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Research for effects of corroboration with apex sparing left ventricular repair surgery and hepatic growth factor using delivery sheet

利用产单证实保心尖左心室修复手术与肝生长因子的效果研究

基本信息

批准号：
15390410
负责人：
NISHINA Takeshi
金额：
$ 6.78万
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：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

项目摘要

Background : We reported that the postoperative effects of left ventricular repair surgery (LVRS) and the initial effects were not long lasting. Hepatic growth factor was well known that facilitate an angiogenesis and has suppression of fibrosis. We estimated the effect of combine treatment both method.(1)Clinical estimation : From April 2003 to march 2005, Thirty-nine patients were performed LVRS. Left ventricular dimension (LVDd) significantly decreased and EF significantly improved after LVRS. Left ventricular (LV) apex was played important role to keep LV function. These patients were divided into 2 groups. One group was LV apex sparing group (AS Group) and other one was LV apex maneuvering group (AM Group). LV end diastolic dimension in AS Group was smaller than in AM Group. Fractional area change (FAC) in SP Group was larger than in AM Group. LV shape in AS Group was more elliptical than in AM Group.(2) Experimental study for HGF : This study was used rat model that was made heart failure with myosin antibody. These rats were divided into 2 groups with HGF delivery Group (HGF Group) and Sham Group after LVR. In HGF delivery Group, LVDd was significantly decreased, and EF and FAC were significantly improved by LVR. The fibrosis area in HGF Group was smaller than in Sham Group. Both of the concentration of Aldosterone and the expression of Bax/Bcl-2 significant suppressed in HGF Group.Conclusion : LV apex sparing LVR improved LV function. HGF delivery suppressed a fibrosis and an apoptosis on cardiac muscle. The combined treatment with LVR and HGF may be more effective for chronic heart failure patients.

背景：我们报道左心室修复手术（LVRS）的术后效果和初始效果并不持久。众所周知，肝生长因子可促进血管生成并抑制纤维化。我们对两种方法联合治疗的效果进行了评估。(1)临床评估：2003年4月至2005年3月，对39例患者进行了LVRS治疗。 LVRS 后左心室尺寸 (LVDd) 显着减小，EF 显着改善。左心室（LV）心尖部对于维持左心室功能发挥着重要作用。这些患者被分为两组。一组为左心室心尖保留组（AS 组），另一组为左心室心尖操作组（AM 组）。 AS组的左室舒张末期尺寸小于AM组。 SP组的面积变化分数(FAC)大于AM组。 AS组左心室形状较AM组更椭圆。 (2)HGF实验研究：本研究采用肌球蛋白抗体制作心力衰竭大鼠模型。 LVR后将这些大鼠分为2组：HGF递送组（HGF组）和Sham组。在HGF递送组中，LVD显着降低，并且EF和FAC通过LVR显着改善。 HGF组纤维化面积小于Sham组。 HGF组醛固酮浓度和Bax/Bcl-2表达均显着受到抑制。结论：保留左心室尖部LVR改善了左室功能。 HGF 递送抑制了心肌的纤维化和细胞凋亡。 LVR和HGF联合治疗对于慢性心力衰竭患者可能更有效。