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一种起搏控制的频率-舒张关系的方案可区分特定于 HFpEF 模型的舒张功能障碍。

A pacing-controlled protocol for frequency-diastolic relations distinguishes diastolic dysfunction specific to a mouse HFpEF model.

机构信息

Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan.

Department of Advanced Translational Research and Medicine in Management of Pulmonary Hypertension, The University of Tokyo Hospital, Tokyo, Japan.

出版信息

Am J Physiol Heart Circ Physiol. 2022 Sep 1;323(3):H523-H527. doi: 10.1152/ajpheart.00241.2022. Epub 2022 Aug 12.

Abstract

Heart failure with preserved ejection fraction (HFpEF), characterized by diastolic dysfunction and insufficient exercise capacity, is a growing health problem worldwide. One major difficulty with experimental research on HFpEF is the lack of methods to consistently detect diastolic dysfunction in mouse models. We developed a pacing-controlled pressure-volume (PV) loop protocol for the assessment of diastolic function at different heart rates in mice and tested if the protocol could detect diastolic dysfunction specific to a HFpEF model. A HFpEF model was generated by high-fat diet (HFD) feeding with concomitant -nitro-l-arginine methyl ester administration, and a pressure-overload hypertrophy (PO) model was produced by surgical constriction of the transverse aorta (TAC). Heart rate (HR) was slowed below 400 beats/min by intraperitoneal injection of ivabradine. PV loop data were acquired and analyzed at HR incrementing from 400 to 700 beats/min via atrial pacing using a miniature pacing catheter inserted into the esophagus, and comparisons were made among control, HFpEF, and PO mice. At baseline without pacing, no diastolic abnormalities were detected in either PO or HFpEF models. Frequency-diastolic relations, however, revealed the significant diastolic impairment specific to the HFpEF model; both relaxation time constant (Tau) and end-diastolic pressure-volume relationship (EDPVR) were worsened as heart rate increased. Peak positive first derivative of left ventricular pressure (dP/d) was significantly lower in HFpEF versus controls only at a high HR of 700 beats/min. A pacing-controlled protocol would be a feasible and potent method to detect diastolic dysfunction specific to a mouse HFpEF model. We developed a pacing-controlled PV loop protocol for the assessment of diastolic function at different heart rates in mice, which is a feasible and potent method for the characterization of diastolic dysfunction in a murine HFpEF model whose diastolic dysfunction might be difficult to be detected under resting conditions without pacing.

摘要

射血分数保留的心力衰竭(HFpEF)以舒张功能障碍和运动能力不足为特征,是全球日益严重的健康问题。HFpEF 实验研究的一个主要难点是缺乏在小鼠模型中一致检测舒张功能障碍的方法。我们开发了一种起搏控制的压力-容积(PV)环方案,用于评估不同心率下的舒张功能,并测试该方案是否可以检测到 HFpEF 模型特有的舒张功能障碍。HFpEF 模型通过高脂肪饮食(HFD)喂养和同时给予硝基-L-精氨酸甲酯来产生,而压力超负荷肥厚(PO)模型则通过横主动脉(TAC)的外科缩窄来产生。通过腹腔内注射伊伐布雷定将心率减慢至 400 次/分以下。通过插入食管的微型起搏导管进行心房起搏,将心率从 400 次/分递增至 700 次/分,获取并分析 PV 环数据,并在对照、HFpEF 和 PO 小鼠之间进行比较。在没有起搏的基础状态下,PO 或 HFpEF 模型均未检测到舒张异常。然而,频率-舒张关系揭示了 HFpEF 模型特有的显著舒张障碍;随着心率的增加,弛豫时间常数(Tau)和舒张末期压力-容积关系(EDPVR)都恶化了。只有在 700 次/分的高心率时,HFpEF 与对照组相比,左心室压力的第一正导数峰值(dP/d)显著降低。在没有起搏的情况下,HFpEF 与对照组相比,只有在高心率 700 次/分的情况下,左心室压力的第一正导数峰值(dP/d)显著降低。起搏控制方案将是一种可行且有效的方法,可用于检测 HFpEF 小鼠模型特有的舒张功能障碍。我们开发了一种起搏控制的 PV 环方案,用于评估不同心率下的舒张功能,这是一种可行且有效的方法,可用于表征在没有起搏的情况下休息状态下可能难以检测到舒张功能障碍的小鼠 HFpEF 模型的舒张功能障碍。

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