National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Xi'an Children's Hospital, Xi'an, China.
Sci Rep. 2024 Oct 4;14(1):23062. doi: 10.1038/s41598-024-73590-7.
There is a lack of in-depth research on the impacts and changes in chronic psychological stress (CPS) on the cardiovascular system after acute myocardial infarction (AMI). This study aims to explore the comorbid mechanism and dynamic evolution of AMI exposed to CPS. 120 Wistar rats were randomly divided into Sham Operation group, Sham Operation + Chronic Unpredictable Mild Stress (CUMS) group, AMI group and AMI + CUMS group, with each group further divided into subgroups at days 7, 14, and 28. The AMI model was created by ligating the left anterior descending coronary artery, and CUMS model was used to induce CPS in rats. Behavioral changes were assessed through open field tests and sucrose preference tests. Cardiac function and structure were evaluated via echocardiography. The serum levels of TNFα, IL-6, NO, ET, CK-MB, cTNT, and ANP were measured using assay kits. Pathological changes in cardiac and brain tissues were observed under an optical microscope. Comparative analysis across different models revealed that CUMS significantly reduced behavioral activities in rats, with an interaction between CUMS and AMI affecting total distance (P < 0.05). Both CUMS and AMI significantly reduced cardiac function indicators, with their interaction effects on LVEF, LVFS, and CO (P < 0.05). AMI significantly altered cardiac structural parameters, particularly on day 28 (P < 0.05); while the impact of CUMS on cardiac structure was not significant, except for a notable reduction in LVAW/s on day 7 in AMI + CUMS group (P < 0.05). AMI caused significant changes in the serum biomarkers, while CUMS only significantly increased cTnT on day 7, ANP, TNFα, and IL-6 on day 14, and CK-MB on day 28, with their interaction effects on the three myocardial injury markers and TNFα (P < 0.05). Comparative analysis across different time points demonstrated that behavioral activity, cardiac function, CK-MB, cTnT, ANP, TNFα, and ET levels decreased significantly over time in the AMI model rats, while the left ventricular mass increased significantly (P < 0.05). Pathologically, compared with stress or AMI alone, the AMI + CUMS group exhibited more severe myocardia cellular degeneration and inflammatory infiltration, causing larger infract areas in myocardial tissue, as well as cell number decreases and morphological changes in hippocampal tissue. AMI with CPS exacerbates myocardial injury through sustained inflammation and endothelial dysfunction, leading to heart-brain pathology manifestations characterized by decreased cardiac function and hippocampal tissue damage.
慢性心理应激(CPS)对急性心肌梗死(AMI)后心血管系统的影响和变化缺乏深入研究。本研究旨在探讨暴露于 CPS 后 AMI 的合并发病机制和动态演变。将 120 只 Wistar 大鼠随机分为假手术组、假手术+慢性不可预测轻度应激(CUMS)组、AMI 组和 AMI+CUMS 组,每组进一步分为第 7、14 和 28 天亚组。通过结扎左前降支冠状动脉建立 AMI 模型,CUMS 模型用于诱导大鼠的 CPS。通过旷场试验和蔗糖偏好试验评估行为变化。通过超声心动图评估心功能和结构。使用试剂盒测定血清 TNFα、IL-6、NO、ET、CK-MB、cTNT 和 ANP 水平。在光学显微镜下观察心脏和脑组织的病理变化。不同模型的比较分析显示,CUMS 显著降低了大鼠的行为活动,CUMS 与 AMI 的相互作用影响总距离(P<0.05)。CUMS 和 AMI 均显著降低了心功能指标,其对 LVEF、LVFS 和 CO 的相互作用效应(P<0.05)。AMI 显著改变了心脏结构参数,特别是在第 28 天(P<0.05);而 CUMS 对心脏结构的影响不显著,除了 AMI+CUMS 组在第 7 天 LVAW/s 明显降低(P<0.05)。AMI 导致血清生物标志物显著变化,而 CUMS 仅在第 7 天显著增加 cTnT、第 14 天增加 ANP、TNFα 和 IL-6,第 28 天增加 CK-MB,其对三种心肌损伤标志物和 TNFα 的相互作用效应(P<0.05)。不同时间点的比较分析表明,AMI 模型大鼠的行为活动、心功能、CK-MB、cTnT、ANP、TNFα 和 ET 水平随时间显著降低,左心室质量显著增加(P<0.05)。病理学检查结果显示,与应激或 AMI 单独作用相比,AMI+CUMS 组心肌细胞变性和炎症浸润更严重,导致心肌组织梗死面积增大,海马组织细胞数量减少和形态改变。CPS 合并 AMI 通过持续的炎症和内皮功能障碍加重心肌损伤,导致心脑病理表现为心功能下降和海马组织损伤。