Thyroid hormone replacement therapy attenuates atrial remodeling and reduces atrial fibrillation inducibility in a rat myocardial infarction-heart failure model.
Thyroid hormone replacement therapy attenuates atrial remodeling and reduces atrial fibrillation inducibility in a rat myocardial infarction-heart failure model.
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DOI：
10.1016/j.cardfail.2014.10.003
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发表时间：
2014-12
影响因子：
6
通讯作者：
Gerdes, A. Martin
中科院分区：
文献类型：
--
作者：
Zhang, Youhua;Dedkov, Eduard I.;Lee, Bianca;Li, Ying;Pun, Khusbu;Gerdes, A. Martin
心力衰竭（HF）与房颤（AF）风险增加相关。越来越多的证据表明，心力衰竭患者存在心肌组织甲状腺功能减退症，这可能导致心力衰竭的发生。我们最近的报告表明，甲状腺功能减退症，像甲状腺功能亢进症，导致增加房颤诱导。本研究旨在探讨甲状腺激素（TH）替代治疗对HF患者AF发生的影响。结扎大鼠冠状动脉造成心肌梗死。在MI后2周，将患有大MI（>40%）的大鼠随机分为L-甲状腺素（T4，n=14）和安慰剂（n=15）组。大鼠接受3.3 mg T4（60天释放形式）或安慰剂颗粒在各自的组2个月。与安慰剂相比，T4治疗改善了心功能，缩小了左心室内径和左心房内径。T4治疗可减少心房有效不应期延长（安慰剂组45±1.5 ms vs T4组37±1.6 ms，P<0.01），减少AF诱发（AF/房扑/心动过速诱导率为11/15，安慰剂组73% vs T4组4/14，T4组29%，P<0.05）。心律失常减少与心房纤维化减少相关，但与连接蛋白43变化无关。据我们所知，这是第一个研究表明，TH替代治疗HF减弱心房重构和减少AF诱导后MI-HF。需要临床研究来证实患者的这种益处。
Heart failure (HF) is associated with increased atrial fibrillation (AF) risk. Accumulating evidence suggests the presence of myocardial tissue hypothyroidism in HF, which may contribute to HF development. Our recent report demonstrated that hypothyroidism, like hyperthyroidism, leads to increased AF inducibility. This study was designed to investigate the effect of thyroid hormone (TH) replacement therapy on AF arrhythmogenesis in HF. Myocardial infarction (MI) was produced in rats by coronary artery ligation. Rats with large MIs (>40%) were randomized into L-thyroxine (T4, n=14) and placebo (n=15) groups 2 weeks after MI. Rats received 3.3 mg T4 (in 60-day release form) or placebo pellets in respective groups for 2 months. Compared with the placebo, T4 treatment improved cardiac function and decreased left ventricular internal diameters as well as left atrial diameter. T4 treatment attenuated atrial effective refractory period prolongation (45±1.5 ms in placebo group vs 37±1.6 ms in T4 group, P<0.01) and reduced AF inducibility (AF/atrial flutter /tachycardia were inducible in 11/15 rats, or 73% in placebo vs 4/14 rats, or 29% in the T4 treated group, P<0.05). Arrhythmia reduction was associated with decreased atrial fibrosis but was not associated with connexin 43 changes. To our knowledge this is the first study demonstrating that TH replacement therapy in HF attenuates atrial remodeling and reduces AF inducibility post MI-HF. Clinical studies are needed to confirm such benefits in patients.
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影响因子：
20.1
作者：
PFEFFER, MA;PFEFFER, JM;BRAUNWALD, E
通讯作者：
BRAUNWALD, E
影响因子：
18.2
作者：
Chen, Shmuel;Shauer, Ayelet;Gotsman, Israel
通讯作者：
Gotsman, Israel
影响因子：
4.6
作者：
Klemperer, JD;Klein, IL;Krieger, KH
通讯作者：
Krieger, KH
影响因子：
9.7
作者：
Henderson, Kyle K.;Danzi, Sara;Samarel, Allen M.
通讯作者：
Samarel, Allen M.
影响因子：
37.8
作者：
Fuster, Valentin;Ryden, Lars E.;Wann, L. Samuel
通讯作者：
Wann, L. Samuel