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目的探讨充血性心力衰竭(CHF)对犬肺静脉(PV)肌袖结构的影响。方法将16只杂种犬,随机等分为CHF组和对照组,CHF组以240次/min的频率在右室持续起搏4周,建立CHF模型;对照组埋置起搏器但不起搏;Burst刺激诱发心房颤动(AF)。分别取两组犬的PV肌袖组织,用天狼星红染色进行纤维化定量分析和胶原组成分析。用免疫组化染色法对缝隙连接蛋白43(Cx43)进行半定量分析。结果4周后,进行快速右室起搏的CHF组的所有犬均可诱发出稳定CHF。终止起搏后,CHF犬的持续AF(>15min)的诱发率为87.5%(7/8),显著高于对照犬(P<0.01)。CHF组PV肌袖纤维化的程度明显增加,总胶原的含量显著高于对照组的相应部位[(5.3±1.0)%vs(2.1±0.7)%,P<0.01]。CHF组Ⅲ型胶原的含量及Ⅲ型胶原与I型胶原含量的比值均显著高于对照组[(4.6±1.0)%vs(1.6±0.7)%和(7.9±3.2)vs(3.0±1.9),P<0.01];但I型胶原的含量与对照组无显著差异[(0.6±0.2)%vs(0.6±0.3)%]。CHF组PV肌袖内Cx43的水平显著高于对照组[(3.3±0.6)%vs(2.8±0.7)%,P<0.05];其PV肌袖内细胞侧侧连接处Cx43的分布较对照组增加。结论CHF对PV肌袖结构具有显著影响。
Objective To investigate the effect of congestive heart failure (CHF) on the muscle sleeve structure of canine pulmonary veins (PV). Methods 16 mongrel dogs were randomly divided into CHF group and control group. The CHF group was kept in the right ventricle at a rate of 240 beats per minute for 4 weeks to establish the CHF model. In the control group, the pacemaker was embedded without pacing Burst stimulation induces atrial fibrillation (AF). The PV muscle sleeves of two groups of dogs were respectively taken for quantitative analysis of fibrosis and collagen composition analysis by Sirius red staining. Semiquantitative analysis of connexin 43 (Cx43) was performed by immunohistochemical staining. Results Four weeks later, stable CHF was induced in all dogs in CHF group with rapid right ventricular pacing. After termination of pacing, the rate of induced persistent AF (> 15 min) in CHF dogs was 87.5% (7/8), significantly higher than that in control dogs (P <0.01). The degree of PV myelofibrosis in CHF group was significantly increased, and the content of total collagen was significantly higher than that in control group [(5.3 ± 1.0)% vs (2.1 ± 0.7)%, P <0.01]. The ratio of type Ⅲ collagen to type Ⅲ collagen and type Ⅰ collagen in CHF group were significantly higher than that in control group [(4.6 ± 1.0)% vs (1.6 ± 0.7)% vs (7.9 ± 3.2) vs (3.0 ± 1.9) , P <0.01]. However, the content of type I collagen was not significantly different from that of the control group [(0.6 ± 0.2)% vs (0.6 ± 0.3)%]. The level of Cx43 in the PV muscle sleeve of CHF group was significantly higher than that of the control group [(3.3 ± 0.6)% vs (2.8 ± 0.7)%, P <0.05] increase. Conclusions CHF has a significant effect on the PV sleeve structure.