Division of Cardiothoracic Surgery, Medical University of South Carolina and Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA.
Am J Physiol Heart Circ Physiol. 2010 Dec;299(6):H1947-58. doi: 10.1152/ajpheart.00314.2010. Epub 2010 Oct 8.
After a myocardial infarction (MI), an episode of ischemia-reperfusion (I/R) can result in a greater impairment of left ventricular (LV) regional function (LVRF) than that caused by an initial I/R episode in the absence of MI. Membrane type-I matrix metalloproteinase (MT1-MMP) proteolytically processes the myocardial matrix and is upregulated in LV failure. This study tested the central hypothesis that a differential induction of MT1-MMP occurs and is related to LVRF after I/R in the context of a previous MI. Pigs with a previous MI [3 wk postligation of the left circumflex artery (LCx)] or no MI were randomized to undergo I/R [60-min/120-min left anterior descending coronary artery (LAD) occlusion] or no I/R as follows: no MI and no I/R (n = 6), no MI and I/R (n = 8), MI and no I/R (n = 8), and MI and I/R (n = 8). Baseline LVRF (regional stroke work, sonomicrometry) was lower in the LAD region in the MI group compared with no MI (103 ± 12 vs. 188 ± 26 mmHg·mm, P < 0.05) and remained lower with peak ischemia (35 ± 8 vs. 88 ± 17 mmHg·mm, P < 0.05). Using a novel interstitial microdialysis method, MT1-MMP was directly measured and was over threefold higher in the LCx region and over twofold higher in the LAD region in the MI group compared with the no MI group at baseline. MT1-MMP fluorogenic activity was persistently elevated in the LCx region in the MI and I/R group but remained unchanged in the LAD region. In contrast, no changes in MT1-MMP occurred in the LCx region in the no MI and I/R group but increased in the LAD region. MT1-MMP mRNA was increased by over threefold in the MI region in the MI and I/R group. In conclusion, these findings demonstrate that a heterogeneous response in MT1-MMP activity likely contributes to regional dysfunction with I/R and that a subsequent episode of I/R activates a proteolytic cascade within the MI region that may contribute to a continued adverse remodeling process.
心肌梗死(MI)后,缺血再灌注(I/R)发作会导致左心室(LV)区域功能(LVRF)的损害大于无 MI 情况下初始 I/R 发作所导致的损害。膜型基质金属蛋白酶-1(MT1-MMP)可对心肌基质进行蛋白水解,并且在 LV 衰竭时上调。本研究检验了一个中心假设,即在先前 MI 的背景下,I/R 后会发生并与 LVRF 相关的 MT1-MMP 诱导存在差异。先前有 MI(左回旋支动脉结扎后 3 周)或无 MI 的猪被随机分为 I/R 组[60min/120min 左前降支冠状动脉(LAD)闭塞]或无 I/R 组,如下:无 MI 且无 I/R(n = 6)、无 MI 且 I/R(n = 8)、MI 且无 I/R(n = 8)和 MI 且 I/R(n = 8)。与无 MI 组相比,MI 组 LAD 区域的基础 LVRF(区域室壁做功,超声心动图)较低(103 ± 12 比 188 ± 26mmHg·mm,P < 0.05),在峰值缺血时仍较低(35 ± 8 比 88 ± 17mmHg·mm,P < 0.05)。使用新型间质微透析方法,直接测量 MT1-MMP,结果显示 MI 组 LCx 区域 MT1-MMP 荧光活性比无 MI 组高 3 倍以上,LAD 区域高 2 倍以上。在 MI 和 I/R 组中,LCx 区域的 MT1-MMP 荧光活性持续升高,但在 LAD 区域无变化。相反,无 MI 和 I/R 组中 LCx 区域的 MT1-MMP 无变化,但在 LAD 区域增加。MI 和 I/R 组中 MI 区域的 MT1-MMP mRNA 增加 3 倍以上。总之,这些发现表明,MT1-MMP 活性的异质性反应可能导致 I/R 后的区域功能障碍,随后的 I/R 发作会激活 MI 区域内的蛋白水解级联反应,这可能导致持续的不良重塑过程。