等长收缩训练促进犬慢性心肌缺血侧支动脉生成的机制
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摘要
目的:观察等长收缩训练对慢性心肌缺血犬血压、血管壁剪切力及血流灌注的影响,探索等长收缩训练促进缺血心肌侧支动脉生成的机制。方法:制备犬慢性冠状动脉狭窄模型,随机分为假手术组,单纯心肌缺血组,被动等长收缩训练组。实验终点时,所有犬在DSA检查后检测血管壁剪切力(wall shear stress,WSS)及记录收缩压、舒张压的数值,记为基础值;PIE组除了测定基础值外,还使用电刺激诱发IE运动,测定IE开始前30s、开始后30s及停止后30s的收缩压、舒张压及WSS的值。检测缺血心肌冠状动脉侧支循环血流量(collateral blood flow,CBF)、单核细胞(mononuclear phagocyte,MP)及平滑肌细胞(smooth muscle cell,SMC)的数量。结果:6周IE后:(1)WSS:实验终点经过DSA造影发现,PIE组WSS的基础数值最高(P<0.05)。PIE组实验犬在DSA造影过程中行IE运动不同时间点的WSS值相比较,IE开始后30s的WSS值最高(P<0.05)。(2)血压:实验终点时基础血压值相比较,SO组的SBP值最低(P<0.05);PIE组的DBP值最高(P<0.05)。PIE组实验犬在DSA造影过程中IE运动不同时间点的SBP、DBP相比较,IE开始后30s的SBP值最高(P<0.05)。(3)心肌局部血流量及细胞学检测:PIE组的CBF、平滑肌数量、单核细胞数量最高(P<0.05)。(6)相关性分析发现:WSS与CBF呈中度正相关;WSS与SMC呈高度正相关;WSS与MP呈高度正相关。实验终点时PIE组犬不同时间点的WSS与SBP、DBP的相关性分析发现,WSS与SBP呈高度正相关;WSS与DBP呈中度正相关。结论:等长收缩训练可以通过升高血压,提高血管壁剪切力水平从而促进缺血心肌血流灌注。
Objective: To investigate the effects of isometric exercise training on blood pressure,WSS and myocardial blood flow in canine chronic ischemic myocardium.Method: An Ameroid constrictor was placed around the left anterior descending branch of the left coronary artery in healthy adult male canine. The animals were divided into 3 groups:sham-operated group,only myocardial ischaemia group,passive isometric exercise training group.At the endpoint,digital subtraction angiography and CFD were used to calculate the values of WSS and blood pressure was recorded.WSS and blood pressure were also measured before,during and after IE exercise in PIE group.Myocardial blood flow,mononuclear phagocyte,smooth muscle cells of ischemic area were measured.Result:(1)The CBF in PIE group was the highest among the four groups. SMC number in PIE group was the highest among the 3 groups.(2) The MP number in PIE group was the highest among the 3 groups.(3) The WSS value in the PIE group was the highest among the 3 groups. WSS value during IE was the highest compared to those before IE(P<0.05) and after IE(P<0.05). The SBP value during IE was the highest than those before IE(P<0.05) and after IE(P<0.05). The SBP in the SO group was the lowest among the 3 groups. The DBP in PIE group was the highest among the 3 groups. SBP during IE was the highest among those before IE(P<0.05) and after IE(P<0.05). DBP during IE was the highest than those before IE(P<0.05) and after IE(P<0.05).(10)Correlation analysis: The collateral blood flow was highly correlated with WSS. The SMC count and MP count were highly correlated with WSS. In the PIE group, the WSS was highly correlated with the SBP.The WSS value was moderately positive correlated with DBP.Conclusion: Isometric exercise could promote the blood perfusion in chronic coronary stenosis model by increasing blood pressure and enhancing wall shear stress. Compared with PIE, AIE was more effective.
Objective: To investigate the effects of isometric exercise training on blood pressure,WSS and myocardial blood flow in canine chronic ischemic myocardium.Method: An Ameroid constrictor was placed around the left anterior descending branch of the left coronary artery in healthy adult male canine. The animals were divided into 3 groups:sham-operated group,only myocardial ischaemia group,passive isometric exercise training group.At the endpoint,digital subtraction angiography and CFD were used to calculate the values of WSS and blood pressure was recorded.WSS and blood pressure were also measured before,during and after IE exercise in PIE group.Myocardial blood flow,mononuclear phagocyte,smooth muscle cells of ischemic area were measured.Result:(1)The CBF in PIE group was the highest among the four groups. SMC number in PIE group was the highest among the 3 groups.(2) The MP number in PIE group was the highest among the 3 groups.(3) The WSS value in the PIE group was the highest among the 3 groups. WSS value during IE was the highest compared to those before IE(P<0.05) and after IE(P<0.05). The SBP value during IE was the highest than those before IE(P<0.05) and after IE(P<0.05). The SBP in the SO group was the lowest among the 3 groups. The DBP in PIE group was the highest among the 3 groups. SBP during IE was the highest among those before IE(P<0.05) and after IE(P<0.05). DBP during IE was the highest than those before IE(P<0.05) and after IE(P<0.05).(10)Correlation analysis: The collateral blood flow was highly correlated with WSS. The SMC count and MP count were highly correlated with WSS. In the PIE group, the WSS was highly correlated with the SBP.The WSS value was moderately positive correlated with DBP.Conclusion: Isometric exercise could promote the blood perfusion in chronic coronary stenosis model by increasing blood pressure and enhancing wall shear stress. Compared with PIE, AIE was more effective.
引文
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[15]Reneman RS,Arts T,Hoeks AP.Wall shear stress--an important determinant of endothelial cell function and structure--in the arterial system in vivo.Discrepancies with theory[J].J Vasc Res,2006,43(3):251-269.
[16]Cunningham KS,Gotlieb AI.The role of shear stress in the pathogenesis of atherosclerosis[J].Lab Invest,2005,85(1):9-23.
[17]Garcia-Cardena G,Comander J,Anderson KR,et al.Biomechanical activation of vascular endothelium as a determinant of its functional phenotype[J].Proc Natl Acad Sci US A,2001,98(8):4478-4485.
[18]张鲁,严志强,李玉青,等.流体切应力梯度对血管内皮细胞排列和形状的影响[J].医用生物力学,2010,(5):328-333.
[19]Heil M,Eitenmuller I,Schmitz-Rixen T,et al.Arteriogenesis versus angiogenesis:similarities and differences[J].JCell Mol Med,2006,10(1):45-55.
[20]Williams MA,Haskell WL,Ades PA,et al.Resistance exercise in individuals with and without cardiovascular disease:2007 update:a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition,Physical Activity,and Metabolism[J].Circulation,2007,116(5):572-584.
[21]蓝敏,励建安,周士枋.血浆内啡肽在等长收缩运动时对心血管运动反应的调节[J].中华物理医学杂志,1998,20(2):105.
[22]Atkinson CL.Impact of handgrip exercise intensity on brachial artery flow-mediated dilation[J].European Journal of Applied Physiology,2015,115(8):1705-1713.
[2]Francis DP,Cole GD.Coronary artery disease:screen or treat?[J].BMJ,2016,352:i1395.
[3]Pollock ML,Franklin BA,Balady GJ,et al.AHA Science Advisory.Resistance exercise in individuals with and without cardiovascular disease:benefits,rationale,safety,and prescription:An advisory from the Committee on Exercise,Rehabilitation,and Prevention,Council on Clinical Cardiology,American Heart Association;Position paper endorsed by the American College of Sports Medicine[J].Circulation,2000,101(7):828-833.
[4]Degen A,Millenaar D,Schirmer SH.Therapeutic approaches in the stimulation of the coronary collateral circulation[J].Curr Cardiol Rev,2014,10(1):65-72.
[5]Schaper W.Collateral circulation:past and present[J].Basic Res Cardiol,2009,104(1):5-21.
[6]Troidl K,Schaper W.Arteriogenesis versus angiogenesis in peripheral artery disease[J].Diabetes Metab Res Rev,2012,28 Suppl 1:27-29.
[7]Shen M,Gao J,Li J,et al.Effect of stimulation frequency on angiogenesis and gene expression in ischemic skeletal muscle of rabbit[J].Can J Physiol Pharmacol,2009,87(5):396-401.
[8]Hoffmann U,Millea R,Enzweiler C,et al.Acute myocardial infarction:contrast-enhanced multi-detector row CT in a porcine model[J].Radiology,2004,231(3):697-701.
[9]Kingma JJ,Simard D,Rouleau JR.Comparison of neutron activated and radiolabeled microsphere methods for measurement of transmural myocardial blood flow in dogs[J].JThromb Thrombolysis,2005,19(3):201-208.
[10]Lozano R,Naghavi M,Foreman K,et al.Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010:a systematic analysis for the Global Burden of Disease Study 2010[J].Lancet,2012,380(9859):2095-2128.
[11]Mukherjee D,Bhatt DL,Roe MT,et al.Direct myocardial revascularization and angiogenesis--how many patients might be eligible?[J].Am J Cardiol,1999,84(5):598-600,A8.
[12]Voisine P,Li J,Bianchi C,et al.Effects of L-arginine on fibroblast growth factor 2-induced angiogenesis in a model of endothelial dysfunction[J].Circulation,2005,112(9 Suppl):I202-I207.
[13]Demicheva E,Hecker M,Korff T.Stretch-induced activation of the transcription factor activator protein-1 controls monocyte chemoattractant protein-1 expression during arteriogenesis[J].Circ Res,2008,103(5):477-484.
[14]Meier P,Seiler C.The coronary collateral circulation--past,present and future[J].Curr Cardiol Rev,2014,10(1):1.
[15]Reneman RS,Arts T,Hoeks AP.Wall shear stress--an important determinant of endothelial cell function and structure--in the arterial system in vivo.Discrepancies with theory[J].J Vasc Res,2006,43(3):251-269.
[16]Cunningham KS,Gotlieb AI.The role of shear stress in the pathogenesis of atherosclerosis[J].Lab Invest,2005,85(1):9-23.
[17]Garcia-Cardena G,Comander J,Anderson KR,et al.Biomechanical activation of vascular endothelium as a determinant of its functional phenotype[J].Proc Natl Acad Sci US A,2001,98(8):4478-4485.
[18]张鲁,严志强,李玉青,等.流体切应力梯度对血管内皮细胞排列和形状的影响[J].医用生物力学,2010,(5):328-333.
[19]Heil M,Eitenmuller I,Schmitz-Rixen T,et al.Arteriogenesis versus angiogenesis:similarities and differences[J].JCell Mol Med,2006,10(1):45-55.
[20]Williams MA,Haskell WL,Ades PA,et al.Resistance exercise in individuals with and without cardiovascular disease:2007 update:a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition,Physical Activity,and Metabolism[J].Circulation,2007,116(5):572-584.
[21]蓝敏,励建安,周士枋.血浆内啡肽在等长收缩运动时对心血管运动反应的调节[J].中华物理医学杂志,1998,20(2):105.
[22]Atkinson CL.Impact of handgrip exercise intensity on brachial artery flow-mediated dilation[J].European Journal of Applied Physiology,2015,115(8):1705-1713.
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