Ventricular Arrhythmias Underlie Sudden Death in Rats With Heart Failure and Preserved Ejection Fraction
Ventricular Arrhythmias Underlie Sudden Death in Rats With Heart Failure and Preserved Ejection Fraction
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DOI：
10.1161/circep.118.006452
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发表时间：
2018-08-01
影响因子：
8.4
通讯作者：
Cingolani, Eugenio
中科院分区：
文献类型：
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作者：
Cho, Jae Hyung;Zhang, Rui;Cingolani, Eugenio
背景：射血分数保留的心力衰竭（HFpEF）在临床上越来越常见，现在可以与射血分数降低的心力衰竭相媲美或超过。猝死是 HFpEF 患者外流的主要方式，但其根本原因尚不清楚。使用大鼠模型中的动态记录，我们检验了室性心律失常 (VA) 导致 HFpEF 猝死的假设。 方法：给 Dahl 盐敏感大鼠（7 周龄）喂食高盐饮食以诱导 HFpEF (n=13) 或正常盐饮食（对照组，n=9）。在 14 至 18 周龄时进行经胸超声心动图检查收缩和舒张功能。分析遥测心电图记录的 QT 间期持续时间、室性早搏负担、自发 VA 和心率变异性。每天监测两次存活率。结果：具有明显舒张功能障碍、射血分数保留和心力衰竭体征的高盐喂养大鼠在 14 至 15 周龄时被诊断为 HFpEF。与对照组相比，HFpEF 大鼠的 QT 和 QTc 间期延长。与对照组相比，HFpEF 大鼠的心率变异性降低。自发性 VA 在 HFpEF 大鼠中更为普遍（6/13=46.1%，对照组为 0/9=0%；P
BACKGROUND: Heart failure (HF) with preserved ejection fraction (HFpEF) is increasingly common clinically, now rivaling or exceeding HF with reduced ejection fraction. Sudden death is the leading mode of exodus in patients with HFpEF, but the underlying causes are largely unknown. Using ambulatory recordings in a rat model, we test the hypothesis that ventricular arrhythmias (VA) underlie sudden death in HFpEF.METHODS: Dahl salt-sensitive rats (7 weeks of age) were fed a high-salt diet to induce HFpEF (n=13) or a normal-salt diet (controls, n=9). Transthoracic echocardiography was performed to check systolic and diastolic function at 14 to 18 weeks of age. Telemetric electrocardiographic recordings were analyzed for QT interval duration, burden of premature ventricular contractions, spontaneous VA, and heart rate variability. Survival was monitored twice daily.RESULTS: High-salt-fed rats with clear diastolic dysfunction, preserved ejection fraction, and HF signs were diagnosed with HFpEF at 14 to 15 weeks of age. QT and QTc intervals were prolonged in HFpEF rats compared with controls. Heart rate variability was reduced in HFpEF rats compared with controls. Spontaneous VA were more prevalent in HFpEF rats (6/13=46.1% versus 0/9=0% in controls; P