Xing Xiao-qian, Xu Jian, Su Hao, Lu Ye-wei
Department of Cardiology, Anhui Provincial Hospital, Hefei 230001, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2011 Feb;39(2):176-80.
Electrical and structural remodeling are of importance for the occurrence and maintenance of atrial fibrillation. We observed association between atrial connexin protein expression and fibrosis in a canine model of prolonged rapid atrial pacing.
"J"-type electrodes were placed in the right atrial appendage under the guidance of X-ray in 16 dogs, Animals in model group (n = 8) received fast pacing (400 beats/min) for 10 weeks while animals in control group (n = 8) maintained at sinus rhythm. Limb-lead ECGs were recorded at 2, 4, 6, 8 weeks respectively. Burst stimulation was applied to induce atrial fibrillation in all animals after 10 weeks, animals were sacrificed thereafter and the left atrial tissues were taken for myocardial collagen measurement (Masson staining) and myocardial ultrastructure examination and detection of protein expression of connexin (Cx) 40 and 45 (immune staining). Procollagen type III N-terminal peptide and type IV collagen in serum were also detected by radioimmunoassay.
Two dogs died in model group due to atrial rupture induced cardiac tamponade or lung emboli. Spontaneously atrial fibrillation was not observed in all animals, but two dogs developed atrial flutter and atrial premature beats. Atrial fibrillation was induced by burst stimulation in 4 out of 6 dogs in model group and in none of the dogs in control group. Atrial myocardial collagen volume fraction was significantly increased in model group compared with the control group (P < 0.05). Ultrastructure examination in atrial tissue evidenced disorder, fracture, collagen fiber proliferation, mitochondrial swelling, blurred cristae, and intercalated disc distortion, expansion, part of gap junction disappears in model group. The serum levels of procollagen type III N-terminal peptide and type IV collagen in model group were significantly higher than in the control group (P < 0.05). The protein expression of Cx 40 in atrial myocardium in model group was significantly higher than in control group (P < 0.05), while Cx 45 protein expression was similar between two groups (P > 0.05). The left atrial CVF was positively correlated with Cx 40 (r = 0.671, P < 0.01).
Increased myocardial fibrosis is positively correlated with upregulation of myocardial Cx 40 protein expression in left atrium in rapid atrial paced canine.
电重构和结构重构对于心房颤动的发生和维持具有重要意义。我们在犬类长时间快速心房起搏模型中观察了心房连接蛋白表达与纤维化之间的关联。
在X线引导下将“J”型电极置于16只犬的右心耳。模型组(n = 8)动物接受快速起搏(400次/分钟)10周,而对照组(n = 8)动物维持窦性心律。分别在第2、4、6、8周记录肢体导联心电图。10周后对所有动物施加猝发刺激以诱发心房颤动,之后处死动物,取左心房组织进行心肌胶原测量(Masson染色)、心肌超微结构检查以及连接蛋白(Cx)40和45蛋白表达检测(免疫染色)。同时采用放射免疫法检测血清中Ⅲ型前胶原N端肽和Ⅳ型胶原。
模型组有2只犬因心房破裂导致心脏压塞或肺栓塞死亡。所有动物均未观察到自发性心房颤动,但有2只犬出现心房扑动和房性早搏。模型组6只犬中有4只经猝发刺激诱发出心房颤动,而对照组犬均未诱发。与对照组相比,模型组心房心肌胶原容积分数显著增加(P < 0.05)。心房组织超微结构检查显示模型组存在紊乱、断裂、胶原纤维增生、线粒体肿胀、嵴模糊以及闰盘扭曲、扩张,部分缝隙连接消失。模型组血清中Ⅲ型前胶原N端肽和Ⅳ型胶原水平显著高于对照组(P < 0.05)。模型组心房肌中Cx 40蛋白表达显著高于对照组(P < 0.05),而两组间Cx 45蛋白表达相似(P > 0.