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트레드밀 운동이 심근경색증 생쥐모델의 심기능 회복에 미치는 효과

Effects of treadmill exercise on recovery of cardiac function in a mouse model of myocardial infarction

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연구는 생쥐 심근경색모델을 이용하여 다양한 강도의 유산소 운동이 심장기능 회복에 미치는 효과를 분석하여, 심근경색 후 심장기능 회복에 적절한 운동 강도 및 최소한의 운동 기간을 조사하고자 하였다. 생후 10∼12주된 CD1 수컷 생쥐의 좌전하행지를 차단하여 심근경색증을 유발시킨 후 운동을 시키지 않은 심근경색 대조군과 심근경색 후 트레드밀을 이용하여 10도 경사에서 8 m/min(저강도), 12 m/min(중강도) 및 16 m/min(고강도)의 다양한 강도로 매일 30분씩 8주까지 운동을 부하시킨 운동군 간의 심장기능 회복 정도를 심장초음파 검사와 조직검사로 분석하였다. 운동군은 심근경색 대조군에 비해 8주 운동 훈련 후 심실벽 비후와 모세혈관 수의 증가가 관찰되었으며, 심장조직 헤마톡실린-에오신 염색 결과 10도 경사 12 m/min의 속도로 매일 30분씩 8주간 운동시킨 운동군에서 4주부터 심근경색 흉터의 크기가 유의하게 감소되었고, 심장초음파검사에서 좌심실 수축기말용적과 좌심실 내경이 감소되고 심박출량과 좌심실 구획단축율은 증가되어 심실 수축계수가 증가되었다. 하지만 고강도 운동군은 심근경색 후 운동을 하지 않은 대조군에 비해 오히려 심근경색 흉터가 더 커지고 심기능 지수들이 악화되었으며, 저강도 운동군은 그 효과가 운동을 하지 않은 대조군과 차이가 없었다. 이상의 결과를 종합하면 심근경색 발생 후 중강도의 트레드밀 운동을 8주 이상 지속하는 것이 심장기능 회복에 가장 효과적일 것으로 사료된다.

Abstract

The purpose of this study was to investigate the adequate intensity and the minimal duration of aerobic exercise to obtain the cardioprotective effect after myocardial infarction. Myocardial infarction model was established by occluding the left descending anterior artery in heart of CD 1 mice. Three days after myocardial infarction, mice were exercised with treadmill running with a speed of 8 m/min(low intensity), 12 m/min(moderate intensity) or 16 m/min(high intensity) at 10 degree incline 30 minutes per day for 8 weeks. Hematoxylin-eosin stain showed significant decrease in the size of infarct scar and increase in the thickness of normal myocardial tissue after 8 weeks of moderate intensity exercise. However, infarct scar was increased and further thinned after 8 weeks of high intensity exercise. Echocardiography revealed that both stroke volume and fractional shortening increased while both left ventricular internal diameter and endsystolic volume decreased after 8 weeks of moderate intensity exercise. Fractional ejection, a representative of cardiac function, was also increased. However, the echocardiographic parameters either became worse after 8 weeks of high intensity exercise or were not significant changed after 8 weeks of low intensity exercise. These results suggest that treadsmill exercise of moderate intensity at least for 8 weeks after myocardial infarction has beneficial effect in recovery of cardiac function in post-infarcted patients

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