持续性快速右心房起搏犬肺静脉-左心房连接处自主神经重构的研究

山东大学学报(医学版) ›› 2013, Vol. 51 ›› Issue (12): 7-10.

持续性快速右心房起搏犬肺静脉-左心房连接处自主神经重构的研究

郑少华1，张玉娇1，李志远2，侯绪娟3，王曦敏1，段文昌4，侯应龙1

1.山东大学附属千佛山医院心内科，济南 250014； 2.山东省泰山疗养院心内科，山东泰安 271000；
3.山东省医学科学院，济南 250012； 4.山东大学附属千佛山医院保健科，济南 250014

收稿日期:2013-06-01 出版日期:2013-12-10 发布日期:2013-12-10
通讯作者: 侯应龙， E-mail:houyinglong2010@hotmail.com
基金资助:
国家自然科学基金(81270237);山东省科技发展计划(2011GSF11837)

Autonomic neural remodeling of pulmonary vein-left atrium junction in a prolonged right atrial pacing canine model

ZHENG Shao-hua1, ZHANG Yu-jiao1, LI Zhi-yuan2, HOU Xu-juan3, WANG Xi-min1, DUAN Wen-chang4, HOU Ying-long1

1. Department of Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, China;
2. Taishan Sanatorium of Shandong Province, Taian 271000, Shandong, China;
3. Shandong Academy of Medical Sciences, Jinan 250012, China;
4. Department of　Health Care, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, China

Received:2013-06-01 Online:2013-12-10 Published:2013-12-10

摘要/Abstract

摘要：

目的定量研究持续性快速右心房起搏后犬肺静脉-左心房(PV-LA)连接处自主神经重构的情况。方法 12只健康成年杂种犬，随机分为对照组和起搏组,每组各6只，起搏组以400次/min的速率快速起搏犬右心房，持续4周。起搏结束后立即测定所有犬左上肺静脉-左心房(LSPV-LA)连接处的有效不应期，并收集所有PV-LA连接处直径为1cm内的组织。用酪氨酸羟化酶(TH)及乙酰胆碱转移酶(ChAT)分别标记交感与副交感神经，并通过免疫组化染色及Western blotting进行神经定量研究。结果起搏组LSPV-LA连接处有效不应期较对照组显著缩短［(83.33±16.33) vs (111.67±20.41)ms, P<0.05］。起搏组2只犬发生自发性房颤，而对照组无房颤发生。免疫组化染色显示，起搏组LSPV-LA连接处TH及ChAT的平均密度及分布不均一程度均显著高于对照组(P<0.01)。Western blotting显示，起搏组的4个PV-LA连接处TH和ChAT总表达量显著增加(P<0.01)。结论持续性快速右心房起搏后犬PV-LA连接处发生了自主神经重构，可能与房颤的发生相关，并在房颤的射频消融治疗中具有重要意义。

关键词: 自主神经重构；肺静脉-左心房连接处；心房颤动；射频消融术

Abstract:

Objective To quantificationally investigate the autonomic neural remodeling of pulmonary vein-left atrium (PV-LA) junction in a prolonged right atrial pacing canine model. Methods A total of 12 healthy adult mongrel dogs, weighing 15-20kg, were randomly divided into 2 groups: 6 (paced group) underwent rapid right atrial pacing at 400 bpm for 4 weeks; 6 (control group) were not paced. The effective refractory period (ERP) of left superior pulmonary vein-left atrium (LSPV-LA) junction in all animals was measured and the experimental tissues were harvested from 1cm around all PV-LA junctions immediately after 4 weeks of pacing. Expressions of tyrosine hydroxylase (TH) and choline acetyltransterase (ChAT) were detected with immunohistochemical staining and Western blotting. Results Compared with that of the control group, the ERP of LSPV-LA junction of the paced group was significantly shortened ［(83.33±16.33) vs (111.67±20.41) ms, P<0.05］. Spontaneous atrial fibrillation developed in 2 animals in the paced group, but not in the control group. Immunohistochemistry showed that the average density and heterogeneity of TH and ChAT at LSPV-LA junction in the paced group were significantly higher than those of the control group (P<0.01). Western blotting showed that the expressions of TH and ChAT at the 4 PV-LA junctions in the paced group increased markedly compared with those of the control group (P<0.01). Conclusion Autonomic neural remodeling does exist in the PV-LA junction after prolonged atrial pacing, which may contribute to the initiation of atrial fibrillation. This may promote the management of atrial fibrillation by effectively guiding the radiofrequency catheter ablation procedure.

Key words: Autonomic neural remodeling; Pulmonary vein-left atrium junction; Atrial fibrillation; Radiofrequency catheter ablation

中图分类号:

R541.7

郑少华1，张玉娇1，李志远2，侯绪娟3，王曦敏1，段文昌4，侯应龙1. 持续性快速右心房起搏犬肺静脉-左心房连接处自主神经重构的研究[J]. 山东大学学报(医学版), 2013, 51(12): 7-10.

ZHENG Shao-hua1, ZHANG Yu-jiao1, LI Zhi-yuan2, HOU Xu-juan3, WANG Xi-min1, DUAN Wen-chang4, HOU Ying-long1. Autonomic neural remodeling of pulmonary vein-left atrium junction in a prolonged right atrial pacing canine model[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(12): 7-10.

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