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Genovés Martínez, Patricia
Chorro Gascó, Francisco Javier (dir.); Such Belenguer, Luis (dir.); Del Canto Serrano, Irene (dir.) Departament de Fisiologia |
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Aquest document és un/a tesi, creat/da en: 2021 | |
The effect of an inhibitor of histone deacetylases, valproic acid, on the magnitude of the infarcted myocardium and on certain electrophysiological and mechanical properties of the ventricular myocardium has been investigated in a rabbit model of chronic infarction (six weeks). The experimental model of infarction has been developed in New Zealand male rabbits, thoracotomized and anesthetized, in which the circumflex coronary artery was occluded (one hour) in the middle of its epicardial course, followed by reperfusion. After six weeks of evolution of the necrotic process, the rabbits were sacrificed, the heart was extracted and placed in a Langendorff-type perfusion system, to proceed to the electrophysiological study by the location, in the left ventricular epicardium, of a multi-electrode plate (256 electrodes) recording, an atrial recording electrode and a ventricular pacing electro...
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The effect of an inhibitor of histone deacetylases, valproic acid, on the magnitude of the infarcted myocardium and on certain electrophysiological and mechanical properties of the ventricular myocardium has been investigated in a rabbit model of chronic infarction (six weeks). The experimental model of infarction has been developed in New Zealand male rabbits, thoracotomized and anesthetized, in which the circumflex coronary artery was occluded (one hour) in the middle of its epicardial course, followed by reperfusion. After six weeks of evolution of the necrotic process, the rabbits were sacrificed, the heart was extracted and placed in a Langendorff-type perfusion system, to proceed to the electrophysiological study by the location, in the left ventricular epicardium, of a multi-electrode plate (256 electrodes) recording, an atrial recording electrode and a ventricular pacing electrode. The determinations were: 1.- Effective and functional ventricular refractory periods, through the application of the extra-stimulus test; 2- Inducibility of ventricular fibrillation, applying the extra-stimulus test in four different areas of the ventricle; 3.- Parameters determined during ventricular fibrillation (without interrupting perfusion): functional refractory period (5th percentile of fibrillatory intervals), coefficient of variation of the refractory period; 4.- The extension of the infarct by macroscopic staining, after the electrophysiological study. During the infarct evolution period and before the electrophysiological study, biochemical indicators of myocardial injury were determined, in serum, and echocardiographic controls were carried out. The results and conclusions were: 1) The infarct model developed, validated with biochemical indicators in serum and identification by macroscopic staining, has made possible the realization of this study and it is considered that it may be of interest for investigations with similar characteristics; 2) valproic acid has exhibited a protective effect manifested by its ability to reduce the magnitude of myocardial damage; 3) valproic acid has shown the ability to prevent the onset of ventricular fibrillation; 4) the anti-arrhythmic protection exhibited by valproic acid may be related to its ability to reduce electrophysiological heterogeneity, evidenced in the present work; 5) the beneficial effect of valproic acid has also been manifested on ventricular remodeling. Therefore, it is generally concluded that valproic acid has exhibited a protective effect on the ischemic myocardium. This protective effect could be linked to the prevention of fibrosis derived from its ability to inhibit histone deacetylases.Se ha investigado, en un modelo de infarto crónico (seis semanas) en conejo, el efecto de un inhibidor de las desacetilasas de histonas, el ácido valproico, sobre la magnitud del miocardio infartado y sobre determinadas propiedades electrofisiológicas y mecánicas del miocardio ventricular. El modelo experimental de infarto ha sido desarrollado en conejos macho Nueva Zelanda, toracotomizados y anestesiados a los que se les ocluyó la arteria coronaria circunfleja (una hora) a mitad de su trayecto epicárdico, seguida de reperfusión. Tras seis semanas de evolución del proceso necrótico, se sacrificó a los conejos, se les extrajo el corazón y se ubicó en un sistema de perfusión tipo Langendorff, para proceder al estudio electrofisiológico mediante la ubicación, en el epicardio ventricular izquierdo, de una placa multielectrodo (256 electrodos) de registro, de un electrodo de registro auricular y otro de estimulación ventricular. Las determinaciones fueron: 1.- Periodos refractarios ventriculares efectivo y funcional, mediante la aplicación del test del extra-estímulo; 2- Inducibilidad de fibrilación ventricular, aplicando el test del extra-estímulo en cuatro diferentes zonas del ventrículo; 3.- Parámetros determinados durante la fibrilación ventricular (sin interrumpir la perfusión): Periodo refractario funcional (percentil 5 de los intervalos fibrilatorios), coeficiente de variación del periodo refractario; 4.- La extensión del infarto mediante tinción macroscópica, finalizado el estudio electrofisiológico. Durante el periodo de evolución del infarto y antes del estudio electrofisiológico se determinaron indicadores bioquímicos de lesión miocárdica, en suero, y se efectuaron controles ecocardiográficos. Los resultados y las conclusiones fueron: 1) El modelo de infarto desarrollado, validado con indicadores bioquímicos en suero e identificación por tinción macroscópica, ha posibilitado la realización del presente estudio y se considera que puede ser de interés para investigaciones de características similares; 2) el ácido valproico ha exhibido un efecto protector manifestado por su capacidad para reducir la magnitud del daño miocárdico; 3) el ácido valproico ha mostrado capacidad para prevenir el desencadenamiento de la fibrilación ventricular; 4) la protección anti arrítmica exhibida por el ácido valproico puede relacionarse con su capacidad para reducir la heterogeneidad electrofisiológica, evidenciada en el presente trabajo; 5) el efecto beneficioso del ácido valproico se ha manifestado asimismo sobre el remodelado ventricular. Por tanto, se concluye de modo general que el ácido valproico ha exhibido un efecto protector sobre el miocardio isquémico. Dicho efecto protector podría estar ligado a la prevención de la fibrosis derivada de su capacidad para inhibir las desacetilasas de histonas.
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