Name: operating transverse aortic constriction with absorbable suture to obtain transient myocardial hypertrophy
Uploaded: 2020-09-09T14:45:00
Description: Watch this Scientific Journal Video about Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy at JoVE.com

Dette arbejde blev støttet af tilskud fra National Natural Science Foundation of China (81770271; til Y, Liao), de fælles fonde for National Natural Science Foundation of China (U1908205; til Y, Liao) og Guangzhous kommunale planlægningsprojekter af videnskabelig teknologi (201804020083; til Dr. Liao).

Alle procedurer blev udført i retningslinjerne for pasning og anvendelse af forsøgsdyr offentliggjort af US National Institutes of Health (NIH Publikation nr. 85-23, revideret i 1996). C57BL/6J mandlige mus (8-10 uger, 20-25 g) blev leveret af Animal Center of South Medical University.
1. Præoperativ forberedelse
<ol><li>Knib spidsen af en 25 G nål med en nåleholder og sløv den med en hård genstand som holderen.</li>
	<li>Send en 5-0 absorberbar sutur gennem nålen, og kurve ...

<ol>
	<li>Murry, C. E., Jennings, R. B., Reimer, K. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preconditioning+with+ischemia:+a+delay+of+lethal+cell+injury+in+ischemic+myocardium.">Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium.</a> Circulation. 74 (5), 1124-1136 (1986).</li><li>Ban, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Phosphatidylinositol+3-kinase+gamma+is+a+critical+mediator+of+myocardial+ischemic+and+adenosine-mediated+preconditioning.">Phosphatidylinositol 3-kinase gamma is a critical mediator of myocardial ischemic and adenosine-mediated preconditioning.</a> Circulation Research. 103 (6), 643-653 (2008).</li><li>Wu, Z. K., Iivainen, T., Pehkonen, E., Laurikka, J., Tarkka, M. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ischemic+preconditioning+suppresses+ventricular+tachyarrhythmias+after+myocardial+revascularization.">Ischemic preconditioning suppresses ventricular tachyarrhythmias after myocardial revascularization.</a> Circulation. 106 (24), 3091-3096 (2002).</li><li>Hausenloy, D. J., Yellon, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preconditioning+and+postconditioning:+underlying+mechanisms+and+clinical+application.">Preconditioning and postconditioning: underlying mechanisms and clinical application.</a> Atherosclerosis. 204 (2), 334-341 (2009).</li><li>Heusch, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Molecular+basis+of+cardioprotection:+signal+transduction+in+ischemic+pre-,+post-,+and+remote+conditioning.">Molecular basis of cardioprotection: signal transduction in ischemic pre-, post-, and remote conditioning.</a> Circulation Research. 116 (4), 674-699 (2015).</li><li>Lund, O., Emmertsen, K., Dorup, I., Jensen, F. T., Flo, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Regression+of+left+ventricular+hypertrophy+during+10+years+after+valve+replacement+for+aortic+stenosis+is+related+to+the+preoperative+risk+profile.">Regression of left ventricular hypertrophy during 10 years after valve replacement for aortic stenosis is related to the preoperative risk profile.</a> European Heart Journal. 24 (15), 1437-1446 (2003).</li><li>Rockman, H. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Segregation+of+atrial-specific+and+inducible+expression+of+an+atrial+natriuretic+factor+transgene+in+an+in+vivo+murine+model+of+cardiac+hypertrophy.">Segregation of atrial-specific and inducible expression of an atrial natriuretic factor transgene in an in vivo murine model of cardiac hypertrophy.</a> Proceedings of the National Academy of Sciiences of the United States of America. 88 (18), 8277-8281 (1991).</li><li>Wei, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Myocardial+hypertrophic+preconditioning+attenuates+cardiomyocyte+hypertrophy+and+slows+progression+to+heart+failure+through+upregulation+of+S100A8/A9.">Myocardial hypertrophic preconditioning attenuates cardiomyocyte hypertrophy and slows progression to heart failure through upregulation of S100A8/A9.</a> Circulation. 131 (17), 1506-1517 (2015).</li><li>Huang, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+biomicroscopy+validation+of+a+murine+model+of+cardiac+hypertrophic+preconditioning:+comparison+with+a+hemodynamic+assessment.">Ultrasound biomicroscopy validation of a murine model of cardiac hypertrophic preconditioning: comparison with a hemodynamic assessment.</a> American Journal of Physiology. Heart and Circulatory Physiology. 313 (1), 138-148 (2017).</li><li>Oka, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiac-specific+deletion+of+Gata4+reveals+its+requirement+for+hypertrophy,+compensation,+and+myocyte+viability.">Cardiac-specific deletion of Gata4 reveals its requirement for hypertrophy, compensation, and myocyte viability.</a> Circulation Research. 98 (6), 837-845 (2006).</li><li>Li, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+cardiac+morphological+and+functional+changes+in+mouse+model+of+transverse+aortic+constriction+by+echocardiographic+imaging.">Assessment of cardiac morphological and functional changes in mouse model of transverse aortic constriction by echocardiographic imaging.</a> Journal of Visualized Experiments. (112), e54101 (2016).</li><li>Veldhuizen, R. A., Slutsky, A. S., Joseph, M., McCaig, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+mechanical+ventilation+of+isolated+mouse+lungs+on+surfactant+and+inflammatory+cytokines.">Effects of mechanical ventilation of isolated mouse lungs on surfactant and inflammatory cytokines.</a> The European Respiratory Journal. 17 (3), 488-494 (2001).</li><li>Wang, Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Induction+of+right+ventricular+failure+by+pulmonary+artery+constriction+and+evaluation+of+right+ventricular+function+in+mice.">Induction of right ventricular failure by pulmonary artery constriction and evaluation of right ventricular function in mice.</a> Journal of Visualized Experiments. (147), e59431 (2019).</li><li>Eichhorn, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+closed-chest+model+to+induce+transverse+aortic+constriction+in+mice.">A closed-chest model to induce transverse aortic constriction in mice.</a> Journal of Visualized Experiments. (134), e57397 (2018).</li><li>Tavakoli, R., Nemska, S., Jamshidi, P., Gassmann, M., Frossard, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Technique+of+minimally+invasive+transverse+aortic+constriction+in+mice+for+induction+of+left+ventricular+hypertrophy.">Technique of minimally invasive transverse aortic constriction in mice for induction of left ventricular hypertrophy.</a> Journal of Visualized Experiments. (127), e56231 (2017).</li></ol>

Der er stadig et langt underudforsket område i hjerte ikke-iskæmisk forudsætning. Baseret på vores tidligere undersøgelser skiftede vi til at bruge absorberbare suturer til at forbedre myokardie hypertrofisk forkonditioneringsmodel.
I tidligere rapporter brugte mange efterforskere silke sutur til at indsnævre aortabuen8,14,15. Silke sutur var let tilgængelig og blev ofte brugt til kirurgisk så...

Iskæmisk forudsætning er et fænomen, der fremkalder korte ikke-dødelige episoder af iskæmi og reperfusion til hjertet og har kapacitet til dramatisk at reducere myokardieskade1. I betragtning af de åbenlyse kliniske konsekvenser af iskæmisk forudsætning, såsom begrænsning af myokardie infarkt størrelse2 og bekæmpelse af ventrikulær tachyarrhythmias efter myokardie revascularization3, har der været masser af forskning for at dissekere de mekanismer, der ligger til grund for hjerte-beskyttende virkninger forårsaget af forkonditionering4,5. I modsætning hertil har andre ikke-iskæmiske former for forkonditionering fået relativt lidt opmærksomhed. Hjertehypertrofi kan blive afstumpet hos patienter med aortastenose, der gennemgår udskiftning af aortaklappen6. Hvor tilstanden af patologisk myokardiehypertrofi findes, rapporteres princippet om forkonditionering sjældent.
I 1991 etablerede Rockman et al. for det første en musemodel af venstre ventrikulær hypertrofi ved tværgående aortasnæring (TAC)7. Ved at betjene TAC to gange i mus har vi tidligere bevist, at myokardie hypertrofisk forkonditionering (MHP) fører til forbigående hypertrofisk stimulation i hjertet og derved gør hjertet mere modstandsdygtigt over for vedvarende hypertrofisk stress i fremtiden8. MHP-modellens egenskaber er blevet valideret ved ultralydbiomikroskop og hæmodynamisk vurdering9. Nøglepunkterne i konstruktionen af modellen var at udføre thoracotomi tre gange, TAC i en uge, debanding i en uge og sekundær TAC i 6 uger. Men debanding kan forårsage blødning, hvilket gjorde det vanskeligt at blive mestret af nybegyndere og svært at blive populariseret. Derudover er det også en teknisk udfordring at intubere mus. Forkert intubation kan forårsage tracheal skade, pneumothorax og endda død hos mus. Så det er nødvendigt og værdifuldt at forbedre nogle procedurer, mens man konstruerer MHP-modellen.
For at reducere modellens sværhedsgrad og øge dens succes skiftede vi til absorberbare suturer til den første TAC og overvågede modellens succes ved at måle trykgradienten over den aortasnære indsnævring under ekkokardiografi10. Baseret på vores indledende eksperiment, ville det være vanskeligt at fremkalde tilstrækkelig myokardie hypertrofi hos mus med for lavt tryk gradient, mens mus med for højt tryk gradient ville udvikle akut hjertesvigt eller endda dø. Den ideelle trykgradient for modellen varierer fra 40-80 mmHg11. Derudover stolede dette eksperiment ikke på en ventilator, som effektivt kunne undgå respiratorrelateret teknisk manipulation og skade12.

<table>
	<tbody>
		<tr>
			<td>Absorbable suture (5-0)</td>
			<td>Shandong Kang Lida Medical Products Co., Ltd</td>
			<td>5-0</td>
			<td>Ligation</td>
		</tr>
		<tr>
			<td>Animal ultrasound system VEVO2100</td>
			<td>Visual Sonic</td>
			<td>VEVO2100</td>
			<td>Echocardiography</td>
		</tr>
		<tr>
			<td>Cold light illuminator</td>
			<td>Olympus</td>
			<td>ILD-2</td>
			<td>Light</td>
		</tr>
		<tr>
			<td>Heat pad- thermostatic surgical system (ALC-HTP-S1)</td>
			<td>SHANGHAI ALCOTT BIOTECH CO</td>
			<td>ALC-HTP-S1</td>
			<td>Heating</td>
		</tr>
		<tr>
			<td>Isoflurane</td>
			<td>RWD life science</td>
			<td>R510-22</td>
			<td>Inhalant anaesthesia</td>
		</tr>
		<tr>
			<td>Matrx VIP 3000 Isofurane Vaporizer</td>
			<td>Midmark Corporation</td>
			<td>VIP 3000</td>
			<td>Anesthetization</td>
		</tr>
		<tr>
			<td>Medical nylon suture (5-0)</td>
			<td>Ningbo Medical Needle Co.</td>
			<td>5-0</td>
			<td>Close the skin</td>
		</tr>
		<tr>
			<td>Pentobarbital sodium salt</td>
			<td>Merck</td>
			<td>25MG</td>
			<td>Anesthetization</td>
		</tr>
		<tr>
			<td>Precision electronic balance</td>
			<td>Denver Instrument</td>
			<td>TB-114</td>
			<td>Weighing sensor</td>
		</tr>
		<tr>
			<td>Self-made spacer</td>
			<td></td>
			<td></td>
			<td>25-gauge needle</td>
		</tr>
		<tr>
			<td>Silk suture (5-0)</td>
			<td>Yangzhou Yuankang Medical Devices Co., Ltd.</td>
			<td>5-0</td>
			<td>Ligation</td>
		</tr>
		<tr>
			<td>Small animal microsurgery equipment</td>
			<td>Napox</td>
			<td>MA-65</td>
			<td>Surgical instruments</td>
		</tr>
		<tr>
			<td>Transmission Gel</td>
			<td>Guang Gong pai</td>
			<td>250ML</td>
			<td>Echocardiography</td>
		</tr>
		<tr>
			<td>Veet hair removal cream</td>
			<td>Reckitt Benchiser</td>
			<td>RQ/B 33 Type 2</td>
			<td>Remove hair of mice</td>
		</tr>
		<tr>
			<td>Vertical automatic electrothermal pressure steam sterilizer</td>
			<td>Hefei Huatai Medical Equipment Co.</td>
			<td>LX-B50L</td>
			<td>Auto clean the surgical instruments</td>
		</tr>
	</tbody>
</table>

operating transverse aortic constriction with absorbable suture to obtain transient myocardial hypertrophy

Baseret på to gange tværgående aorta indsnævringer (TAC'er) hos mus, er det bevist, at myokardie hypertrofisk forkonditionering (MHP) kunne dæmpe kardiomyocyt hypertrofi og bremse progression til hjertesvigt. For nybegyndere er MHP-modellen dog normalt ret vanskelig at etablere på grund af de tekniske forhindringer i respiratordrift, åbning af brystet gentagne gange og blødning forårsaget af debanding. For at lette denne model, for at øge den kirurgiske succesrate og for at reducere forekomsten af blødning skiftede vi til absorberbare suturer til den første TAC-kæmning med en respiratorfri teknik. Ved hjælp af en 2-ugers absorberbar sutur viste vi, at denne procedure kan forårsage betydelig myokardiehypertrofi om 2 uger; og 4 uger efter operationen, myokardie hypertrofi var næsten helt tilbage til baseline. Ved hjælp af denne protokol kunne operatørerne nemt mestre MHP-modellen med en lavere driftsdødelighed.

I denne undersøgelse opdelte vi tilfældigt 45 mus i tre grupper, sham, silke suturgruppen og den absorberbare suturgruppe (antallet af hver gruppe på D0 (baseline), D14 og D28 efter TAC var henholdsvis 15, 10 og 5). På D7, D14, D21 og D28 efter operationen blev den indsnævrede tophastighed bestemt af ekkokardiografi. Vi fandt, at blodgennemstrømningen hastighed ved indsnævring stadig var større end 3.000 mm / s i den anden uge efter TAC, selv om en absorberbar sutur var blevet brugt til at indsnævre aorta bue (<...

Watch this Scientific Journal Video about Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy at JoVE.com

Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy

Denne protokol præsenterer en forbedret metode til at opnå forbigående myokardie hypertrofi med absorberbar sutur, simulere venstre ventrikulær hypertrofi falde efter fjernelse af tryk overbelastning. Det kunne være værdifuldt for undersøgelserne af myokardie hypertrofiske forudsætninger.

Drift af transvers aortasnæering med absorberbar sutur for at opnå forbigående myokardie hypertrofi

Based on twice transverse aortic constrictions (TACs) in mice, it is proved that myocardial hypertrophic preconditioning (MHP) could attenuate ...

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