Kato Ryuji, Nomura Atsuo, Sakamoto Aiji, Yasuda Yuki, Amatani Koyuha, Nagai Sayuri, Sen Yoko, Ijiri Yoshio, Okada Yoshikatsu, Yamaguchi Takehiro, Izumi Yasukatsu, Yoshiyama Minoru, Tanaka Kazuhiko, Hayashi Tetsuya
Laboratory of Cardiovascular Pharmacotherapy and Toxicology, Osaka University of Pharmaceutical Sciences, Takatsuki, Japan;
Laboratory of Vascular Biology, National Cerebral and Cardiovascular Center, Suita, Japan;
Am J Physiol Heart Circ Physiol. 2014 Dec 1;307(11):H1626-33. doi: 10.1152/ajpheart.00228.2014. Epub 2014 Oct 3.
The prevalence of sleep apnea is very high in patients with heart failure (HF). The aims of this study were to investigate the influence of intermittent hypoxia (IH) on the failing heart and to evaluate the antioxidant effect of hydrogen gas. Normal male Syrian hamsters (n = 22) and cardiomyopathic (CM) hamsters (n = 33) were exposed to IH (repeated cycles of 1.5 min of 5% oxygen and 5 min of 21% oxygen for 8 h during the daytime) or normoxia for 14 days. Hydrogen gas (3.05 vol/100 vol) was inhaled by some CM hamsters during hypoxia. IH increased the ratio of early diastolic mitral inflow velocity to mitral annulus velocity (E/e', 21.8 vs. 16.9) but did not affect the LV ejection fraction (EF) in normal Syrian hamsters. However, IH increased E/e' (29.4 vs. 21.5) and significantly decreased the EF (37.2 vs. 47.2%) in CM hamsters. IH also increased the cardiomyocyte cross-sectional area (672 vs. 443 μm(2)) and interstitial fibrosis (29.9 vs. 9.6%), along with elevation of oxidative stress and superoxide production in the left ventricular (LV) myocardium. Furthermore, IH significantly increased the expression of brain natriuretic peptide, β-myosin heavy chain, c-fos, and c-jun mRNA in CM hamsters. Hydrogen gas inhalation significantly decreased both oxidative stress and embryonic gene expression, thus preserving cardiac function in CM hamsters. In conclusion, IH accelerated LV remodeling in CM hamsters, at least partly by increasing oxidative stress in the failing heart. These findings might explain the poor prognosis of patients with HF and sleep apnea.
心力衰竭(HF)患者中睡眠呼吸暂停的患病率非常高。本研究的目的是调查间歇性缺氧(IH)对衰竭心脏的影响,并评估氢气的抗氧化作用。将正常雄性叙利亚仓鼠(n = 22)和心肌病(CM)仓鼠(n = 33)暴露于IH(白天8小时内重复进行1.5分钟5%氧气和5分钟21%氧气的循环)或常氧环境14天。一些CM仓鼠在缺氧期间吸入氢气(3.05体积/100体积)。IH增加了正常叙利亚仓鼠舒张早期二尖瓣流入速度与二尖瓣环速度之比(E/e',21.8对16.9),但不影响左心室射血分数(EF)。然而,IH增加了CM仓鼠的E/e'(29.4对21.5),并显著降低了EF(37.2对47.2%)。IH还增加了心肌细胞横截面积(672对443μm²)和间质纤维化(29.9对9.6%),同时左心室(LV)心肌中的氧化应激和超氧化物生成增加。此外,IH显著增加了CM仓鼠中脑钠肽、β-肌球蛋白重链、c-fos和c-jun mRNA的表达。吸入氢气显著降低了氧化应激和胚胎基因表达,从而在CM仓鼠中保留了心脏功能。总之,IH至少部分通过增加衰竭心脏中的氧化应激加速了CM仓鼠的左心室重构。这些发现可能解释了HF和睡眠呼吸暂停患者预后不良的原因。