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老年自发性高血压大鼠具有人类慢性左心室功能障碍伴射血分数保留的典型特征。

Old spontaneously hypertensive rats gather together typical features of human chronic left-ventricular dysfunction with preserved ejection fraction.

作者信息

Marzak Halim, Ayme-Dietrich Estelle, Lawson Roland, Mokni Walid, Combe Roy, Becker Julien, Fertak Lahcen El, Champy Marie-France, Monassier Laurent

机构信息

aLaboratoire de Neurobiologie et Pharmacologie Cardiovasculaire, Faculté de Médecine, Fédération de Médecine translationnelle, Université et Centre Hospitalier de Strasbourg, Strasbourg bMouse Clinical Institute, Illkirch-Graffenstaden, France.

出版信息

J Hypertens. 2014 Jun;32(6):1307-16. doi: 10.1097/HJH.0000000000000159.

Abstract

OBJECTIVE

Heart failure with preserved left-ventricular ejection fraction (HF-PEF) is an entity leading to pulmonary congestion because of impaired diastolic filling. This syndrome usually strikes those who have experienced a long history of hypertension or metabolic risk factors. Pathophysiological mechanisms are not fully understood, and standard therapy is not established. Relevant preclinical models are still lacking. The aim of this work was to evaluate aging spontaneously hypertensive rats (SHRs) as a model of HF-PEF.

METHODS

Serial echocardiographic and blood pressure (BP) measurements were performed in 28, 36, 43, 47 and 51-week-old SHRs and their normotensive controls (Wistar-Kyoto rats). In 52-53-week-old animals, final investigations included ECG, invasive left-ventricular (LV) and aortic catheterization, brain natriuretic peptide (BNP) plasma concentrations, ventricular reverse transcription-qPCR evaluations (β-myosin heavy chain, atrial natriuretic peptide, BNP, sarco/endoplasmic reticulum calcium ATPase 2a and collagens 1a, 3a and 2a) and cardiac histology.

RESULTS

SHRs develop a progressive alteration of the early diastole, some of the echocardiographic parameters being not sensitive to BP reduction by the calcium blocker, nicardipine. The systolic function evaluated by echocardiography and invasive catheterization was preserved. When the observation period was over, an increase in collagen synthesis and deposits were identified in subendocardial layers. This attested a probable myocardial ischemia that was confirmed by ECG changes of the ST segment. BNP increased in the blood and at the mRNA level in the myocardium.

CONCLUSION

When aging, SHRs progressively develop HF-PEF showed by impaired LV relaxation and hypertrophy, BNP increase but preserved contractility and fibrosis. This model seems pertinent for further pharmacological preclinical studies in the field.

摘要

目的

射血分数保留的心力衰竭(HF-PEF)是一种由于舒张期充盈受损导致肺充血的病症。该综合征通常发生在有长期高血压病史或代谢危险因素的人群中。其病理生理机制尚未完全明确,标准治疗方法也未确立。相关的临床前模型仍然缺乏。本研究的目的是评估老年自发性高血压大鼠(SHR)作为HF-PEF的模型。

方法

对28、36、43、47和51周龄的SHR及其血压正常的对照大鼠(Wistar-Kyoto大鼠)进行连续的超声心动图和血压(BP)测量。在52-53周龄的动物中,最终研究包括心电图、有创左心室(LV)和主动脉插管、血浆脑钠肽(BNP)浓度、心室逆转录-定量聚合酶链反应评估(β-肌球蛋白重链、心房钠尿肽、BNP、肌浆网/内质网钙ATP酶2a以及胶原蛋白1a、3a和2a)和心脏组织学检查。

结果

SHR出现早期舒张期的进行性改变,一些超声心动图参数对钙通道阻滞剂尼卡地平降低血压不敏感。通过超声心动图和有创插管评估的收缩功能得以保留。观察期结束时,在心内膜下层发现胶原蛋白合成和沉积增加。这证明可能存在心肌缺血,ST段心电图改变证实了这一点。血液中BNP升高,心肌中BNP的mRNA水平也升高。

结论

随着年龄增长,SHR逐渐发展为HF-PEF,表现为左心室舒张功能受损和肥厚、BNP升高,但收缩功能和纤维化得以保留。该模型似乎适用于该领域进一步的临床前药理学研究。

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