Tsutsui H, Tagawa H, Kent R L, McCollam P L, Ishihara K, Nagatsu M, Cooper G
Department of Medicine, Medical University of South Carolina, Charleston.
Circulation. 1994 Jul;90(1):533-55. doi: 10.1161/01.cir.90.1.533.
Cardiac hypertrophy in response to systolic pressure overloading frequently results in contractile dysfunction, the cause for which has been unknown. Since, in contrast, the same degree and duration of hypertrophy in response to systolic volume overloading does not result in contractile dysfunction, we postulated that the contractile dysfunction of pressure hypertrophied myocardium might result from a direct effect of stress as opposed to strain loading on an intracellular structure of the hypertrophied cardiocyte. The specific hypothesis tested here is that the microtubule component of the cytoskeleton is such an intracellular structure, which, forming in excess, impedes sarcomere motion. The feline right ventricle was either pressure overloaded by pulmonary artery banding or volume overloaded by atrial septotomy. The quantity of microtubules was estimated from immunoblots and immunofluorescent micrographs, and their mechanical effects were assessed by measuring sarcomere motion during microtubule depolymerization. We show here that stress loading increases the microtubule component of the cardiac muscle cell cytoskeleton; this apparently is responsible for the entirety of the cellular contractile dysfunction seen in our model of pressure-hypertrophied myocardium. No such effects were seen in right ventricular cardiocytes from normal or volume-overloaded cats or in left ventricular cardiocytes from any group of cats. Importantly, the linked microtubule and contractile abnormalities are persistent and thus may be found to have significance for the deterioration of initially compensatory cardiac hypertrophy into the congestive heart failure state.
对收缩压超负荷产生的心脏肥大常常导致收缩功能障碍,其原因一直不明。相比之下,对收缩期容量超负荷产生的相同程度和持续时间的肥大却不会导致收缩功能障碍,因此我们推测压力超负荷心肌的收缩功能障碍可能是由应激的直接作用而非应变负荷对肥大心肌细胞的细胞内结构产生影响所致。此处所验证的具体假说是,细胞骨架的微管成分就是这样一种细胞内结构,其过度形成会阻碍肌节运动。猫的右心室要么通过肺动脉束带造成压力超负荷,要么通过房间隔切开术造成容量超负荷。通过免疫印迹和免疫荧光显微照片估算微管数量,并通过在微管解聚过程中测量肌节运动来评估其机械效应。我们在此表明,应激负荷会增加心肌细胞细胞骨架的微管成分;这显然是我们压力超负荷心肌模型中所见全部细胞收缩功能障碍的原因。在正常或容量超负荷猫的右心室心肌细胞或任何一组猫的左心室心肌细胞中均未观察到此类效应。重要的是,微管与收缩异常之间的关联是持续存在的,因此可能会发现其对于最初代偿性心脏肥大恶化为充血性心力衰竭状态具有重要意义。