Transition from compensated to decompensated left ventricular hypertrophy (LVH) is accompanied by functional and structural changes. Here, the aim was to evaluate dystrophin expression in murine models and human subjects with LVH by transverse aortic constriction (TAC) and aortic stenosis (AS), respectively. We determined whether doxycycline (Doxy) prevented dystrophin expression and myocardial stiffness in mice. Additionally, ventricular function recovery was evaluated in patients 1 year after surgery. Mice were subjected to TAC and monitored for 3 weeks. A second group received Doxy treatment after TAC. Patients with AS were stratified by normal left ventricular end-diastolic wall stress (LVEDWS) and high LVEDWS, and groups were compared. In mice, LVH decreased inotropism and increased myocardial stiffness associated with a dystrophin breakdown and a decreased mitochondrial O2 uptake (MitoMVO2). These alterations were attenuated by Doxy. Patients with high LVEDWS showed similar results to those observed in mice. A correlation between dystrophin and myocardial stiffness was observed in both mice and humans. Systolic function at 1 year post-surgery was only recovered in the normal-LVEDWS group. In summary, mice and humans present diastolic dysfunction associated with dystrophin degradation. The recovery of ventricular function was observed only in patients with normal LVEDWS and without dystrophin degradation. In mice, Doxy improved MitoMVO2. Based on our results it is concluded that the LVH with high LVEDWS is associated to a degradation of dystrophin and increase of myocardial stiffness. At least in a murine model these alterations were attenuated after the administration of a matrix metalloprotease inhibitor.

译文

从代偿性向代偿性失衡的左心室肥大(LVH)的转变伴随着功能和结构的变化。在这里,目的是通过横向主动脉缩窄(TAC)和主动脉狭窄(AS)评估鼠模型和LVH人体受试者中的肌营养不良蛋白表达。我们确定强力霉素(Doxy)是否能预防小鼠中的肌营养不良蛋白表达和心肌僵硬。此外,术后1年评估患者的心室功能恢复。对小鼠进行TAC并监测3周。第二组在TAC后接受Doxy治疗。 AS患者按正常左心室舒张末期壁应力(LVEDWS)和高LVEDWS进行分层,并比较各组。在小鼠中,LVH降低了肌力,并增加了肌营养不良蛋白的分解和线粒体O2摄取(MitoMVO2)的减少,从而增加了心肌的硬度。这些改变被Doxy减弱了。 LVEDWS高的患者显示的结果与小鼠观察到的结果相似。在小鼠和人类中都观察到肌营养不良蛋白与心肌硬度之间的相关性。术后1年的收缩功能仅在正常LVEDWS组中得以恢复。总之,小鼠和人类表现出与肌营养不良蛋白降解相关的舒张功能障碍。仅在LVEDWS正常且无肌营养不良蛋白降解的患者中观察到心室功能的恢复。在小鼠中,Doxy改善了MitoMVO2。根据我们的结果,可以得出结论,LVEDWS高的LVH与肌营养不良蛋白的降解和心肌硬度的增加有关。至少在鼠模型中,在施用基质金属蛋白酶抑制剂后,这些改变被减弱了。

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