Benvenuti C, Aptecar E, Deleuze P, Benaïem N, Mazzucotelli J P, Charloux C, Castaigne A, Loisance D, Astier A, Paul M
Department of Cardiac Surgery, Hopital Henri Mondor, Creteil, France.
J Heart Lung Transplant. 1994 Sep-Oct;13(5):857-61.
The present study was designed to assess whether acute rejection affects myocardial energy content of the human orthotopically transplanted heart. Adenosine triphosphate content was measured in one tissue sample obtained during 46 routine right ventricular endomyocardial biopsies 6 to 455 days (98 +/- 110) after transplantation in 19 cyclosporine-treated transplant recipients. Tissue samples were immediately frozen in liquid nitrogen within 10 seconds after excision. Adenosine triphosphate analysis was performed with high performance liquid chromatography. Three groups of biopsy specimens were classified according to the standardized cardiac biopsy grading system. Group 1: Eight biopsy specimens without rejection; group 2: 24 biopsy specimens with mild rejection; group 3: 14 biopsy specimens with moderate or severe rejection. Graft systolic function evaluated by echocardiographic fractional shortening was in the normal range the day of biopsy. All patients had normal coronary angiograms within 1 month of the study. In the presence of mild rejection (grade 1A or 1B), adenosine triphosphate content was not significantly different from that of nonrejecting hearts (26.15 +/- 7.1 and 28.57 +/- 8.23 nmol/mg protein, respectively). By contrast, a significant decrease in adenosine triphosphate content was observed when moderate or severe rejection with focal or diffuse aggressive infiltrates were present (10.46 +/- 4.11 nmol/mg protein; p < 0.01 versus two other groups). In seven cases, sequential analysis showed a significant increase in adenosine triphosphate content after rejection therapy concomittant with histologic improvement: 10.19 +/- 2.9 before and 30.13 +/- 7.0 nmol/mg protein after treatment (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在评估急性排斥反应是否会影响人类原位移植心脏的心肌能量含量。在19例接受环孢素治疗的移植受者中，于移植后6至455天（98±110天）进行的46次常规右心室心内膜活检所获取的一个组织样本中测量三磷酸腺苷含量。组织样本在切除后10秒内立即置于液氮中冷冻。采用高效液相色谱法进行三磷酸腺苷分析。根据标准化的心脏活检分级系统对三组活检标本进行分类。第1组：8例无排斥反应的活检标本；第2组：24例有轻度排斥反应的活检标本；第3组：14例有中度或重度排斥反应的活检标本。活检当天通过超声心动图缩短分数评估的移植物收缩功能在正常范围内。所有患者在研究的1个月内冠状动脉造影均正常。在存在轻度排斥反应（1A或1B级）时，三磷酸腺苷含量与无排斥反应的心脏相比无显著差异（分别为26.15±7.1和28.57±8.23 nmol/mg蛋白质）。相比之下，当存在伴有局灶性或弥漫性侵袭性浸润的中度或重度排斥反应时，观察到三磷酸腺苷含量显著降低（10.46±4.11 nmol/mg蛋白质；与其他两组相比，p<0.01）。在7例病例中，连续分析显示排斥反应治疗后三磷酸腺苷含量显著增加，同时组织学改善：治疗前为10.19±2.9，治疗后为30.13±7.0 nmol/mg蛋白质（p<0.01）。（摘要截取自250字）
