Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar 66421, Germany.
J Transl Med. 2012 Sep 10;10:187. doi: 10.1186/1479-5876-10-187.
The additive effects of obesity and metabolic syndrome on left ventricular (LV) maladaptive remodeling and function in hypertension are not characterized.
We compared an obese spontaneously hypertensive rat model (SHR-ob) with lean spontaneously hypertensive rats (SHR-lean) and normotensive controls (Ctr). LV-function was investigated by cardiac magnetic resonance imaging and invasive LV-pressure measurements. LV-interstitial fibrosis was quantified and protein levels of phospholamban (PLB), Serca2a and glucose transporters (GLUT1 and GLUT4) were determined by immunohistochemistry.
Systolic blood pressure was similar in SHR-lean and SHR-ob (252 ± 7 vs. 242 ± 7 mmHg, p = 0.398) but was higher when compared to Ctr (155 ± 2 mmHg, p < 0.01 for both). Compared to SHR-lean and Ctr, SHR-ob showed impaired glucose tolerance and increased body-weight. In SHR-ob, LV-ejection fraction was impaired vs. Ctr (46.2 ± 1.1 vs. 59.6 ± 1.9%, p = 0.007). LV-enddiastolic pressure was more increased in SHR-ob than in SHR-lean (21.5 ± 4.1 vs. 5.9 ± 0.81 mmHg, p = 0.0002) when compared to Ctr (4.3 ± 1.1 mmHg, p < 0.0001 for both), respectively. Increased LV-fibrosis together with increased myocyte diameters and ANF gene expression in SHR-ob were associated with increased GLUT1-protein levels in SHR-ob suggestive for an upregulation of the GLUT1/ANF-axis. Serca2a-protein levels were decreased in SHR-lean but not altered in SHR-ob compared to Ctr. PLB-phosphorylation was not altered.
In addition to hypertension alone, metabolic syndrome and obesity adds to the myocardial phenotype by aggravating diastolic dysfunction and a progression towards systolic dysfunction. SHR-ob may be a useful model to develop new interventional and pharmacological treatment strategies for hypertensive heart disease and metabolic disorders.
肥胖和代谢综合征对高血压患者左心室(LV)适应性重构和功能的附加影响尚不清楚。
我们比较了肥胖自发性高血压大鼠模型(SHR-ob)与瘦自发性高血压大鼠(SHR-lean)和正常血压对照(Ctr)。通过心脏磁共振成像和侵入性 LV 压力测量来研究 LV 功能。通过免疫组化定量 LV 间质纤维化,并测定磷酸化肌浆球蛋白结合蛋白(PLB)、肌浆网 Ca2+-ATP 酶 2a(Serca2a)和葡萄糖转运蛋白(GLUT1 和 GLUT4)的蛋白水平。
与 SHR-lean 相比,SHR-ob 的收缩压相似(252 ± 7 对 242 ± 7 mmHg,p = 0.398),但与 Ctr(155 ± 2 mmHg)相比则更高(两者均 p < 0.01)。与 SHR-lean 和 Ctr 相比,SHR-ob 表现出葡萄糖耐量受损和体重增加。与 Ctr 相比,SHR-ob 的左心室射血分数受损(46.2 ± 1.1 对 59.6 ± 1.9%,p = 0.007)。与 SHR-lean 相比,SHR-ob 的 LV 舒张末期压力增加(21.5 ± 4.1 对 5.9 ± 0.81 mmHg,p = 0.0002),与 Ctr 相比则更高(两者均 p < 0.0001)。SHR-ob 中增加的 LV 纤维化以及心肌细胞直径的增加和 ANF 基因表达与 SHR-ob 中 GLUT1 蛋白水平的增加有关,提示 GLUT1/ANF 轴的上调。与 Ctr 相比,SHR-lean 中的 Serca2a 蛋白水平降低,但 SHR-ob 中没有改变。PLB 磷酸化没有改变。
除了单纯的高血压外,代谢综合征和肥胖症通过加重舒张功能障碍和向收缩功能障碍进展,加剧了心肌表型。SHR-ob 可能是一种有用的模型,可用于开发治疗高血压性心脏病和代谢紊乱的新的介入和药物治疗策略。