Ogata Tsuyoshi, Ito Kenta, Shindo Tomohiko, Hatanaka Kazuaki, Eguchi Kumiko, Kurosawa Ryo, Kagaya Yuta, Monma Yuto, Ichijo Sadamitsu, Taki Hirofumi, Kanai Hiroshi, Shimokawa Hiroaki
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Electronic Engineering, Graduate School of Engineering, Tohoku University, Sendai, Japan.
PLoS One. 2017 Sep 28;12(9):e0185555. doi: 10.1371/journal.pone.0185555. eCollection 2017.
Chronic left ventricular (LV) pressure overload causes relative ischemia with resultant LV dysfunction. We have recently demonstrated that low-intensity pulsed ultrasound (LIPUS) improves myocardial ischemia in a pig model of chronic myocardial ischemia through enhanced myocardial angiogenesis. In the present study, we thus examined whether LIPUS also ameliorates contractile dysfunction in LV pressure-overloaded hearts.
Chronic LV pressure overload was induced with transverse aortic constriction (TAC) in mice. LIPUS was applied to the whole heart three times in the first week after TAC and was repeated once a week for 7 weeks thereafter (n = 22). Animals in the control groups received the sham treatment without LIPUS (n = 23). At 8 weeks after TAC, LV fractional shortening was depressed in the TAC-Control group, which was significantly ameliorated in the TAC-LIPUS group (30.4±0.5 vs. 36.2±3.8%, P<0.05). Capillary density was higher and perivascular fibrosis was less in the LV in the TAC-LIPUS group than in the TAC-Control group. Myocardial relative ischemia evaluated with hypoxyprobe was noted in the TAC-Control group, which was significantly attenuated in the TAC-LIPUS group. In the TAC-LIPUS group, as compared with the control group, mRNA expressions of BNP and collagen III were significantly lower (both P<0.05) and protein expressions of VEGF and eNOS were significantly up-regulated associated with Akt activation (all P<0.05). No adverse effect related to the LIPUS therapy was noted.
These results indicate that the LIPUS therapy ameliorates contractile dysfunction in chronically pressure-overloaded hearts through enhanced myocardial angiogenesis and attenuated perivascular fibrosis. Thus, the LIPUS therapy may be a promising, non-invasive treatment for cardiac dysfunction due to chronic pressure overload.
慢性左心室(LV)压力超负荷会导致相对性缺血,进而引起左心室功能障碍。我们最近证明,低强度脉冲超声(LIPUS)通过增强心肌血管生成,改善了慢性心肌缺血猪模型中的心肌缺血情况。因此,在本研究中,我们检测了LIPUS是否也能改善左心室压力超负荷心脏的收缩功能障碍。
通过对小鼠进行横断主动脉缩窄(TAC)诱导慢性左心室压力超负荷。在TAC后的第一周,对整个心脏进行三次LIPUS治疗,此后每周重复一次,共7周(n = 22)。对照组动物接受无LIPUS的假治疗(n = 23)。TAC后8周,TAC-对照组的左心室短轴缩短率降低,而TAC-LIPUS组明显改善(30.4±0.5对36.2±3.8%,P<0.05)。TAC-LIPUS组左心室的毛细血管密度更高,血管周围纤维化更少。用低氧探针评估的TAC-对照组心肌存在相对缺血,而TAC-LIPUS组明显减轻。与对照组相比,TAC-LIPUS组中BNP和胶原蛋白III的mRNA表达显著降低(均P<0.05),VEGF和eNOS的蛋白表达显著上调,并与Akt激活相关(均P<0.05)。未观察到与LIPUS治疗相关的不良反应。
这些结果表明,LIPUS治疗通过增强心肌血管生成和减轻血管周围纤维化,改善了慢性压力超负荷心脏的收缩功能障碍。因此,LIPUS治疗可能是一种有前景的、用于治疗慢性压力超负荷导致的心脏功能障碍的非侵入性治疗方法。