Takaki Miyako
Department of Physiology II, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan.
Pathophysiology. 2012 Jun;19(3):163-70. doi: 10.1016/j.pathophys.2012.04.004. Epub 2012 Jun 9.
Considering from clinical implication, it is often complained that short-term experimental diseased heart models do not mimic long-term diseased hearts that one often clinically encountered. The left ventricle (LV) function in rat cardiac hypertrophy models treated with isoproterenol (ISO) up to 16 weeks was followed up with a non-invasive echocardiography. Infusion of either ISO (1.2mgkg(-1)day(-1) for 3 days-16 weeks) or vehicle (saline 24μlday(-1) for 3 days-16 weeks; SA group) was performed by subcutaneously implanting osmotic minipump. LV and right ventricle (RV) weight ratios to body weight (mgg(-1)) in SA, ISO3d, ISO7d and ISO4w were: 1.94±0.10 and 0.54±0.04 (n=7), 2.56±0.10 and 0.66±0.05 (n=7), 2.50±0.25 and 0.64±0.07 (n=10) and 2.40±0.08 and 0.59±0.08 (n=9), respectively. From echocardiography, the LV function of the hypertrophy models at 3 days, 1 and 2 weeks was unchanged but the model at the longer-term than 4 weeks resulted in prolonged systolic failure. These results indicated that only 3-day ISO infusion induced the hypertrophy model similar in shape and function to that induced by 2-week ISO infusion; the 3-day model sufficiently represents the effects of 2-week ISO infusion. In this review, left ventricular (LV) function was compared between rat cardiac hypertrophy models treated with ISO for 3 days (ISO3d) and 7 days (ISO7d) by analyzing LV mechanical work and energetics. The LV mechanical work and energetics was unchanged in SA, ISO3d and ISO7d groups. The LV relaxation rate at 240bpm in ISO3d and ISO7d groups was significantly slower than that in SA group with unchanged contraction rate. The amounts of expression of sarcoplasmic reticulum Ca(2+)-ATPase (SERCA2a), phospholamban (PLB), phosphorylated-Ser(16) PLB (p-PLB), phospholemman (PLM) and Na(+)-K(+)-ATPase (NKA) are significantly decreased in ISO3d and ISO7d groups. Furthermore, the marked collagen production (types I and III) was observed in ISO3d and ISO7d groups. These results suggested the possibility that physiological LV function is compensated, although molecular changes have been generated even in the short-term hypertrophy model. Although a novel histone deacetylase (HDAC) inhibitor, has some beneficial effects on hemodynamics, it has no effects of anti-hypertrophic modalities in ISO3d model. However, a selective sodium proton exchanger-1 (NHE-1) inhibitor normalized ISO-induced down-regulation of SERCA2a without changes in pPLB/PLB expression in the ISO7d model and ameliorates cardiac Ca(2+) handling impairment and prevents the development of cardiac dysfunction. This result indicated that SERCA2a is a key molecule in the ISO7d model. Slow LV relaxation rate in ISO7d model may be due to down-regulation of SERCA2a. In conclusion, lowering the heart rate make it possible to rescue the impairment of LV mechanical work and energetics in the ISO-induced compensatory hypertrophied rat hearts, providing basic evidence for clinical therapy for patients with some types of cardiac failure.
从临床意义考虑,人们常常抱怨短期实验性患病心脏模型无法模拟临床上常见的长期患病心脏。采用无创超声心动图对用异丙肾上腺素(ISO)处理长达16周的大鼠心脏肥大模型的左心室(LV)功能进行随访。通过皮下植入渗透微型泵给予ISO(1.2mgkg(-1)天(-1),持续3天至16周)或赋形剂(生理盐水24μl天(-1),持续3天至16周;SA组)。SA、ISO3d、ISO7d和ISO4w组的左心室和右心室(RV)与体重的重量比(mgg(-1))分别为:1.94±0.10和0.54±0.04(n = 7)、2.56±0.10和0.66±0.05(n = 7)、2.50±0.25和0.64±0.07(n = 10)以及2.40±0.08和0.59±0.08(n = 9)。超声心动图显示,肥大模型在3天、1周和2周时左心室功能未改变,但4周以上的长期模型导致收缩期衰竭延长。这些结果表明,仅3天的ISO输注诱导的肥大模型在形状和功能上与2周ISO输注诱导的模型相似;3天模型足以代表2周ISO输注的效果。在本综述中,通过分析左心室机械功和能量学,比较了用ISO处理3天(ISO3d)和7天(ISO7d)的大鼠心脏肥大模型之间的左心室(LV)功能。SA、ISO3d和ISO7d组的左心室机械功和能量学未改变。ISO3d和ISO7d组在240bpm时的左心室舒张速率明显慢于SA组,而收缩速率未改变。ISO3d和ISO7d组肌浆网Ca(2+)-ATP酶(SERCA2a)、受磷蛋白(PLB)、磷酸化-Ser(16)PLB(p-PLB)、磷膜蛋白(PLM)和Na(+)-K(+)-ATP酶(NKA)的表达量显著降低。此外,在ISO3d和ISO7d组中观察到明显的I型和III型胶原产生。这些结果提示,尽管在短期肥大模型中已发生分子变化,但生理性左心室功能可能得到了代偿。尽管一种新型组蛋白去乙酰化酶(HDAC)抑制剂对血流动力学有一些有益作用,但在ISO3d模型中对抗肥大方式无作用。然而,一种选择性钠质子交换体-1(NHE-1)抑制剂可使ISO诱导的SERCA2a下调正常化,而在ISO7d模型中pPLB/PLB表达无变化,并改善心脏Ca(2+)处理损伤,预防心脏功能障碍的发展。这一结果表明,SERCA2a是ISO7d模型中的关键分子。ISO7d模型中左心室舒张速率减慢可能是由于SERCA2a下调所致。总之,降低心率有可能挽救ISO诱导的代偿性肥大大鼠心脏中左心室机械功和能量学的损伤,为某些类型心力衰竭患者的临床治疗提供了基础证据。