Department of Cardiology, The Second Xiangya Hospital of Central South University, Renmin Road, Furong District, Changsha 410011, China.
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
Europace. 2023 Jun 2;25(6). doi: 10.1093/europace/euad171.
Subarachnoid haemorrhage (SAH) is one of the causes of sudden cardiac death (SCD). However, the time course of ventricular arrhythmias and potential mechanisms responsible for this effect after SAH remain unknown.
This study aims to investigate the effect of SAH on ventricular electrophysiological changes and its potential mechanisms in long-term phase.
We examined the ventricular electrophysiological remodelling and potential mechanisms in a Sprague Dawley rat model of SAH at six time points (baseline, and Days 1, 3, 7, 14 and 28) and explored the potential mechanisms. We measured the ventricular effective refractory period (ERP), ventricular fibrillation threshold (VFT) and left stellate ganglion (LSG) activity at different time points before and after SAH. We also detected neuropeptide Y (NPY) levels in plasma and myocardial tissues by enzyme-linked immunosorbent assay, and quantified NPY 1 receptor (NPY1R) protein and mRNA expression levels by western blotting and quantitative real-time reverse transcription-polymerase chain reaction, respectively. Subarachnoid haemorrhage gradually prolonged QTc intervals, shortened ventricular ERP and reduced VFT during the acute phase, peaking at Day 3. However, no significant changes were observed from Days 14 to 28 compared to Day 0. Subarachnoid haemorrhage gradually increased LSG activity, increased NPY concentrations and up-regulated NPY1R expression in the acute phase of SAH, peaking at Day 3. However, no significant variations were found from Days 14 to 28 compared to Day 0.
Subarachnoid haemorrhage increases the transient susceptibility of VAs in the acute phase, and the underlying mechanisms for this response included increased sympathetic activity and up-regulated NPY1R expression.
蛛网膜下腔出血 (SAH) 是心源性猝死 (SCD) 的原因之一。然而,SAH 后导致这种效应的室性心律失常的时间进程和潜在机制仍不清楚。
本研究旨在探讨 SAH 在长期阶段对心室电生理变化的影响及其潜在机制。
我们在蛛网膜下腔出血的 SD 大鼠模型中,在六个时间点(基线,以及第 1、3、7、14 和 28 天)检查了心室电生理重塑及其潜在机制,并探讨了潜在机制。我们在 SAH 前后的不同时间点测量了心室有效不应期 (ERP)、心室颤动阈值 (VFT) 和左侧星状神经节 (LSG) 活动。我们还通过酶联免疫吸附试验检测了血浆和心肌组织中的神经肽 Y (NPY) 水平,并通过 Western 印迹和定量实时逆转录聚合酶链反应分别定量了 NPY1 受体 (NPY1R) 蛋白和 mRNA 表达水平。蛛网膜下腔出血逐渐延长 QTc 间期,在急性期缩短心室 ERP,降低 VFT,在第 3 天达到高峰。然而,与第 0 天相比,从第 14 天到第 28 天没有观察到显著变化。蛛网膜下腔出血在急性期逐渐增加 LSG 活性,增加 NPY 浓度,并上调 NPY1R 表达,在第 3 天达到高峰。然而,与第 0 天相比,从第 14 天到第 28 天没有发现显著变化。
蛛网膜下腔出血增加了急性期 VA 的短暂易感性,这种反应的潜在机制包括增加交感神经活性和上调 NPY1R 表达。