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高血压患者运动训练对心肌低灌注/再灌注的耐受性

Myocardial hypoperfusion/reperfusion tolerance with exercise training in hypertension.

作者信息

Reger Patricia O, Barbe Mary F, Amin Mamta, Renna Brian F, Hewston Leigh Ann, MacDonnell Scott M, Houser Steven R, Libonati Joseph R

机构信息

Department of Kinesiology, Temple Univ., 122 Pearson Hall, 1800 North Broad St., Philadelphia, PA 19122, USA.

出版信息

J Appl Physiol (1985). 2006 Feb;100(2):541-7. doi: 10.1152/japplphysiol.00350.2005. Epub 2005 Oct 13.

Abstract

The purpose of this study was to examine whether exercise training, superimposed on compensated-concentric hypertrophy, could increase myocardial hypoperfusion-reperfusion (H/R) tolerance. Female Wistar-Kyoto rats (WKY) and spontaneously hypertensive rats (SHR) (age: 4 mo; N = 40) were placed into a sedentary (SED) or exercise training (TRD) group (treadmill running; 25 m/min, 1 h/day, 5 days/wk for 16 wk). Four groups were studied: WKY-SED (n = 10), WKY-TRD (n = 10), SHR-SED (n = 10), and SHR-TRD (n = 10). Blood pressure and heart rate were determined, and in vitro isolated heart performance was measured with a retrogradely perfused, Langendorff isovolumic preparation. The H/R protocol consisted of a 75% reduction in coronary flow for 17 min followed by 30 min of reperfusion. Although the rate-pressure product was significantly elevated in SHR relative to WKY, training-induced bradycardia reduced the rate-pressure product in SHR-TRD (P < 0.05) without an attenuation in systolic blood pressure. Heart-to-body weight ratio was greater in both groups of SHR vs. WKY-SED (P < 0.001). Absolute and relative myocardial tolerance to H/R was greater in WKY-TRD and both groups of SHR relative to WKY-SED (P < 0.05). Endurance training superimposed on hypertension-induced compensated hypertrophy conferred no further cardioprotection to H/R. Postreperfusion 72-kDa heat shock protein abundance was enhanced in WKY-TRD and both groups of SHR relative to WKY-SED (P < 0.05) and was highly correlated with absolute left ventricular functional recovery during reperfusion (R2= 0.86, P < 0.0001). These data suggest that both compensated hypertrophy associated with short-term hypertension and endurance training individually improved H/R and that increased postreperfusion 72-kDa heat shock protein abundance was, in part, associated with the cardioprotective phenotype observed in this study.

摘要

本研究的目的是检验在代偿性向心性肥大基础上进行运动训练是否能增加心肌缺血再灌注(H/R)耐受性。将雌性Wistar-Kyoto大鼠(WKY)和自发性高血压大鼠(SHR)(年龄:4个月;N = 40)分为久坐组(SED)或运动训练组(TRD)(跑步机跑步;25米/分钟,每天1小时,每周5天,共16周)。研究了四组:WKY-SED(n = 10)、WKY-TRD(n = 10)、SHR-SED(n = 10)和SHR-TRD(n = 10)。测定血压和心率,并使用逆行灌注的Langendorff等容标本测量体外离体心脏功能。H/R方案包括冠状动脉血流减少75%持续17分钟,然后再灌注30分钟。尽管相对于WKY,SHR的心率血压乘积显著升高,但训练诱导的心动过缓使SHR-TRD的心率血压乘积降低(P < 0.05),而收缩压未降低。与WKY-SED相比,两组SHR的心脏重量与体重比更大(P < 0.001)。相对于WKY-SED,WKY-TRD和两组SHR对H/R的绝对和相对心肌耐受性更大(P < 0.05)。在高血压诱导的代偿性肥大基础上进行耐力训练并未对H/R提供进一步的心脏保护。相对于WKY-SED,WKY-TRD和两组SHR再灌注后72-kDa热休克蛋白丰度增加(P < 0.05),且与再灌注期间左心室绝对功能恢复高度相关(R2 = 0.86,P < 0.0001)。这些数据表明,与短期高血压相关的代偿性肥大和耐力训练单独均可改善H/R,且再灌注后72-kDa热休克蛋白丰度增加部分与本研究中观察到的心脏保护表型相关。

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