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长期 T3 和 T4 治疗作为心肌梗死后改善心功能的替代有氧运动训练。

Long-term T3 and T4 treatment as an alternative to aerobic exercise training in improving cardiac function post-myocardial infarction.

机构信息

Laboratório de Fisiologia Cardiovascular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, University of Manitoba, Winnipeg, MB, Canada.

出版信息

Biomed Pharmacother. 2017 Nov;95:965-973. doi: 10.1016/j.biopha.2017.09.021. Epub 2017 Sep 11.

Abstract

Here we aimed to compare the beneficial effects of T3 and T4 hormone treatment to those provided by aerobic exercise training in Wistar rats post-myocardial infarction (MI). Rats in one group were SHAM-operated and in the other group were subjected to MI surgery. One week after surgery, the MI group animals either received T3 and T4 hormones by gavage or underwent a low intensity aerobic exercise training protocol on a treadmill, and both treatments lasted until 10 weeks after MI. Untreated SHAM-operated and MI groups were also followed for the same duration. The cardiac function was assessed by echocardiography and catheterization, followed by blood collection (to measure T3, T4, and TSH hormones), and euthanasia. The lung, liver, heart, and tibia were collected (to assess hypertrophy and congestion indices). The left ventricle homogenate (without a scar) was used for the analyses of calcium handling proteins. Results showed that enhanced cardiac function was promoted by both interventions, with infarct size reduction, increased ejection fraction, and diastolic posterior wall thickness, but no alterations in heart rate, cardiac output, or T3, T4, and TSH levels. There was a positive force-frequency relationship accompanied by increased α-MHC, as well as decreased HSP70 protein expression. In conclusion, the effects of T3 and T4 hormone treatments were similar, and in some parameters superior, to those provided by the aerobic exercise training. Thus, lower doses of thyroid hormones could be more suitable as a coadjuvant treatment after MI, as a plausible alternative for patients who are intolerant to aerobic exercise training.

摘要

在这里,我们旨在比较 T3 和 T4 激素治疗与有氧运动训练对心肌梗死后 Wistar 大鼠的有益作用。一组大鼠接受 SHAM 手术,另一组大鼠接受心肌梗死手术。手术后一周,MI 组大鼠通过灌胃接受 T3 和 T4 激素治疗或在跑步机上进行低强度有氧运动训练,两种治疗均持续至 MI 后 10 周。未接受治疗的 SHAM 手术组和 MI 组也随访了相同的时间。通过超声心动图和心导管术评估心功能,随后采集血液(测量 T3、T4 和 TSH 激素),并进行安乐死。收集肺、肝、心脏和胫骨(评估肥大和充血指数)。左心室匀浆(无疤痕)用于钙处理蛋白分析。结果表明,两种干预措施均可促进心脏功能增强,减少梗死面积,提高射血分数和舒张后壁厚度,但心率、心输出量或 T3、T4 和 TSH 水平无变化。存在正性肌力频率关系,伴随着α-MHC 增加和 HSP70 蛋白表达减少。总之,T3 和 T4 激素治疗的效果相似,在某些参数上优于有氧运动训练。因此,较低剂量的甲状腺激素可能更适合作为 MI 后的辅助治疗,对于不能耐受有氧运动训练的患者来说是一种可行的替代方案。

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