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梗死后早期应用秋水仙碱治疗可通过 C-蛋氨酸成像显示心肌炎症反应,并通过定量门控 SPECT 显示随后的心室重构。

Colchicine treatment early after infarction attenuates myocardial inflammatory response demonstrated by C-methionine imaging and subsequent ventricular remodeling by quantitative gated SPECT.

机构信息

Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.

Institute for Frontier Science Initiative, Kanazawa University, Kanazawa, Japan.

出版信息

Ann Nucl Med. 2021 Feb;35(2):253-259. doi: 10.1007/s12149-020-01559-3. Epub 2021 Jan 3.

Abstract

OBJECTIVE

Colchicine has been used as an anti-inflammatory agent and may be cardioprotective after acute myocardial infarction (AMI). We investigated how colchicine administration after AMI affects the myocardial inflammatory response using C-methionine and subsequent ventricular remodeling using single-photon emission computed tomography (SPECT) in a rat model of AMI.

METHODS

The left coronary artery (LCA) was occluded for 30 min followed by reperfusion. C-methionine was injected at 20 min before sacrifice. The LCA was re-occluded at 1 min before sacrifice and Tc-methoxyisobutylisonitrile (Tc-MIBI) was injected. Colchicine was administered intraperitoneally from day 1 to the day before C-methionine injection. Dual-tracer autoradiography of the left ventricular short-axis slices was performed. The methionine uptake ratio in an ischemic area was calculated. Tc-MIBI gated SPECT assessed end-diastolic volume (EDV), end-systolic volume (ESV) and left ventricular ejection fraction (LVEF). On Cluster of Differentiation 68 with 4',6-diamidino-2-phenylindole (CD68/DAPI) staining the positive myocardial cell percentage in an ischemic area was calculated.

RESULTS

In control rats, C-methionine uptake ratios on day 3 and 7 were 1.87 ± 0.15 and 1.39 ± 0.12, respectively. With colchicine, the uptake was reduced on days 3 (1.56 ± 0.26, p = 0.042) and 7 (1.23 ± 0.10, p = 0.030). Colchicine treated rats showed smaller EDV, ESV, and higher LVEF compared with control rats. At 8 weeks, those in control rats were 864 ± 115 μL, 620 ± 100 μL, 28.4 ± 2.5%, and in colchicine rats 665 ± 75 μL, 390 ± 97 μL, 42.2 ± 8.5% (p = 0.012, 0.0061, 0.0083), respectively. In control rats, CD68/DAPI positive myocardial cell percentages on days 3 and 7 were 38.4 ± 1.9% and 24.0 ± 2.4%, respectively. With colchicine, the percentages were reduced significantly on both days 3 (31.5 ± 2.0%, p < 0.0001) and 7 (12.0 ± 1.6%, p < 0.0001) as compared with the control.

CONCLUSIONS

Short-term colchicine treatment after AMI attenuated the post-AMI inflammatory response and subsequent ventricular remodeling and dysfunction. C-methionine imaging and gated Tc-MIBI SPECT would be feasible to monitor the effectiveness of anti-inflammatory therapy and left ventricular function.

摘要

目的

秋水仙碱已被用作抗炎药物,并且在急性心肌梗死(AMI)后可能具有心脏保护作用。我们使用 C-蛋氨酸在 AMI 大鼠模型中研究了 AMI 后秋水仙碱给药如何影响心肌炎症反应,并用单光子发射计算机断层扫描(SPECT)研究随后的心室重构。

方法

左冠状动脉(LCA)闭塞 30 分钟,然后再灌注。在牺牲前 20 分钟注射 C-蛋氨酸。在牺牲前 1 分钟再次闭塞 LCA,并注射 Tc-甲氧基异丁基异腈(Tc-MIBI)。秋水仙碱从第 1 天到 C-蛋氨酸注射前一天每天腹腔给药。对左心室短轴切片进行双示踪剂放射自显影。计算缺血区的蛋氨酸摄取比。Tc-MIBI 门控 SPECT 评估舒张末期容积(EDV)、收缩末期容积(ESV)和左心室射血分数(LVEF)。在 CD68/4',6-二脒基-2-苯基吲哚(CD68/DAPI)染色上,计算缺血区 CD68/DAPI 阳性心肌细胞的百分比。

结果

在对照大鼠中,第 3 天和第 7 天的 C-蛋氨酸摄取比分别为 1.87±0.15 和 1.39±0.12。用秋水仙碱处理后,第 3 天(1.56±0.26,p=0.042)和第 7 天(1.23±0.10,p=0.030)的摄取减少。与对照组相比,秋水仙碱处理的大鼠 EDV、ESV 较小,LVEF 较高。8 周时,对照组大鼠分别为 864±115 μL、620±100 μL、28.4±2.5%,秋水仙碱组大鼠分别为 665±75 μL、390±97 μL、42.2±8.5%(p=0.012、0.0061、0.0083)。在对照组大鼠中,第 3 天和第 7 天的 CD68/DAPI 阳性心肌细胞百分比分别为 38.4±1.9%和 24.0±2.4%。用秋水仙碱处理后,第 3 天(31.5±2.0%,p<0.0001)和第 7 天(12.0±1.6%,p<0.0001)的百分比均显著降低。

结论

AMI 后短期秋水仙碱治疗可减轻 AMI 后炎症反应及随后的心室重构和功能障碍。C-蛋氨酸成像和门控 Tc-MIBI SPECT 可用于监测抗炎治疗和左心室功能的效果。

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