de Waard Monique C, van der Velden Jolanda, Bito Virginie, Ozdemir Semir, Biesmans Liesbeth, Boontje Nicky M, Dekkers Dick H W, Schoonderwoerd Kees, Schuurbiers Hans C H, de Crom Rini, Stienen Ger J M, Sipido Karin R, Lamers Jos M J, Duncker Dirk J
Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
Circ Res. 2007 Apr 13;100(7):1079-88. doi: 10.1161/01.RES.0000262655.16373.37. Epub 2007 Mar 8.
The extent and mechanism of the cardiac benefit of early exercise training following myocardial infarction (MI) is incompletely understood, but may involve blunting of abnormalities in Ca(2+)-handling and myofilament function. Consequently, we investigated the effects of 8-weeks of voluntary exercise, started early after a large MI, on left ventricular (LV) remodeling and dysfunction in the mouse. Exercise had no effect on survival, MI size or LV dimensions, but improved LV fractional shortening from 8+/-1 to 12+/-1%, and LVdP/dt(P30) from 5295+/-207 to 5794+/-207 mm Hg/s (both P<0.05), and reduced pulmonary congestion. These global effects of exercise were associated with normalization of the MI-induced increase in myofilament Ca(2+)-sensitivity (DeltapCa(50)=0.037). This effect of exercise was PKA-mediated and likely because of improved beta(1)-adrenergic signaling, as suggested by the increased beta(1)-adrenoceptor protein (48%) and cAMP levels (36%; all P<0.05). Exercise prevented the MI-induced decreased maximum force generating capacity of skinned cardiomyocytes (F(max) increased from 14.3+/-0.7 to 18.3+/-0.8 kN/m(2) P<0.05), which was associated with enhanced shortening of unloaded intact cardiomyocytes (from 4.1+/-0.3 to 7.0+/-0.6%; P<0.05). Furthermore, exercise reduced diastolic Ca(2+)-concentrations (by approximately 30%, P<0.05) despite the unchanged SERCA2a and PLB expression and PLB phosphorylation status. Importantly, exercise had no effect on Ca(2+)-transient amplitude, indicating that the improved LV and cardiomyocyte shortening were principally because of improved myofilament function. In conclusion, early exercise in mice after a large MI has no effect on LV remodeling, but attenuates global LV dysfunction. The latter can be explained by the exercise-induced improvement of myofilament function.
心肌梗死(MI)后早期运动训练对心脏的益处程度及机制尚未完全明确,但可能涉及对钙(Ca2+)处理和肌丝功能异常的改善。因此,我们研究了在大面积心肌梗死后早期开始的8周自愿运动对小鼠左心室(LV)重构和功能障碍的影响。运动对生存率、心肌梗死面积或左心室大小无影响,但左心室缩短分数从8±1%提高到12±1%,左心室压力变化率(LVdP/dt(P30))从5295±207提高到5794±207 mmHg/s(均P<0.05),并减轻了肺淤血。运动的这些整体效应与心肌梗死引起的肌丝Ca2+敏感性增加(DeltapCa(50)=0.037)的正常化有关。运动的这种效应是由蛋白激酶A(PKA)介导的,可能是由于β1-肾上腺素能信号改善,这可由β1-肾上腺素能受体蛋白增加(48%)和环磷酸腺苷(cAMP)水平升高(36%;均P<0.05)表明。运动防止了心肌梗死引起的去表皮心肌细胞最大产力能力下降(F(max)从14.3±0.7增加到18.3±0.8 kN/m2,P<0.05),这与未负荷完整心肌细胞缩短增强有关(从4.1±0.3%增加到7.0±0.6%;P<0.05)。此外,尽管肌浆网Ca2+ATP酶(SERCA2a)和受磷蛋白(PLB)表达及PLB磷酸化状态未改变,但运动降低了舒张期Ca2+浓度(约30%,P<0.05)。重要的是,运动对Ca2+瞬变幅度无影响,表明左心室和心肌细胞缩短改善主要是由于肌丝功能改善。总之,大面积心肌梗死后小鼠早期运动对左心室重构无影响,但可减轻整体左心室功能障碍。后者可通过运动诱导的肌丝功能改善来解释。