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早期给予依那普利可预防心肌梗死家兔的舒张功能障碍和心室重构。

Early administration of Enalapril prevents diastolic dysfunction and ventricular remodeling in rabbits with myocardial infarction.

作者信息

González Germán E, Wilensky Luciana, Cassaglia Pablo, Morales Celina, Gelpi Ricardo J

机构信息

Instituto de Fisiopatología Cardiovascular, Departamento de Patología, Facultad de Medicina, Universidad de Buenos Aires, Argentina; Instituto de Bioquímica y Medicina Molecular, Consejo Nacional de Investigaciones Científicas y Técnicas, Departamento de Patología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.

Instituto de Fisiopatología Cardiovascular, Departamento de Patología, Facultad de Medicina, Universidad de Buenos Aires, Argentina; Instituto de Bioquímica y Medicina Molecular, Consejo Nacional de Investigaciones Científicas y Técnicas, Departamento de Patología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.

出版信息

Cardiovasc Pathol. 2016 May-Jun;25(3):208-213. doi: 10.1016/j.carpath.2016.01.004. Epub 2016 Jan 22.

Abstract

We aimed to investigate the role of early administration of Enalapril (Enal) on post-myocardial infarction (MI) ventricular remodeling and diastolic dysfunction in rabbits. White New Zealand rabbits that underwent coronary artery ligature or Sham were divided in three experimental groups: (1) Sham, (2) MI, and (3) MI+Enal. Enal was given by gavage at a dose of 10mg/kg/day starting at 3h after surgery for 35days. At the end of the protocol, we measured (1) mean arterial pressure, (2) left ventricular (LV)+dP/dtmax, (3) LV end-diastolic pressure (LVEDP) and isovolumic relaxation (Tau), (4) LV dimensions, (5) LV ejection and shortening fraction, (6) infarct size (Masson's trichrome-stained slices), (7) fibrosis in the infarct and remote zone (Picrosirius red-stained slices), and (8) myocyte cross-sectional area (MCSA) in WGA-stained section. Enal reduced the mean arterial pressure by 30% as compared with untreated animals and Sham (P<.05). MI reduced LV+dP/dtmax and LV-dP/dtmax (mmHg/s), increased LVEDP (mmHg), Tau (ms), and t50 (ms) values, suggesting a decrease in the relaxation rate. LV end-diastolic dimension and LV end-systolic dimension (LVESD, mm) increased in untreated MI (P<.05 vs. Sham). In contrast, Enal markedly prevented post-MI diastolic dysfunction by significantly decrease LVEDP from 8.2±0.2 to 5.1±0.3mmHg, Tau from 19.8±0.8 to 15.3±0.9ms, and t50 from 12.4±0.5 to 9.6±0.8ms as well as reduced LVESD from 15±1.1 to 12±0.8mm (P<.05 MI vs. MI+Enal). Collagen concentration in the scar was unaffected, but chronic treatment with Enal prevented myocardial fibrosis and MCSA in the remote zone. In summary, chronic early administration of Enal to rabbits with experimental MI has a favorable effect on ventricular remodeling and diastolic function by reducing MCSA and fibrosis, without affecting the wound healing.

摘要

我们旨在研究早期给予依那普利(Enal)对兔心肌梗死后(MI)心室重构和舒张功能障碍的作用。将接受冠状动脉结扎或假手术的新西兰白兔分为三个实验组:(1)假手术组,(2)MI组,(3)MI + Enal组。术后3小时开始,以10mg/kg/天的剂量经口灌胃给予Enal,持续35天。在实验结束时,我们测量了:(1)平均动脉压,(2)左心室(LV)+dP/dtmax,(3)左心室舒张末期压力(LVEDP)和等容舒张期(Tau),(4)左心室尺寸,(5)左心室射血分数和缩短分数,(6)梗死面积(Masson三色染色切片),(7)梗死区和远隔区的纤维化(天狼星红染色切片),以及(8)WGA染色切片中的心肌细胞横截面积(MCSA)。与未治疗的动物和假手术组相比,Enal使平均动脉压降低了30%(P<0.05)。MI降低了LV + dP/dtmax和LV - dP/dtmax(mmHg/s),增加了LVEDP(mmHg)、Tau(ms)和t50(ms)值,提示舒张速率降低。未治疗的MI组左心室舒张末期内径和左心室收缩末期内径(LVESD,mm)增加(与假手术组相比,P<0.05)。相比之下,Enal通过将LVEDP从8.2±0.2显著降低至5.1±0.3mmHg,Tau从19.8±0.8显著降低至15.3±0.9ms,t50从12.4±0.5显著降低至9.6±0.8ms,以及将LVESD从15±1.1显著降低至12±0.8mm,显著预防了MI后的舒张功能障碍(MI组与MI + Enal组相比,P<0.05)。瘢痕中的胶原浓度未受影响,但Enal的长期治疗预防了远隔区的心肌纤维化和MCSA。总之,对实验性MI兔早期长期给予Enal通过减少MCSA和纤维化,对心室重构和舒张功能有有利影响,且不影响伤口愈合。

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