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左心室肥厚情况下心肌对缺血-再灌注损伤的易感性增加。

Increased myocardial vulnerability to ischemia-reperfusion injury in the presence of left ventricular hypertrophy.

作者信息

Mølgaard Søren, Faricelli Barbara, Salomonsson Max, Engstrøm Thomas, Treiman Marek

机构信息

aDepartment of Medical Sciences and The Danish National Research Foundation Centre for Heart Arrhythmia, University of CopenhagenbCardiac Catheterization Laboratory, The Heart Centre, Rigshospitalet, Copenhagen, Denmark*Søren Mølgaard and Barbara Faricelli contributed equally to the writing of this article.

出版信息

J Hypertens. 2016 Mar;34(3):513-23; discussion 523. doi: 10.1097/HJH.0000000000000826.

Abstract

OBJECTIVE

Despite its high prevalence among patients suffering myocardial infarction, the significance of left ventricle hypertrophy for infarct size is not known. We asked whether infarct size might be increased by this condition, and whether any such increase might be associated with an increased mitochondrial damage following coronary occlusion.

METHODS

Occlusion of the left descending artery in isolated, perfused hearts of SHR-SP (spontaneously hypertensive rat stroke-prone) (left ventricular hypertrophy) or Wistar-Kyoto (WKY) (control) rats was used, followed by reperfusion with or without exendin-4 (Exe-4), a glucagon-like peptide-1 receptor agonist. Infarct size relative to area-at-risk was determined. Separately, mitochondria were isolated after global ischemia. Activities of complexes III and IV and amounts of selected complex subunits and cytochromes a, b, c, and c1 were determined.

RESULTS

Infarct size (ischemia 35  min and 120  min reperfusion) was 65.8% (±3.3%) and 37.1% (±3.4%) in the SHR-SP and WKY hearts, respectively (P < 0.05). Exe-4 significantly decreased infarct size and hypercontracture in WKY, but not in SHR-SP, hearts. After ischemia 15  min in SHR-SP hearts, Exe-4 reduced the infarct (26.6%, ±3.8% to 9.3% ± 1.5%; P < 0.05). Mitochondria from postischemic SHR-SP hearts showed a reduction of complex III (368.1 ± 37.5 to 175.8 ± 23.0  nmoles/min × mg; P < 0.05) and complex IV (14.4 ± 0.22 to 5.8 ± 0.8 1/s × mg; P < 0.05) activities and decreased amounts of cytochromes a, b, and c.

CONCLUSION

Hearts from hypertensive (SHR-SP) rats with left ventricle hypertrophy appeared more vulnerable to ischemia-reperfusion injury, as supported by a more profound infarct development and an earlier loss of postconditioning by Exe-4. Mitochondrial complexes III and IV were identified among possible loci of this increased, hypertrophy-associated vulnerability.

摘要

目的

尽管左心室肥厚在心肌梗死患者中普遍存在,但其对梗死面积的影响尚不清楚。我们研究了这种情况是否会增加梗死面积,以及这种增加是否与冠状动脉闭塞后线粒体损伤增加有关。

方法

采用结扎自发性高血压大鼠易卒中型(SHR-SP,左心室肥厚)或Wistar-Kyoto(WKY,对照)大鼠离体灌注心脏的左冠状动脉,再灌注时给予或不给予胰高血糖素样肽-1受体激动剂艾塞那肽-4(Exe-4)。测定梗死面积与危险区域面积的比值。另外,在全心缺血后分离线粒体,测定复合物III和IV的活性以及选定复合物亚基和细胞色素a、b、c和c1的含量。

结果

SHR-SP组和WKY组心脏的梗死面积(缺血35分钟和再灌注120分钟)分别为65.8%(±3.3%)和37.1%(±3.4%)(P<0.05)。Exe-4可显著降低WKY组心脏的梗死面积和高收缩反应,但对SHR-SP组心脏无效。在SHR-SP组心脏缺血15分钟后,Exe-4可使梗死面积减小(从26.6%±3.8%降至9.3%±1.5%;P<0.05)。缺血后SHR-SP组心脏的线粒体复合物III(从368.1±37.5降至175.8±23.0纳摩尔/分钟×毫克;P<0.05)和复合物IV(从14.4±0.22降至5.8±0.8 1/秒×毫克;P<0.05)活性降低,细胞色素a、b和c含量减少。

结论

左心室肥厚的高血压(SHR-SP)大鼠心脏似乎对缺血-再灌注损伤更敏感,表现为梗死发展更严重,Exe-4的后适应作用更早丧失。线粒体复合物III和IV被确定为这种与肥厚相关的易感性增加的可能位点。

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