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1.河南中医药大学第一附属医院,河南省郑州市人民路19号,450046
2.河南中医药大学
Received:27 June 2024,
Revised:2024-10-26,
Published:17 April 2025
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邢作英,胡宇才,宋欢欢等.通脉养心丸对缺血再灌注模型大鼠心律失常及心肌组织中K+、Ca2+通道相关蛋白和基因表达的影响[J].中医杂志,2025,66(08):851-859. DOI: 10.13288/j.11-2166/r.2025.08.016.
XING Zuoying,HU Yucai,SONG Huanhuan,et al.Effects of Tongmai Yangxin Pills (通脉养心丸) on Arrhythmia and K+/Ca2+ Channel-Related Proteins and Gene Expression in Myocardial Tissue of Ischemia-Reperfusion Model Rats[J].Journal of Traditional Chinese Medicine,2025,66(08):851-859. DOI: 10.13288/j.11-2166/r.2025.08.016.
邢作英,胡宇才,宋欢欢等.通脉养心丸对缺血再灌注模型大鼠心律失常及心肌组织中K+、Ca2+通道相关蛋白和基因表达的影响[J].中医杂志,2025,66(08):851-859. DOI: 10.13288/j.11-2166/r.2025.08.016. DOI:
XING Zuoying,HU Yucai,SONG Huanhuan,et al.Effects of Tongmai Yangxin Pills (通脉养心丸) on Arrhythmia and K+/Ca2+ Channel-Related Proteins and Gene Expression in Myocardial Tissue of Ischemia-Reperfusion Model Rats[J].Journal of Traditional Chinese Medicine,2025,66(08):851-859. DOI: 10.13288/j.11-2166/r.2025.08.016. DOI:
目的
2
探索通脉养心丸预防缺血再灌注心律失常的作用及可能机制。
方法
2
60只雄性SD大鼠随机分为假手术组、模型组、胺碘酮组和通脉养心丸低、高剂量组,每组12只。假手术组和模型组大鼠给予10 g/(kg·d)生理盐水灌胃,胺碘酮组大鼠给予60 mg/(kg·d)胺碘酮灌胃,通脉养心丸低、高剂量组大鼠分别给予通脉养心丸溶液1、2 g/(kg·d)灌胃。预防性给药21天,每日灌胃2次。最后一次灌胃后次日,模型组和各药物组采用结扎前降支加置套管制备大鼠缺血再灌注模型,假手术组只穿线不结扎。造模过程中全程记录心电图,分别记录缺血前连续记录10min(t-0期),缺血后5~10 min(t-1期)、缺血后10~15 min(t-2期)、缺血后15~30 min(t-3期)及再灌注开始至灌注2 min(t-4期)5个时间段心率;计算t-0期至t-4期各组大鼠心律失常发生情况,包括室性早搏、室性心动过速、心室颤动;计算心律失常评分。再灌注24 h后取左室心肌组织,HE染色观察心肌组织病理改变,采用RT-PCR检测心肌组织中微小核糖核酸1(
miRNA
-
1
)、微小核糖核酸133a(
miRNA
-
133a
)和K
+
、Ca
2+
通道基因[包括电压门控性钾通道D亚家族成员2(
KCND2
)
、
电压门控性钾通道H亚家族成员2(
KCNH2
)
、
电压门控性钾通道E亚家族成员2(
KCNE2
)
、
电压门控性钾通道Q亚家族成员1(
KCNQ1
)
、
电压门控性钾通道E亚家族成员1(
KCNE1
)
、
内向整流钾通道J亚家族成员2(
KCNJ2
)
、
电压门控性钙
通道α1C亚基(
CACNA1C
)
、
电压门控性钙通道β1(
CACNB1
)]mRNA表达水平,蛋白免疫印迹法检测心肌组织中瞬时外向钾电流蛋白(Kv4.2)、延迟整流钾电流快激活成分蛋白(HERG)、延迟整流钾电流慢激活成分蛋白(KvLQT1)、内向整流钾电流蛋白(Kir2.1)和L-型钙离子通道电流蛋白(Cav1.2)蛋白水平。
结果
2
与假手术组比,模型组大鼠心肌组织中有弥漫性出血,出血灶周围出现炎性细胞浸润,心肌细胞坏死,核皱缩,出现空泡,心肌纤维断裂;t-1期至t-4期大鼠心率均降低,心律失常评分升高,心肌组织
miRNA
-
1
和
miRNA
-
133a
表达升高,
KCND2、KCNH2、KCNE2、KCNQ1、KCNE1、KCNJ2、CACNA1C、CACNB1
mRNA表达量降低,Kv4.2、HERG、KvLQT1、Kir2.1和Cav1.2蛋白水平降低(
P
<0.01)。与模型组比较,各药物组病理结果显示心肌损伤均有减轻,出血减少,炎性细胞浸润减轻,核固缩和空泡减少,排列较整齐,通脉养心丸高剂量组整体改善程度最明显;胺碘酮组和通脉养心丸高剂量组t-1期至t-4期大鼠心率升高,各给药组心律失常评分、
miRNA
-
1、miRNA
-
133a
表达降低,通脉养心丸高剂量组
KCND2、KCNH2、KCNQ1、KCNJ2、CACNA1C
mRNA表达量及Kv4.2、HERG、KvLQT1、Kir2.1和Cav1.2蛋白水平升高(
P
<0.05或
P
<0.01)。
结论
2
通脉养心丸可改善缺血再灌注大鼠心肌损伤,降低室性心律失常发生率,其机制可能与通过降低心肌组织
miRNA
-
1、miRNA
-
133a
基因表达,升高K
+
、Ca
2+
离子通道相关基因及蛋白水平有关。
Objective
2
To investigate the effects and potential mechanisms of
Tongmai Yangxin Pills
(通脉养心丸) (TYPs) in preventing ischemia-reperfusion (I/R)-induced arrhythmia.
Methods
2
Sixty male SD rats were randomly assigned to sham operation group, model group, amiodarone group, low-dose and high-dose TYPs
group, with 12 rats in each group. The sham operation group and the model group received 10 g/(kg·d) normal saline by gavage, the amiodarone group received 60 mg/(kg·d) amiodarone, and the low-dose and high-dose TMP groups received 1 g/(kg·d) and 2 g/(kg·d) TYPs solution respectively, for 21 days, administered twice daily. On the day after the last administration, the I/R model was established in the model and medication groups by ligation of the left anterior desce
nding coronary artery with a cannula, while the sham operation group underwent the same procedure without ligation. Electrocardiogram recordings were continuously monitored throughout the modeling process. Heart rate was recorded at five time points, before ischemia (t-0), 5-10 min after ischemia (t-1), 10-15 min after ischemia (t-2), 15-30 min after ischemia (t-3), and during the first 2 min of reperfusion (t-4); the incidence of arrhythmia including ventricular premature beats (VPB), ventricular tachycardia (VT), and ventricular fibrillation (VF) was recorded; arrhythmia scores were calculated. After 24 hours of reperfusion, left ventricular myocardial tissue was collected. Hematoxylin-eosin (HE) staining was performed to observe pathological changes. RT-PCR was used to detect the mRNA expression of microRNA-1 (
miRNA
-
1
), microRNA-133a (
miRNA
-
133a
), and potassium (K
+
) and calcium (Ca
2+
) ion channel-related genes including
KCND2
,
KCNH2
,
KCNE2
,
KCNQ1
,
KCNE1
,
KCNJ2
,
CACNA1C
, and
CACNB1
. Western blot analysis was used to measure protein levels of transient outward potassium current protein (Kv4.2), rapidly activating delayed rectifier potassium current protein (HERG), slowly activating delayed rectifier potassium current protein (KvLQT1), inward rectifier potassium current protein (Kir2.1), and L-type calcium channel protein (Cav1.2).
Results
2
Compared with sham operation group, the model group showed diffuse myocardial hemorrhage, inflammatory cell infiltration, myocardial necrosis, nuclear pyknosis, vacuolar degeneration, and disrupted myocardial fibers; the model group also exhibited a decreased heart rate (t-1 to t-4), increased arrhythmia scores, elevated
miRNA
-
1
and
miRNA
-
133a
expression, and
decreased mRNA expression of
KCND2
,
KCNH2
,
KCNE2
,
KCNQ1
,
KCNE1
,
KCNJ2
,
CACNA1C
, and
CACNB1
in myocardial tissue; additionally, Kv4.2, HERG, KvLQT1, Kir2.1, and Cav1.2 protein levels significantly reduced (
P
<0.01). Compared to the model group, all medication-treated groups showed reduced myocardial damage, including less hemorrhage, reduced inflammatory infiltration, and improved myocardial structure, with the high-dose TYPs group exhibiting the most significant improvement; the amiodarone group and high-dose TYPs group showed a significant increase in heart rate (t-1 to t-4), lower arrhythmia scores, reduced
miRNA
-
1
and
miRNA
-
133a
expression; the high-dose TYPs group exhibited significantly increased mRNA expression levels of
KCND2
,
KCNH2
,
KCNQ1
,
KCNJ2
, and
CACNA1C
, as well as elevated protein levels of Kv4.2, HERG, KvLQT1, Kir2.1, and Cav1.2 (
P
<0.05 or
P
<0.01).
Conclusion
2
TMPs can improve myocardial damage and reduce the incidence of ventricular arrhythmia in I/R rats. The underlying mechanism may be related to the downregulation of
miRNA
-
1
and
miRNA
-
133a
gene expression, as well as the upregulation of K
+
and Ca
2+
channel-related genes and proteins.
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