超声心动图评价雌二醇对肺动脉高压大鼠右心室功能的作用

摘要

Objective To evaluate right ventricular ( RV ) function in male rats with pulmonary arterial hypertension (PAH) induced by Monocrotaline (MCT) and discuss the effect of 17β-estradiol (E2) on RV function in PAH rats . Methods Thirty-two male SD rats were randomly divided into 4 groups( n =8) :MCT group ,MCT+E2 group ,MCT+Veh group and control group . MCT group ,MCT +E2 group and MCT+Veh group were given monocrotaline through intraperitoneal injection . MCT + E2 group and MCT+Veh group were also treated with E2 and placebo at the same time respectively . Echocardiography was performed four weeks later after MCT injection . Right heart catheterization was performed after echocardiography . Echocardiography right ventricular function parameters included:tricuspid annular plane systolic excursion (TAPSE) ,RV index of myocardial performance (RIMP) ,right ventricular fractional area change ( RVFAC) ,tissue Doppler-derived tricuspid lateral annular systolic velocity ( s′) and right ventricular free wall longitudinal strain ( RVLSFW ) . Results Compared with control group ,TAPSE ,RVFAC and RVLSFW decreased ,and RIMP increased in MCT group ,( P <0 .001 , P <0 .001 , P <0 .001 , P =0 .001 , P <0 .001 ,respectively) . TAPSE ,RVFAC and RVLSFW in MCT+ E2 group were higher and RIMP was lower than those in MCT group ( P < 0 .001 , P = 0 .001 , P = 0 .001 , P = 0 .002 , P = 0 .002 , respectively) . The parameters regarding RV function were slightly lower in MCT + E2 group ,compared with control group . However , these differences had no obvious statistical significance ( P > 0 .05 ) . Moreover ,Pearson correlation analysis showed that the serum E2 level was positively correlated with TAPSE ,RVFAC ,s′and RVLSFW ( r =0 .845 , P <0 .001 ;r =0 .859 , P <0 .001 ;r =0 .802 , P =0 .006 , respectively) ,and negatively correlated with RIPM ( r = -0 .803 , P <0 .001) . Conclusions RV function in male PAH rats induced by MCT decreased significantly ,while E2 could improve RV function in PAH rats and has a protective effect on RV function . Echocardiography could contribute to the quantitative evaluation of RV function in PAH rats induced by MCT .%目的 应用超声心动图评价经野百合碱(MCT)诱导的肺动脉高压大鼠右室功能,并探讨17β-雌二醇(E2)对肺动脉高压大鼠右室功能的作用.方法 选取8周龄雄性SD大鼠32只,随机平均分为4组(每组8只):MCT组、MCT+E2组,MCT+安慰剂(Veh)组和对照组.MCT组、MCT+E2组及MCT+Veh组大鼠均予以1％ 野百合碱腹腔注射.MCT+E2组及MCT+Veh组大鼠分别予以E2或安慰剂经皮下微量泵持续泵入.MCT注射4周后对所有大鼠进行超声心动图检查.超声心动图检查完毕后进行右心导管测压.超声心动图右室功能测量参数包括三尖瓣环收缩期位移(TAPSE)、右室心肌做功指数(RIMP)、右室面积变化分数(RVFAC)、三尖瓣环收缩期峰值速度(s′)及右室游离壁纵向应变(RVLSFW).结果 与对照组相比,MCT组TAPSE、RVFAC、s′、RVLSFW降低,RIMP升高,差异有统计学意义(分别P<0.001,P<0.001,P<0.001,P=0.001,P<0.001);MCT+E2组TAPSE、RVFAC、RVLSFW高于MCT组,RIMP低于MCT组(分别P<0.001,P=0.001,P=0.001,P=0.002,P=0.002);MCT+E2组右室功能参数虽较对照组有所减低,但差异无统计学意义(P>0.05).Pearson相关性分析结果示大鼠E2浓度与TAPSE、RVFAC、s′及RVLSFW呈正相关(分别r=0.845,P<0.001;r=0.859,P<0.001;r=0.802,P=0.006),与RIM P呈负相关(r=-0.803,P<0.001).结论 经MCT诱导的肺动脉高压大鼠右室功能减低,E2可以改善肺动脉高压大鼠右室功能不全,对肺动脉高压右室功能具有保护作用.超声心动图在定量评价肺动脉高压大鼠右室功能中具有重要作用.