The Research on the Lowering of Coronary Flow Reserve and Smooth Muscle Transformation of Small Coronary Artery in Hypertrophic Cardiomyopathy.

肥厚型心肌病冠状动脉血流储备降低及小冠状动脉平滑肌转化的研究。

• 批准号: 10670661
• 负责人: FUJII Takashi
• 金额: $ 1.28万
• 依托单位: Yamaguchi University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10670661/
• 关键词: Hypertrophic Cardiomyopathy; Coronary Flow Reserve; Transformation of Smooth Muscle; Coronary Blood Flow; ミオシン重鎖

A) Coronary flow reserve and endothelium-dependent dilator response.The coronary flow reserve, using the papaverine, in the hypertrophic cardiomyopathy (HCM) group lowered clearly in comparison with that of the normal control ( C ) group. (1.8±0.4 and 2.9±0.5, respectively ; p<0.001). The endothelium-dependent dilator response required in the acetylcholine administration was more remarkable loweing over the coronary reserve capacity in the HCM group than that of C group (1.2±0.2, 2.5±0.4, respectively ; p<0.001).B) Pathologic evaluation of the small artery in heart muscle.There was the clear hyperplasia in intima-media complex of intramural small coronary arteries got from myocardial biopasy in the HCM group(%LA=22.4±15.2%). Moreover, there was the remarkable hyperplasy on the circuferencial fibrosis around the small coronary vessel in the HCM group (PFR=5.3±3.1). Though the coronary flow reserve tended to correlate lineally with %LA, and inversely with PFR, anyway not obtained the sig … More nificant correlation either. And, though max %APV and PFR tended to also correlate Inversely, this was not also significant. There is significant positive correlation on %LA with max%APV. Percent increase of coronary blood flow in the high-frequent atrial pacing was more reduced, as the intima-media complex of intramural coronary artery was thicker.C) The transformation of the smooth muscle in intramural coronary artery.The immunostaining was carried out using the monoclonal antibody, and the existence of the transformation of the smooth muscle in the intima-media complex was examined. The Intima-media complex was often covered for the fibrous tissues, and rather the smooth muscle cell often decreased. There was few cases dyed clearly by the immunostaining, and it was not possible to prove the transformation of the smooth muscle clearly. However, is a part of case, there was the transformation mainly on undifferentiated non-muscle myosin(SM emb) in the intima-media complex of the small coronary artery. Less

肥厚型心肌病(HCM)组使用罂粟碱后，冠脉血流储备明显低于正常对照组(C)。(1.8±0.4和2.9±0.5；p&lt；0.001)。给予乙酰胆碱所需的内皮依赖性扩张器反应在心肌梗死组明显低于对照组(分别为1.20±0.2plt；0.001)。b)心肌小动脉的病理改变。心肌活检显示心肌内小动脉内膜-中膜复合体明显增生(%LA=22.4%±15.2%)。此外，肥厚型心肌病组冠状动脉小血管周围的环状纤维化明显增生(PFR=5.3±3.1)。冠脉血流储备与%LA呈线性相关，与PfR呈负相关，但仍未获得Sig型…相关性也更显著。而且，尽管最大百分比APV和PFR也倾向于呈负相关，但这也不显著。%LA与最大%APV呈显著正相关。3)冠状动脉壁内膜-中膜复合体的转化。用单抗进行免疫组织化学染色，观察内膜-中膜复合体中是否存在转化的平滑肌。内膜-中膜复合体常被纤维组织覆盖，而平滑肌细胞常减少。免疫组织化学染色可见少数病例染色清晰，尚不能清楚地证明平滑肌的转化。但部分病例中，小冠状动脉内膜-中层复合体内未分化的非肌球蛋白(SM-emb)有转化。较少

项目成果

Kawamura A: "Abnormal Coronary Flow Profile at Rest and During Rapid Atrial Pacing in Patients with Hypertronphic Cardiomyopathy."Japanese Circulation Journal. 63(5). 350-356 (1999)

Kawamura A：“肥厚型心肌病患者静息时和快速心房起搏时冠状动脉血流剖面异常。”日本循环杂志。

Atsushi Kawamura: "Abnormal Coronary Flow Profile at Rest and During Rapid Atrial Pacing in Patients with Hypertrophic Cardiomyopathy" Japanese Circulation Journal. Vo163,No5(印刷中). (1999)

Atsushi Kawamura：“肥厚型心肌病患者静息时和快速心房起搏期间的冠状动脉血流异常”，日本循环杂志 Vo163，第 5 期（出版中）。

Kawamura A: "Abnormal Coronary Flow Profile at Reat and During Rapid Atrial Pacing in Patients with Hypertrophic Cardiomyopathy"Japanese Circulation Journal. 63(5). 350-356 (1999)

Kawamura A：“肥厚型心肌病患者在快速心房起搏时和快速心房起搏期间冠状动脉血流剖面异常”，日本循环杂志。

Fujii K: "Angiotensin ll Type 1 Receptor Antagonist Downregulates Nonmuscle Myosin Heavy Chains in Spontaneously Hypertensive Rat Aorta."Hypertension.. 33. 975-980 (1999)

Fujii K：“血管紧张素 ll 1 型受体拮抗剂下调自发性高血压大鼠主动脉中的非肌肉肌球蛋白重链。”高血压.. 33. 975-980 (1999)

藤井崇史: "心臓病診断プラクティス 心筋症の冠血流"文光堂. 3 (1999)

藤井隆：“心脏病诊断实践心肌病中的冠状动脉血流”文科堂3（1999）。