目的 探讨超声引导下急性缺血性左室舒张功能障碍并二尖瓣反流犬模型的构建。方法 (1)二尖瓣反流模型的建立:比格犬15条,经左颈动脉穿刺并送入动脉鞘。在超声引导下,将动脉鞘送入左室,鞘前端置于二尖瓣前叶边缘,经动脉鞘将内镜活体取样钳置于二尖瓣尖下,钳断二尖瓣腱索。经胸心脏超声证实存在二尖瓣反流。(2)急性缺血性左室舒张功能障碍模型的建立:在超声引导下,外撤动脉鞘使其前端置于左冠状动脉窦内,间歇多次注射塑料微球于左冠状动脉窦内,微栓塞冠状动脉,左室舒张末压升高≥5 mmHg定义为建模成功,形成急性缺血性舒张功能不全。结果 (1)15条比格犬制作二尖瓣反流模型全部成功;14条犬形成中度二尖瓣反流,1条比格犬造成重度二尖瓣反流。多普勒频谱测量二尖瓣反流,V max为(483.0 ±1.1) m/s,PG max为(162.7± 1.8) mmHg。(2)15条二尖瓣反流比格犬进行急性缺血左室舒张功能障碍模型构建,成功12条,3条未成功。12条成功模型的左室舒张末压升高、最大左室压力下降速率(-dP/dtmax)降低、左室松弛时间常数(Tau)延长。结论 超声引导下,经颈动脉鞘管送入活检钳钳夹二尖瓣腱索制造二尖瓣反流(MR)、间歇多次注射微球入左冠状动脉窦构建急性缺血性舒张功能障碍比格犬模型,具有操作简便、方法可靠、成功率高等优点。
Abstract
Objective To establish the model of acute ischaemic left heart failure with mitral regurgitation in beagles. Methods (1)The construction of mitral regurgitation (MR)animal model: a catheter was introduced into left ventricle through the carotid artery in 15 experiment beagles, then a biopsy clamp was put into the mitral valve nearby through the catheterization and chordae tendineae was pinched under the guidance of echo in order to construct mitral regurgitation.(2) The construction of acute ischaemic left ventricular (LV) diastolic heart failure: 15 beagles with MR were further processed with coronary microembolization by microspheres repeatedly. Results (1) All mitral regurgitation models were successfully produced. The chordae tendineaes were broken in thirteen dogs, causing moderate MR. One dog with natural mild MR was with broken chordae tendineae. Continuous wave Doppler showed that the MR peak velocity was (483±1.12) cm/s, the maximun pressure gradient was (162.7±1.8) mmHg. (2)12 models of acute ischaemic left diastolic heart failure with mitral regurgitation were established. Left ventricular end-diastolic pressure emitting equal or greater than 5 mmHg was defined as model successful. The left ventricular end-diastolic pressure (LVEDP), -dP/dtmax, Tau-c in successful model were increased significantly (P＜0.05). Conclusions This method is safe, feasible and easily successful in constructing the MR animal model under the guidance of transthoracic echocardiography.Coronary microembolization with microspheres is a sueeessfull way for establishing the acute ischaemic left diastolic heart failure.
关键词
超声引导 /
二尖瓣反流 /
急性心肌缺血 /
左室舒张功能障碍 /
比格犬动物模型
Key words
guiding of transthoracic echocardiography /
MR /
acute myocardial ischaemic /
left ventricular (LV) diastolic failure /
beagles animal model
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Weiss J L, Frederiksen J W, Weisfeldt M L, et al. Hemodynamic determi-nants of the time-course of fall in canine left ventricular pressure [J]. J Clin Invest, 1976,58: 751-760.
[2] Kleaveland J P, Kussmaul W G, Vinciguerra T, et al. Volume overload hypertrophy in a closed-chest model of mitral regurgitation [J]. Am J Physiol, 1988, 254(6 Pt 2): H1034-H1041.
[3] 李 凯,罗富良,田 毅,等. 比格犬二尖瓣反流慢性心力衰竭模型的建立[J]. 中国循环杂志, 2014, 29(增刊):37.
[4] Pierpont M E, Foker J E, Pierpont G L. Myocardial carnitine metabolism in congestive heart failure induced by incessant tachycardia [J]. Basic Res Cardiol, 1993, 88(4): 362-370.
[5] Igawa A, Nozawa T, Yoshida N,et al. Heterogeneous cardiac sympathetic innervation in heart failure after myocardial infarction of rats [J]. Am J Physiol Heart Circ Physiol, 2000, 278(4): H1134-H1141.
[6] 刘宝辉,李明凯,罗晓星,等.心力衰竭实验动物模型构建方法研究[J]. 中国心血管杂志, 2013, 18(3): 233-236.
[7] 李彩红,王永刚,罗文平,等.慢性心力衰竭动物模型的制作进展[J]. 长春中医药大学学报, 2015, 31(3): 647-650.
[8] 苏 强,李 浪,马国添,等.猪急性冠状动脉微栓塞模型的建立[J]. 中国动脉硬化杂志, 2014, 22(4): 335-339.
[9] New York Heart Association. New concepts in diastolic dysfunction and diastolic heart failure. Part II: causal mechanisms and treatment [J]. Circulation, 2002,105(12): 1503-1508.
[10] Lew Y W. Evaluation of left ventricular disatolic function [J]. Circulation, 1989, 79(6):1393-1397.
[11] 张庆勇,王志华,李晓波,等.介入法建立长期可随访冠状动脉微栓塞动物模型[J]. 介入放射学杂志, 2009, 18(12): 920-922.
[12] Smiseth O A. A reproducible and stable model of acute ischaemic left ventricular failure in dogs [J]. Clin Physiol, 1982, 2(3):225-239.
[13] Houser S R, Margulies K B, Murphy A M, et al. Animal models of heart failure: a scientific statement from the American Heart Association.[J]. Circul Res, 2012, 111(1):131-150.
[14] Alpert N R, Mulieri L A, Warshaw D. The failing human heart[J]. Cardiovasc Res, 2002,54(1): 1-10.
[15] Schmitto J D, Ortmann P, Wachter R. Chronic heart failure induced by multiple sequential coronary microembolization in sheep[J]. Int J Artif Organs, 2008, 31(4): 348-353.
[16] Schmitto J D, Coskun K O, Coskun S T. Hemodynamic changes in a model of chronic heart failure induced by multiple sequential coronary microembolization in sheep[J]. Artif Organs, 2009, 33(11): 947-952.
[17] He K L, Dickstein M, Sabbah H N. Mechanisms of heart failure with well preserved ejection fraction in dogs following limited coronary microembolization[J]. Cardiovasc Res, 2004, 64(1): 72-83.
PDF(874 KB)
