阿托伐他汀对心肌梗死后心脏交感神经重塑的影响

目的研究阿托伐他汀对心肌梗死后心脏交感神经重塑和室性心律失常易感性的影响。方法随机将SD大鼠分为3组:假手术组;单纯心梗组;心梗+阿托伐他汀组。4周后进行程序电刺激(PES)评价心律失常易感性;组织化学染色观察交感神经的再生(anti-TH、anti-GAP43);同时采用酶联免疫吸附试验检测梗死周边心肌组织中内皮素1(ET-1)水平;免疫印迹法检测心梗周边组织白介素1(IL-1)和神经生长因子(NGF)的含量。结果 4周后,与单纯心梗组相比,阿托伐他汀组梗死周边交感神经密度(P<0.05)及室性心律失常易感性(P<0.05)明显降低,同时可降低梗死周边心肌组织ET-1(P<0.001)、IL-1(P<0.05)及NGF(P<0.001)水平。结论急性心肌梗死后,给予阿托伐他汀4周能抑制内皮素系统、降低炎症因子和神经生长因子的表达,进一步抑制心肌梗死后交感神经过度再生,降低心脏室性心律失常易感性。

Effect of Atorvastatin on Sympathetic Reinnervation in Post-infarcted Rat Heart

Objective To investigate the influence of atorvastatin in cardiac sympathetic nerve sprouting and ventricular susceptibility after MI.Methods Sprague-Dawley rats were randomly divided into 3 groups of Sham group,MI group and MI+ Atorvastatin(MI+A) group.At the fourth week after surgery,the programmed electrical stimulation was used to evaluate the ventricular susceptibility.The immunohistochemical stainings for tyrosine hydroxylase(TH) and growth association protein 43(GAP-43) were performed to assess the distribution and generation of sympathetic nerve.ET-1 level at the border zone was measured using commercial ELISA kit.Additionally,the levels of Interleukin-1(IL-1) and nerve growth factor(NGF) at the border zone were also measured using Western-blot method.Results At the fourth week after surgery,compared with the MI group,sympathetic nerve density(P<0.05) and arrhythmic scores during programmed stimulation(P<0.05) decreased significantly in the MI+A group.Furthermore,atorvastatin decreased ET-1 level(P<0.001),IL-1 level(P<0.05) and NGF level(P<0.001) at the border zone.Conclusion The administration of atorvastatin for four weeks after acute myocardial infarction can result in attenuated sympathetic sprouting and ventricular susceptibility by inhibiting endothelin system,decreasing the expressions of inflammatory factor and nerve growth factor.