Decreased expression of tumor necrosis factor-alpha in failing human myocardium after mechanical circulatory support : A potential mechanism for cardiac recovery.
Decreased expression of tumor necrosis factor-alpha in failing human myocardium after mechanical circulatory support : A potential mechanism for cardiac recovery.
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机械循环支持后衰竭的人类心肌中肿瘤坏死因子-α 的表达减少：心脏恢复的潜在机制。
DOI：
10.1161/01.cir.100.11.1189
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发表时间：
1999
期刊：
影响因子：
37.8
通讯作者：
Noon,GP
中科院分区：
文献类型：
--
作者：
Torre-Amione,G;Stetson,SJ;Youker,KA;Durand,JB;Radovancevic,B;Delgado,RM;Frazier,OH;Entman,ML;Noon,GP
背景——越来越多的终末期心力衰竭患者的观察表明，通过机械循环支持进行慢性心室减负荷可能会导致心功能的恢复。肿瘤坏死因子-α (TNF-α) 是一种促炎细胞因子，能够引起肺水肿、扩张型心肌病和死亡。心肌因容量超负荷而产生 TNF-α；然而，心室负荷正常化对心肌 TNF-α 表达的影响尚不清楚。我们假设通过放置左心室辅助装置 (LVAD) 来实现慢性心室减负荷可以消除导致人类衰竭心肌中持续 TNF-α 表达的应激。方法和结果——心肌组织取自正常心脏以及 8 名非缺血性终末期心肌病患者在 LVAD 植入和移除时的配对样本。对组织切片进行TNF-α染色，并对染色区域进行定量分析。我们发现 LVAD 支持后 TNF-α 含量显着下降。此外，变化的幅度与 LVAD 支持的时间长短并不相关，尽管在成功戒除 LVAD 且不需要移植的患者中，心肌 TNF-α 含量降低幅度更大。结论——这些数据首次表明，长期机械循环辅助可降低衰竭心肌中的 TNF-α 含量；此外，我们认为变化的幅度可以预测哪些患者将恢复心脏功能。
Background—An increasing number of observations in patients with end-stage heart failure suggest that chronic ventricular unloading by mechanical circulatory support may lead to recovery of cardiac function. Tumor necrosis factor-α (TNF-α) is a proinflammatory cytokine capable of producing pulmonary edema, dilated cardiomyopathy, and death. TNF-α is produced in the myocardium in response to volume overload; however, the effects of normalizing ventricular loading conditions on myocardial TNF-α expression are not known. We hypothesize that chronic ventricular unloading by the placement of a left ventricular assist device (LVAD) may eliminate the stress responsible for persistent TNF-α expression in human failing myocardium.Methods and Results—Myocardial tissue was obtained from normal hearts and from paired samples of 8 patients with nonischemic end-stage cardiomyopathy at the time of LVAD implantation and removal. Tissue sections were stained for TNF-α, and quantitative analysis of the stained area was performed. We found that TNF-α content decreased significantly after LVAD support. Furthermore, the magnitude of the changes did not correlate with the length of LVAD support, although greater reductions in myocardial TNF-α content were found in patients who were successfully weaned off the LVAD who did not require transplantation.Conclusions—These data show for the first time that chronic mechanical circulatory assistance decreases TNF-α content in failing myocardium; furthermore, we suggest that the magnitude of the change may predict which patients will recover cardiac function.
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影响因子：
37.8
作者：
Bozkurt, B;Kribbs, SB;Mann, DL
通讯作者：
Mann, DL
影响因子：
158.5
作者：
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4.6
作者：
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作者：
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