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自体骨骼肌成肌细胞移植后兔动脉瘤心肌内的收缩期收缩。

Systolic contraction within aneurysmal rabbit myocardium following transplantation of autologous skeletal myoblasts.

作者信息

Emani Sitaram M, Ellis Matthew J, Dibernardo Louis R, Colgrove Sharon, Glower Donald D, Taylor Doris A

机构信息

Department of Surgery, Duke University Medical Center, Durham, NC, USA.

出版信息

J Surg Res. 2006 Sep;135(1):202-8. doi: 10.1016/j.jss.2006.03.020. Epub 2006 May 22.

Abstract

OBJECTIVE

Transplantation of autologous skeletal myoblasts (SKMB) into infarcted heart (or cellular cardiomyoplasty, CCM) augments myocardial performance in animal models of myocardial infarction. However, the effect of CCM in the setting of ventricular aneurysm has not been evaluated. This study analyzes the effects of transplanted SKMB on regional wall motion in a rabbit model of postinfarct ventricular aneurysm. We hypothesize that CCM, performed early after myocardial infarction, prevents the progression of dyskinetic wall motion.

METHODS

Twenty-six rabbits underwent apical left ventricular cryoinfarction and soleus muscle biopsy for in vitro isolation of skeletal myoblasts. At 2 weeks postinfarct, the presence of ventricular aneurysm was detected in 23/26 animals by sonomicrometry and micromanometry. Seventeen of 23 animals were randomized to receive either 108 autologous myoblasts (CCM) or vehicle. Regional stroke work, percent systolic shortening, and synchronicity of regional wall motion were determined prior to, and four weeks following, injection (CCM; n = 9; vehicle, n = 8). Wall motion was evaluated under baseline and stress (dobutamine, 10 (g/kg/min) conditions. Six animals did not undergo randomization, but their hearts were used to measure the size of infarction.

RESULTS

Four weeks following treatment of animals with ventricular aneurysm, systolic contractile activity was present in most animals treated with myoblasts but in none treated with vehicle (5/7 versus 0/6, respectively, P < 0.05). Dobutamine tended to accentuate the differences seen at baseline between the groups.

CONCLUSIONS

This study demonstrates a high incidence of systolic contractile activity in a previously aneurysmal region of myocardium following CCM and may represent a novel therapy for the prevention and treatment of postinfarct aneurysm.

摘要

目的

将自体骨骼肌成肌细胞(SKMB)移植到梗死心脏(即细胞心肌成形术,CCM)可增强心肌梗死动物模型的心肌功能。然而,CCM在室壁瘤情况下的效果尚未得到评估。本研究分析了移植的SKMB对兔心肌梗死后室壁瘤模型局部室壁运动的影响。我们假设,在心肌梗死后早期进行CCM可防止运动障碍性室壁运动的进展。

方法

26只兔子接受左心室心尖冷冻梗死及比目鱼肌活检,用于体外分离骨骼肌成肌细胞。在梗死后2周,通过超声测微法和微测压法在23/26只动物中检测到室壁瘤的存在。23只动物中的17只被随机分为接受108个自体成肌细胞(CCM)或赋形剂。在注射前及注射后4周(CCM组;n = 9;赋形剂组,n = 8)测定局部每搏功、收缩期缩短百分比和局部室壁运动的同步性。在基线和应激(多巴酚丁胺,10μg/kg/min)条件下评估室壁运动。6只动物未进行随机分组,但用它们的心脏测量梗死面积。

结果

在患有室壁瘤的动物接受治疗4周后,大多数接受成肌细胞治疗的动物出现收缩期收缩活动,而接受赋形剂治疗的动物均未出现(分别为5/7和0/6,P < 0.05)。多巴酚丁胺倾向于加剧两组在基线时观察到的差异。

结论

本研究表明,CCM后心肌先前存在瘤样病变的区域出现收缩期收缩活动的发生率很高,这可能代表了一种预防和治疗心肌梗死后室壁瘤的新疗法。

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