摘要
目的通过快速右房起搏建立心动过速性心肌病模型,观察该病不同时期血流动力学改变和心肌重构情况。方法将15头滇南小耳猪,按随机区组的方法分为起搏1周组、起搏4周组、假手术组,分别采用240次/分快速起搏右房1周、4周和只手术不起搏。运用超声心动图和左心导管检查测量窦性心律下的血流动力学参数并观察心脏大体结构变化。经Masson染色检测心肌纤维化,测定心肌胶原容积分数(CVF),比较房、室重塑差异。结果起搏1周组左室射血分数、左室收缩末压、左室压力上升最大速率、左室压力下降高峰速率均较假手术组降低(P<0.01);起搏4周组上述血流动力学指标继续恶化,且腔室扩大、室壁变薄,(P<0.01)。心房、心室CVF随起搏时间的延长逐渐增加(P<0.01)。结论采用快速右房起搏成功制作了心动过速性心肌病模型,证实该病是以严重的左、右室舒缩功能障碍,腔室扩大,室壁变薄,心肌重塑为特征。
Objective To evaluate the effects of both short-term （ 1 week） and prolonged （4 weeks） rapid atrial pacing on cardiac hemodynamics and myocardial remodling through establish an experimental model of tachycardiomyopathy by rap- id right atrial pacing. Methods Fifteen Diannan pigs were equally divided into five blocks by randomized block design. Each block randomly received three managements： rapid atrial pacing （240 beats/rain） for 1 week（n =5）, rapid atrial pa- cing for 4 weeks（ n = 5 ） and sham-operated control （control, n = 5 ）. Echocardiogram study and left heart catheterization were performed to evaluate the effects of both different-term rapid atrial pacing on cardiac bemodynamics. Furthermore, the differences of myocardial remodling between atrial and ventricular were observed by light microscopic examination and na- ked eye. Results Short-term tachypacing resulted in significantly depressed ejection fraction. Maximum rate of pressure development and maximum negative rate of pressure development decreased lightly compared with control （ P 〈 0.01 ）. Compared with control, all indexs of systolic function became deteriorative after 4 weeks tachypacing （ all P 〈 0.01 ）. Postmortom examination revealed a reduction in biventricular wall thickness compared with control after 4 weeks tachypacing （ all P 〈 0.01 ）. Furthermore, determination of collagen volume fraction revealed the myocardial remodling with tissue fi- brosis being much more intense after 4 weeks pacing. Conclusions Tachycardiomyopathy can be successfully established by rapid right atrial pacing in the pigs which characterize with biventricular pump dysfunction, biventricular cardiac dila- tion, biventricular wall thickness and the myocardial remodling. [ Chinese Journal of Cardiac Pacing and Electrophysiology, 2008,22（5） ：442 -446]
出处
《中国心脏起搏与心电生理杂志》
2008年第5期442-446,共5页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
心血管病学
心肌病
动物模型
快速右房起搏
心肌重塑
猪
Cardiology
Cardiomyopathy
Animal model
Rapid right atrial pacing
Myocardial remodling, Pigs
