适度缺血性腹回的早期修复逆转左心室重塑:一个功能和分子研究
Ronen Beeri1, Chaim Yosefy, J Luis Guerrero
1Cardiac Ultrasound Laboratory, Cardiovascular Research Center, and Cardiothoracic Surgery Department, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Circulation
|September 14, 2007
概括
在心脏病发作 (MI) 后修复中度腹 (MR) 逆转了不良的心脏重塑. 早期修复可以改善心脏功能,减少负面的分子变化,为患者提供潜在的益处.
科学领域:
- 心血管研究研究心血管研究
- 心脏外科手术 心脏外科手术
- 再生医学是一种再生医学.
背景情况:
- 心肌梗塞 (MI) 后的腹 (MR) 将死亡率提高一倍.
- 适度的MR可以增加心脏在顶部MI后的心脏重塑.
- 之前的研究已经确定了MR和心脏逆转型后心脏逆转型之间的联系.
研究的目的:
- 为了调查一下,在顶端MI发生一个月后修复中度MR是否可以逆转心脏重塑.
- 评估MR修复对左心室体积和心脏收缩性的影响.
- 分析MR修复对细胞内信号通路和矩阵金属蛋白酶活性的影响.
主要方法:
- 在绵羊中诱导了抗疗MI.
- 植入左心室到左心房的分流,以创建中度MR (30%的反分数).
- 在MI后一个月的修复组中关闭了分流;对照组包括没有修复的MR和MI的MI.
主要成果:
- 修复组在3个月后出现了逆转的重塑,与未修复的MR相比,左心室末端透缩体积和末端抽缩体积显著接近基线.
- 心脏收缩性 (dP/dt,预加载可招募的中风工作) 在修复组与未修复组相比更好地保持.
- 在修复后的组中,关键的促增多和抗亡细胞内信号仍然较高,而矩阵蛋白质解活性则降低.
结论:
- 在尖端MI之后,中度MR的早期修复显著逆转了渐进的心脏重塑.
- 修复导致左心室体积减少,保持收缩性和有利的细胞内信号传递.
- 这些发现支持在特定的后心脏病患者群体中考虑早期MR修复.
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