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心外膜递送导电膜使传导同步以减少心房颤动。

Epicardial delivery of a conductive membrane synchronizes conduction to reduce atrial fibrillation.

机构信息

Department of Trauma and Orthopaedics, Peking University People's Hospital, Beijing, China; Toronto General Hospital Research Institute, Division of Cardiovascular Surgery, University Health Network, Toronto, Canada.

Toronto General Hospital Research Institute, Division of Cardiovascular Surgery, University Health Network, Toronto, Canada.

出版信息

J Control Release. 2022 Nov;351:847-859. doi: 10.1016/j.jconrel.2022.09.062. Epub 2022 Oct 10.

DOI:10.1016/j.jconrel.2022.09.062
PMID:36206946
Abstract

Conductive polymers have been investigated as a medium for the transmission of electrical signals in biological tissues, but their capacity to rewire cardiac tissue has not been evaluated. Myocardial tissue is unique in being able to generate an electrical potential at a fixed rate; this potential spreads rapidly among cells to trigger muscle contractions. Tissue injuries result in myocardial fibrosis and subsequent non-uniform conductivity, leading to arrhythmia. Atrial fibrillation (AF) is the most common sustained arrhythmia, associated with disruption of atrial electrical signaling, which can potentially be restored by the epicardial delivery of conductive polymers. In this work, poly-3-amino-4-methoxybenzoic acid, conjugated to gelatin, is fabricated as a membrane (PAMB-G) to support conductive velocities that are close to that of the myocardium. A cross-linked gelatin membrane (Gelatin) is used as a control. The as-fabricated PAMB-G has similar tensile elasticities, determined using the Young's modulus, as contracting myocardium; it can also transmit electrical signals to initiate cardiac cell and tissue excitation. Delivering PAMB-G onto the atrium of a rat AF model shortens AF duration and improves post-AF recovery for the duration of a 28-day-long study. Atrial tissue in the PAMB-G-implanted group has lower impedance, higher conduction velocity, and higher field potential amplitude than that in the Gelatin-implanted group. Therefore, the as-proposed PAMB-G is a suitable medium for restoring proper cardiac electrical signaling in AF hearts.

摘要

导电聚合物已被研究作为在生物组织中传输电信号的介质,但它们对心脏组织重新布线的能力尚未得到评估。心肌组织的独特之处在于能够以固定的速率产生电势能;这种势能在细胞间迅速传播,引发肌肉收缩。组织损伤导致心肌纤维化和随后的非均匀导电性,导致心律失常。心房颤动(AF)是最常见的持续性心律失常,与心房电信号的中断有关,通过心外膜递送导电聚合物可能会恢复这种电信号。在这项工作中,聚-3-氨基-4-甲氧基苯甲酸与明胶结合,制成一种膜(PAMB-G),以支持接近心肌的导电速度。交联明胶膜(Gelatin)用作对照。所制备的 PAMB-G 具有与收缩心肌相似的拉伸弹性,这是通过杨氏模量确定的;它还可以传输电信号来引发心脏细胞和组织兴奋。在大鼠 AF 模型的心房上递送 PAMB-G 可以缩短 AF 持续时间,并在 28 天的研究期间改善 AF 后的恢复。与 Gelatin 植入组相比,PAMB-G 植入组的心房组织具有更低的阻抗、更高的传导速度和更高的场电势幅度。因此,所提出的 PAMB-G 是一种在 AF 心脏中恢复适当心脏电信号的合适介质。

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