参松养心胶囊对心功能及心脏电生理影响的实验研究

Effects of shen song yang xin（SSYX） on cardiac function and electrophysiological characteristics in rab-bits

目的观察中成药参松养心胶囊对日本大耳兔心力衰竭模型的心功能及心脏电生理特性的影响，以探讨其治疗心力衰竭及心律失常的机制。方法将32只日本大耳兔随机分为假手术对照组、假手术参松组、心力衰竭对照组、心力衰竭参松组，以人工主动脉瓣反流术联合腹主动脉缩窄术建立心力衰竭模型，药物干预组于主动脉瓣反流术后给予0．4g·kg^-1·d^-1参松养心原粉灌胃。8周后，行超声心动图检查及在体电生理研究。结果心力衰竭对照组与假手术对照组相比，心力衰竭对照组左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）、左心室收缩末期容积（LVESV）、左心室舒张末期容积（LVEDV）增大（P〈0．05），左心室射血分数（LVEF）、左心室短轴缩短分数（LVFS）减小（P〈0．05）；左右心房、心室动作电位时限复极90％时间（MAPD90）延长（P〈0．05）；右心房、左右心室有效不应期（ERP）延长（P〈0．05）；左心室内、中、外膜层心肌细胞MAPD90及跨室壁复极离散度（TDR）明显延长（P〈0．05）；心室颤动（室颤）阈值（VFT）明显降低（P〈0．05）。心力衰竭参松组与心力衰竭对照组比较，心力衰竭参松组LVESD减小（P〈0．05），LVFS、LVEF增大（P〈0．05）；左心房MAPD90缩短（P〈0．05）；右心房、右心室MAPD50、MAPD90、ERP均缩短（P〈0．05）；左心室MAPD90、ERP缩短（P〈0．05）；左心室内、中、外膜层心肌细胞MAPD90、TDR明显缩短（P〈0．05）； VFT明显升高（P〈0．05）。结论参松养心胶囊可改善因前后负荷增加引起的心功能减退、缩短因压力负荷增加而延长的ERP及APD，通过缩短TDR、提高VFT发挥抗心力衰竭后心律失常的作用。

Objective To investigate the effects of shen song yang xin （SSYX） on heart function and the electrophysiological characteristics in a rabbit model of heart failure （HF）. Methods Thirty-two rabbits were randomly divided into four groups （n=8 ,each） ,the first two groups received sham operation were alloca-ted to either SSYX or placebo for 8 weeks as control groups（ sham SSYX group and sham placebo group）. The second two groups were also administered with SSYX or placebo, but underwent combined aortic insufficiency and aortic constriction to induce HF （ HF SSYX group and HF placebo group）. Left ventricular systolic and di-astolic function were studied using echocardiography. Cardiac electrophysiological study was performed in vivo by monophasic action potential technique. Results In sham SSYX and placebo groups, heart function and elec- trophysiological properties were not significant different. In HF placebo group,left ventricular end-systolic dimen-sion （LVESD） was increased,left ventricular ejection fraction （LVEF） and fractional shortening （FS） were significantly decreased, but HF rabbits treated with SSYX significantly improved LV function as compared with HF rabbits treated with placebo. Action potential durations （APD） and effective refractory period （ERP） of left atrium （ LA）, right atrium （ RA）, left ventricle （LV） and right ventricle （ RV）, transmural dispersion of repo-larization （TDR） of LV in HF placebo group were significantly longer than those in controls. In addition, the ventricular fibrillation threshold （VFY） was also decreased in HF placebo group. But administration of SSYX attenuated the electrophysiological changes in HF rabbits, including shortened the APDs, ERP, TDR and in-creased the VFT as compared with HF placebo group. Conclusion Administration of SSYX can improve the cardiac function and reverse the electrical remodeling in the rabbit HF model.