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目的:建立慢性心肌缺血致心力衰竭的动物模型。方法:小型猪18只,随机分为假手术组(n=4)和模型组(n=14),模型组开胸于前降支近端放置ameroid缩窄环,假手术组分离前降支不套环。术后4周,行单光子发射计算机断层成像(SPECT)观察心脏灌注情况。应用无创超声心动图、有创血流动力学检查并评价心脏的舒缩功能。应用放射免疫测定法检测血清脑钠尿肽(BNP)、心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、内皮素1(ET-1)和血管紧张素Ⅱ(AngⅡ)等浓度的变化。结果:模型组死亡2只,其余16只动物手术顺利完成。SPECT显示,模型组前降支供血区域心肌存在严重灌注障碍;假手术组无明显灌注缺损。超声心动图和血流动力学检查提示,模型组心脏的收缩和舒张功能严重受损,并发生心腔扩张,同时血清BNP的水平增高,心肌损伤标记物、炎性因子和神经体液因子的浓度也明显增高;假手术组上述参数均无显著改变。结论:在猪的前降支近端放置ameroid缩窄环是制作慢性心肌缺血心力衰竭动物模型的有效方法。
Objective: To establish an animal model of chronic heart failure caused by myocardial ischemia. Methods: A total of 18 miniature pigs were randomly divided into sham operation group (n = 4) and model group (n = 14). The ameroid constriction ring was placed on the proximal end of the descending branch in the model group, No collar. Four weeks after operation, single photon emission computed tomography (SPECT) was used to observe the cardiac perfusion. Application of noninvasive echocardiography, invasive hemodynamic examination and evaluation of cardiac systolic and diastolic function. Serum brain natriuretic peptide (BNP), cardiac troponin T (cTnT), creatine kinase MB (CK-MB), tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) were measured by radioimmunoassay -6), ET-1 and AngⅡ were measured. Results: Two rats died in the model group and the remaining 16 animals were successfully completed. SPECT showed severe myocardial perfusion in the anterior descending coronary artery in the model group, and no significant perfusion defect in the sham-operated group. Echocardiography and hemodynamic examination showed that the systolic and diastolic function of the model group was severely impaired and the heart chamber was dilated and the level of serum BNP was increased. The concentrations of myocardial injury markers, inflammatory cytokines and neurohumoral factors Also significantly higher; sham group no significant change in the above parameters. Conclusion: Ameroid constriction ring placed near the anterior descending artery of pigs is an effective method for making animal models of chronic myocardial ischemia and heart failure.