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糖尿病合并心肌梗死后兔室性心律失常的风险与交感神经重塑相关

Risk of ventricular arrhythmias after myocardial infarction with diabetes associated with sympathetic neural remodeling in rabbits.

作者信息

Wang Ye, Xuan Yong-Li, Hu He-Sheng, Li Xiao-Lu, Xue Mei, Cheng Wen-Juan, Suo Fei, Yan Su-Hua

机构信息

School of Medicine, Shandong University, Jinan, PR China.

出版信息

Cardiology. 2012;121(1):1-9. doi: 10.1159/000336148. Epub 2012 Feb 23.

Abstract

BACKGROUND

Abnormal sympathetic innervation underlies both long-term hyperglycemia and myocardial infarction (MI). The incidence of ventricular arrhythmias (VAs) after MI is higher in diabetic than in nondiabetic patients. However, the exact mechanism remains unclear. In this study, we aimed to explore sympathetic neural remodeling after MI in diabetic rabbits and its relationship with VAs.

METHODS

Rabbits were randomly assigned to 4 groups: control, diabetes mellitus (DM), MI and diabetic myocardial infarction (DI). After electrophysiological experiments in vivo, immunohistochemistry and real-time RT-PCR were used to measure sympathetic innervations. To test the function of sympathetic nerve fibers, norepinephrine levels were measured by high-performance liquid chromatography.

RESULTS

The corrected QT interval and QT dispersion were significantly more prolonged with DI than other conditions. The density of tyrosine hydroxylase-positive fibers and corresponding mRNA abundance was significantly higher with DI than with DM and under control conditions, but was lower than with the MI group. Moreover, the distribution and structure of regenerated nerve was heterogeneous in DI rabbits. Norepinephrine content was higher in the DI group, and accompanied by an increased quantity of tyrosine hydroxylase-positive fibers.

CONCLUSION

MI results in sympathetic neural remodeling in diabetic rabbits, which may be responsible in part for the increased occurrence of VAs.

摘要

背景

异常的交感神经支配是长期高血糖和心肌梗死(MI)的基础。糖尿病患者心肌梗死后室性心律失常(VAs)的发生率高于非糖尿病患者。然而,确切机制仍不清楚。在本研究中,我们旨在探讨糖尿病兔心肌梗死后的交感神经重塑及其与室性心律失常的关系。

方法

将兔子随机分为4组:对照组、糖尿病组(DM)、心肌梗死组和糖尿病心肌梗死组(DI)。在进行体内电生理实验后,采用免疫组织化学和实时RT-PCR检测交感神经支配情况。为测试交感神经纤维的功能,采用高效液相色谱法测量去甲肾上腺素水平。

结果

与其他情况相比,DI组校正QT间期和QT离散度显著延长。DI组酪氨酸羟化酶阳性纤维密度和相应mRNA丰度显著高于DM组和对照组,但低于MI组。此外,DI兔再生神经的分布和结构存在异质性。DI组去甲肾上腺素含量较高,且酪氨酸羟化酶阳性纤维数量增加。

结论

心肌梗死导致糖尿病兔交感神经重塑,这可能部分解释了室性心律失常发生率增加的原因。

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