Research for Improving Effects of Clinical after Left Ventricle Repair Surgery on Chronic Cardiac Failure

改善慢性心力衰竭左心室修复术后临床效果的研究

• 批准号: 13557108
• 负责人: KOMEDA Masashi
• 金额: $ 1.86万
• 依托单位: KYOTO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-13557108/
• 关键词: Heart Failure; Surgical treatment; LV repair surgery; Ischemic cardiomyopathy; Dor method; Batista method; 左心室瘤; リモデリング; ACE阻害薬; 心筋梗塞; 酸化ストレス

Background: We reported that the initial effects of left ventricular repair surgery (LVR) for ischemic cardiomyopathy were not long lasting. Angiotensin-converting enzyme inhibitor (ACE-I) and Angiotensin-II receptor blocker (ARB) are known to attenuate remodeling after MI. Addition, the effect to attenuate remodeling of human atrial natriuretic peptide (hANP) after MI was estimated. Method: (1) ACE- I administration: Ischemic cardiomyopathy rats were developed after LAD ligation. Rats were divided 2groups, LVR with ACE-I (ACE Group) and LVR with placebo (LVR Group) at 4weeks after LAD ligation, and rats in 2 groups were underwent LVR by plication. LV function was evaluated by echocardiography and catheterization. (2) ABR administration: Rats were divided 2groups, LVR with ARB (ARB Group) and LVR with placebo (LVR Group). Other methods were underwent same as above. (3) Rats were divided into 2 groups after LAD ligation, an ANP group were intravenously administrated with hANP, Control group were with saline. LV function was estimated by echocardiography and catheter 1 or 2 week after administration. Results: (1)(2) LV end diastolic area in ACE Group and ARB Group was smaller than LVR Group, significantly. E-max in ACE Group was significant higher than LVR Group 4 weeks after LVR. (3) LVEDA in hANP Group was small than Control Group and FAC in hANP Group was significant higher 1 and 2 weeks after MI. Conclusion: 1. Administration of ACE or ARB after LVR was preventing re-dilation and maintaining LV function. 2. Intravenous administration of ANP reduced infarct size and maintained LV function.

背景：我们报道了左心室修复手术（LVR）治疗缺血性心肌病的初步效果并不持久。已知血管紧张素转换酶抑制剂（ACE-I）和血管紧张素- ii受体阻滞剂（ARB）可减弱心肌梗死后的重构。此外，还估计了心肌梗死后人心房钠素肽（hANP）重构的减弱作用。方法：(1)ACE- I给药：LAD结扎后培养缺血性心肌病大鼠。将大鼠分为2组，在LAD结扎后4周，LVR联合ACE组（ACE组）和LVR联合安慰剂组（LVR组），两组大鼠均采用涂抹法进行LVR。通过超声心动图和导管检查评估左室功能。(2) ABR给药：将大鼠分为2组，LVR加ARB组（ARB组）和LVR加安慰剂组（LVR组）。其他方法同上。(3) LAD结扎后将大鼠分为2组，ANP组静脉给予hANP，对照组给予生理盐水。给药后1或2周通过超声心动图和导管评估左室功能。结果：(1)(2)ACE组和ARB组左端舒张面积均明显小于LVR组。LVR后4周，ACE组E-max显著高于LVR组。(3)心肌梗死后1、2周，hANP组LVEDA小于对照组，FAC显著高于对照组。在LVR后给予ACE或ARB是防止再扩张和维持左室功能。2. 静脉注射ANP可减小梗死面积，维持左室功能。

项目成果

Takeshi Nishina: "A rat model of ischemic or dilated cardiomyopathy for investigating left ventricular repair surgery"CEPP. 29. 728-730 (2002)

Takeshi Nishina：“用于研究左心室修复手术的缺血性或扩张性心肌病大鼠模型”CEPP。

Takuya Nomoto: "Angiotensin-Converting enzyme inhibitor helps prevent late remodeling after Left ventricular aneurysm repair in rats"Circulation. 106(Suppl I). I-115-I-119 (2002)

Takuy​​a Nomoto：“血管紧张素转换酶抑制剂有助于防止大鼠左心室动脉瘤修复后的晚期重塑”循环。

Hiroshi Tsuneyoshi, Takuya Nomoto, Takeshi Nishina, Hideo Kanemitu, Kazunobu Nishimura, Masashi Komeda: "Dose longer term intravenous administration of Atrial Natiuretic Peptide prevent left ventricular remodeling after myocardial infarction in rats?"Circ

Hiroshi Tsuneyoshi、Takuy​​a Nomoto、Takeshi Nishina、Hideo Kanemitu、Kazunobu Nishimura、Masashi Komeda：“长期静脉注射心房钠尿肽可以预防大鼠心肌梗塞后的左心室重构吗？”Circ

仁科 健: "虚血性心筋症の外科治療"Cardiovascular Med-Surg. 3. 228-233 (2001)

Ken Nishina：“缺血性心肌病的手术治疗”心血管医学外科杂志 3. 228-233 (2001)

Sadatoshi Yuasa, Takeshi Nishina, Kazunobu Nishimura, Senri Miwa, Tadashi Ikeda, Michiya Hanyu, Yasutada Fujioka, Yasuki Kihara, Sigetake Sasayama, Masashi Komeda: "A rat model of dilated cardiomyopathy to investigate partial left ventriculectomy"J Card S

Sadatoshi Yuasa、Takeshi Nishina、Kazunobu Nishimura、Senri Miwa、Tadashi Ikeda、Michiya Hanyu、Yasutada Fujioka、Yasuki Kihara、Sigetake Sasayama、Masashi Komeda：“用于研究部分左心室切除术的扩张型心肌病大鼠模型”J Card S