大。将动物分为两组,分别表现为心室功能障碍和衰竭。功能障碍表现为左心室舒张末期压力(LVEDP)增加2.4倍,左心室收缩压峰值(LVPSP)降低15%,发展压力(DP)降低24%,以及-dP/dt降低16%。衰竭的定义是LVEDP升高4.7倍,LVPSP、DP、+dP/dt和-dP/dt分别降低26%、47%、45%和41%。此外,在该组中,右心室舒张末期和收缩期压力分别增加5.5倍和1.2倍。左心室和右心室重量在功能障碍时分别增加23%和51%,在衰竭时分别增加30%和56%。左心室肥大的特征是心室扩张和室壁变薄,在衰竭动物中更为严重。两组均发现损伤灶,但组织损伤在内膜心肌层和衰竭大鼠中更为突出。最后,心室中的心肌细胞损失在功能障碍和衰竭时分别为10%和20%,而未受影响的心肌细胞相应增大分别为34%和53%。因此,尽管有中度的心肌细胞损失和存活细胞的代偿性反应性肥大,但冠状动脉狭窄导致心脏动力学异常,舒张期壁应力增加和广泛的心室重塑。