Fu Zhen-hong, Dong Wei, Gai Lu-yue, Wang Fan, Ding Rui, Chen Yun-dai
Department of Cardiology, General Hospital of PLA, Beijing 100853, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2011 Jan;31(1):17-22.
To evaluate the effects of erythropoietin (EPO) combined with granulocyte-colony stimulating factor (G-CSF) on left ventricular function and ventricular remodeling after acute myocardial infarction (AMI) and investigate the possible mechanism.
The experimental design consisted of 5 groups of rats, namely the sham, myocardial infarction (MI) model, MI with EPO treatment, MI with G-CSF treatment, and MI with EPO plus G-CSF treatment groups. Apoptosis of the cardiomyocytes was detected by TUNEL staining, and HE staining, Masson trichrome staining, scarlatinum staining, and VIII agent staining were used to evaluate the survival, scar collagen deposition, and angiogenic effects. The cardiac structure and function of the rats after the treatments were assessed by echocardiography and hemodynamic examination.
Echocardiography indicated that LVEF and FS were improved in all the intervention groups 7 days after MI, and the rats in EPO plus G-CSF treatment group showed the most obvious reduction of LVESD and LVESV (P<0.01). On day 28 after MI, all the intervention groups showed improvements in LVEF, FS, LVESD, LVEDD, LVESV and LVEDV, which were especially obvious in the combined treatment group; the interventions, especially the combined treatment, also resulted in decreased LVEDP and increased LVSP and +dP/dtmax. On day 1 after MI, the number of apoptotic cells was significantly greater in the MI model group than in EPO and G-CSF groups, and was the fewest in the combined treatment group (P<0.01). On day 28, the number of new vessels increased and the scar and collagen deposition reduced in the EPO and G-CSF groups, and these changes were more obvious in the combined treatment group.
EPO combined with G-CSF can prevent left ventricular remodeling and improve cardiac systolic and diastolic functions by inhibiting cardiomyocyte apoptosis, reducing tissue collagen deposition and inducing neovascularisation.
评估促红细胞生成素(EPO)联合粒细胞集落刺激因子(G-CSF)对急性心肌梗死(AMI)后左心室功能和心室重构的影响,并探讨其可能机制。
实验设计包括5组大鼠,即假手术组、心肌梗死(MI)模型组、EPO治疗MI组、G-CSF治疗MI组和EPO加G-CSF治疗MI组。通过TUNEL染色检测心肌细胞凋亡,采用苏木精-伊红(HE)染色、Masson三色染色、猩红染色和Ⅷ因子染色评估心肌细胞存活、瘢痕胶原沉积和血管生成效应。通过超声心动图和血流动力学检查评估治疗后大鼠的心脏结构和功能。
超声心动图显示,MI后7天,所有干预组的左心室射血分数(LVEF)和左心室短轴缩短率(FS)均有所改善,EPO加G-CSF治疗组大鼠的左心室舒张末期内径(LVESD)和左心室舒张末期容积(LVESV)减小最为明显(P<0.01)。MI后28天,所有干预组的LVEF、FS、LVESD、左心室舒张末期内径(LVEDD)、LVESV和左心室舒张末期容积(LVEDV)均有所改善,联合治疗组尤为明显;干预措施,尤其是联合治疗,还导致左心室舒张末期压力(LVEDP)降低,左心室收缩压(LVSP)和最大上升速率(+dP/dtmax)增加。MI后1天,MI模型组的凋亡细胞数量明显多于EPO组和G-CSF组,联合治疗组最少(P<0.01)。MI后28天,EPO组和G-CSF组的新生血管数量增加,瘢痕和胶原沉积减少,联合治疗组的这些变化更为明显。
EPO联合G-CSF可通过抑制心肌细胞凋亡、减少组织胶原沉积和诱导新生血管形成,预防左心室重构,改善心脏收缩和舒张功能。