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容量负荷性肥大时心肌功能障碍伴心室顺应性增加。

Myocardial dysfunction with increased ventricular compliance in volume overload hypertrophy.

作者信息

De Stefano Laercio Martins, Matsubara Luiz Shiguero, Matsubara Beatriz Bojikian

机构信息

Department of Clinical Medicine, Botucatu School of Medicine-UNESP, Brazil.

出版信息

Eur J Heart Fail. 2006 Dec;8(8):784-9. doi: 10.1016/j.ejheart.2006.02.005. Epub 2006 Mar 6.

Abstract

The aim this study was to evaluate systolic and diastolic function in volume overload induced myocardial hypertrophy in rats. Volume overload myocardial hypertrophy was induced in thirteen male Wistar rats by creating infrarenal arteriovenous fistula (AVF). The results were compared with a SHAM operated group (n=11). Eight weeks after surgery, tail-cuff blood pressure was recorded, then rats were sacrificed for isolated heart studies using Langendorff's preparation. AVF rats presented increased left and right ventricular weights, compared to controls. The increased normalized ventricular volume (V0/LVW, 0.141+/-0.035 mL/g vs. 0.267+/-0.071 mL/g, P<0.001) in the AVF group indicated chamber dilation. Myocardial hydroxyproline concentration remained unchanged. There was a significant decrease in +dP/dt (3318+/-352 mm Hg s(-1) vs. 2769+/-399 mm Hg s(-1); P=0,002), end-systolic pressure-volume relation (246+/-56 mm Hg mL(-1) vs. 114+/-63 mm Hg mL(-1); P<0,001), and -dP/dt (1746+/-240 mm Hg s(-1) vs. 1361+/-217 mm Hg s(-1), P<0.001) in the AVF group, which presented increased ventricular compliance (DeltaV(25): SHAM=0.172+/-0.05 mL vs. AVF=0.321+/-0.072 mL, P<0.001) with preserved myocardial passive stiffness (Strain(25): SHAM=13.5+/-3.0% vs. AVF=12.3+/-1.9%, P>0.05). We conclude that volume-overload induced hypertrophy causes myocardial systolic and diastolic dysfunction with increased ventricular compliance. These haemodynamic features help to explain the long-term compensatory phase of chronic volume overload before transition to overt congestive heart failure.

摘要

本研究的目的是评估大鼠容量超负荷诱导的心肌肥大中的收缩和舒张功能。通过创建肾下动静脉瘘(AVF),在13只雄性Wistar大鼠中诱导容量超负荷心肌肥大。将结果与假手术组(n = 11)进行比较。手术后8周,记录尾套血压,然后处死大鼠,使用Langendorff装置进行离体心脏研究。与对照组相比,AVF大鼠的左心室和右心室重量增加。AVF组中增加的标准化心室容积(V0/LVW,0.141±0.035 mL/g对0.267±0.071 mL/g,P<0.001)表明心室扩张。心肌羟脯氨酸浓度保持不变。AVF组的 +dP/dt(3318±352 mmHg s(-1)对2769±399 mmHg s(-1);P = 0.002)、收缩末期压力-容积关系(246±56 mmHg mL(-1)对114±63 mmHg mL(-1);P<0.001)和 -dP/dt(1746±240 mmHg s(-1)对1361±217 mmHg s(-1),P<0.001)显著降低,其心室顺应性增加(DeltaV(25):假手术组 = 0.172±0.05 mL对AVF组 = 0.321±0.072 mL,P<0.001),同时心肌被动僵硬度保持不变(Strain(25):假手术组 = 13.5±3.0%对AVF组 = 12.3±1.9%,P>0.05)。我们得出结论,容量超负荷诱导的肥大导致心肌收缩和舒张功能障碍,心室顺应性增加。这些血流动力学特征有助于解释慢性容量超负荷在转变为明显充血性心力衰竭之前的长期代偿期。

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