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程度相当的生理性和病理性左心室肥厚与体内血流动力学的特征性差异相关。

Physiological and pathological left ventricular hypertrophy of comparable degree is associated with characteristic differences of in vivo hemodynamics.

作者信息

Oláh Attila, Németh Balázs Tamás, Mátyás Csaba, Hidi László, Lux Árpád, Ruppert Mihály, Kellermayer Dalma, Sayour Alex Ali, Szabó Lilla, Török Marianna, Meltzer Anna, Gellér László, Merkely Béla, Radovits Tamás

机构信息

Heart and Vascular Center, Semmelweis University, Budapest, Hungary

Heart and Vascular Center, Semmelweis University, Budapest, Hungary.

出版信息

Am J Physiol Heart Circ Physiol. 2016 Mar 1;310(5):H587-97. doi: 10.1152/ajpheart.00588.2015. Epub 2015 Dec 30.

Abstract

Left ventricular (LV) hypertrophy is a physiological or pathological response of LV myocardium to increased cardiac load. We aimed at investigating and comparing hemodynamic alterations in well-established rat models of physiological hypertrophy (PhyH) and pathological hypertrophy (PaH) by using LV pressure-volume (P-V) analysis. PhyH and PaH were induced in rats by swim training and by abdominal aortic banding, respectively. Morphology of the heart was investigated by echocardiography. Characterization of cardiac function was completed by LV P-V analysis. In addition, histological and molecular biological measurements were performed. Echocardiography revealed myocardial hypertrophy of similar degree in both models, which was confirmed by post-mortem heart weight data. In aortic-banded rats we detected subendocardial fibrosis. Reactivation of fetal gene program could be observed only in the PaH model. PhyH was associated with increased stroke volume, whereas unaltered stroke volume was detected in PaH along with markedly elevated end-systolic pressure values. Sensitive indexes of LV contractility were increased in both models, in parallel with the degree of hypertrophy. Active relaxation was ameliorated in athlete's heart, whereas it showed marked impairment in PaH. Mechanical efficiency and ventriculo-arterial coupling were improved in PhyH, whereas they remained unchanged in PaH. Myocardial gene expression of mitochondrial regulators showed marked differences between PaH and PhyH. We provided the first comparative hemodynamic characterization of PhyH and PaH in relevant rodent models. Increased LV contractility could be observed in both types of LV hypertrophy; characteristic distinction was detected in diastolic function (active relaxation) and mechanoenergetics (mechanical efficiency), which might be explained by mitochondrial differences.

摘要

左心室(LV)肥厚是左心室心肌对心脏负荷增加的一种生理或病理反应。我们旨在通过使用左心室压力-容积(P-V)分析来研究和比较成熟的生理性肥厚(PhyH)和病理性肥厚(PaH)大鼠模型中的血流动力学改变。分别通过游泳训练和腹主动脉缩窄在大鼠中诱导出PhyH和PaH。通过超声心动图研究心脏形态。通过左心室P-V分析完成心脏功能的表征。此外,还进行了组织学和分子生物学测量。超声心动图显示两种模型中均有相似程度的心肌肥厚,这在死后心脏重量数据中得到证实。在腹主动脉缩窄的大鼠中,我们检测到心内膜下纤维化。仅在PaH模型中可观察到胎儿基因程序的重新激活。PhyH与每搏输出量增加有关,而在PaH中检测到每搏输出量未改变,同时收缩末期压力值明显升高。两种模型中左心室收缩性的敏感指标均增加,与肥厚程度平行。运动员心脏的主动舒张得到改善,而在PaH中则显示出明显受损。PhyH中机械效率和心室-动脉耦合得到改善,而在PaH中则保持不变。线粒体调节因子的心肌基因表达在PaH和PhyH之间存在明显差异。我们在相关啮齿动物模型中首次对PhyH和PaH进行了比较血流动力学表征。在两种类型的左心室肥厚中均可观察到左心室收缩性增加;在舒张功能(主动舒张)和机械能量学(机械效率)方面检测到特征性差异,这可能由线粒体差异来解释。

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