Reacher On Mental Stress And The Occurrence Mechanism Of Arrhythmia

Objective:1. To make Sprague-Dawley rat depressive model by chronic stress which cannot be forecasted and isolate feed. Observe the weight, sucrose preference solution, open Field test and fecal grains.Analyze all of the data from the experiment.2. To study the validity, reliability and utility of the chronic unpredictable mild stress model of depression (CUMS) and investigate electrophysiological characteristics of the heart tissue action potential and thoracic spinalcord 1～5 nerves by a technique of microelectrode arrays (MEA), pathological change, immunofluorescence and Confocal laser scanning microscope (LSCM) in chronic stresses mice.3. To explore heart rate variability of the Arrhythmia Patients with anxiety and depression and the Characteristics of various evaluation indexes in social support, sleep, life events, health that the psychosocial factors influence arrhythmia. Methods:1. Male Sprague-Dawley rats were allowed to enter the experimental group and acclimate to the surroundings for 1 week after open-field test, horizontal and vertical movement, all animals (n=30) were randomly separated into 3 groups (n=30), one (n=10) is normal Control group, one (n=10) is stress group and the last is treated group by Fluoxetine.There was no any stress to normal control group, which was fed resident. Eleven unpredicted chronic stresses mice models made by Cronli methods (CUMS) were repeated 2～3 times put on the stress group and this group were individually housed.The third group (n=10), which is treated by Fluoxetine (10mg/d/kg) got the same stress as the second group and were given the therapy at the same time. Measure the rats'weight, sucrose preferenee, daily food intake, open field test and fluid consumption were investigated during the whole procedure.2. After intraperitoneal injection of chloral hydrate (0.3mL/100mg), thoracic spinalcord 1～5, and left, right atrial ventricular local tissue field action potential duration (fAPD) were recorded by microeletrode arrays (MEAs) technique, and cardiac tissues were stained with Massion and HE.GAP-43, TH, CHAT were observed by immunofluorescence and LSCM in the left ventricular of chronic stresses mice.3.160 patients with arrhythmic disease and 50 normal human were investigated with Zung Self-Rating Anxiety Scale (SAS), Zung Self-rating Depression Scale (SDS), Social support rating scale (SSRS), Pittsburgh Sleep Quality Index scale (PSQI), Life events scale, Health Survey Scale (SF-36),57 patients were allowed to enter the depressive group for depression,48 patients were allowed to enter the anxious group for anxiety,38 patients were anxiety and depression as the comorbidity group.55 patients were allowed to enter the patient group. 50 normal human as the control group.All patients were examined by dynamic electrocardiogram for HRV time domain indexes (SDNN, SDANN, rMSSD, PNN50). Results:1. Rats exposed to CUMS showed decreased body weight and food intake from (200.35±13.57,40.35±5.45) g to (279.6±17.24,12.63±2.24) g (P<0.01), horizontal and vertical movement in open-field test of the stress group (12.34±0.51,10.45±1.51) was lower than that of normal group and before test (38.42±3.36,18.21±2.46, P<0.01), reduced squares crossed, and rears and grooming and an increased central time stopped in open field test.a significant reduction of consumption and preference for sucrose solutions from (80.43±7.35,68.04±4.35) to (14.75±3.31,16.34±3.51, P<0.01). There was no significantly difference between normal and therapy group in stress during 14 days, these values were significantly difference from (217.21±15.92,41.72±5.90,37.36±5.23, 16.34±1.45,18.32±1.75,81.32±6.78,65.18±7.56,8.23±1.54) to (307.51±33.23, 28.50±6.28,27.48±2.42,12.86±1.07,14.75±1.37,37.51±7.15,55.50±5.13, P< 0.01) after 3 weeks. There was significantly difference between normal and stress group in fecal grains from (8.26±0.67) to (15.40±1.57) (P<0.01), There was no significantly difference between normal and therapy group in fecal grains.2. HE stain show:In depressive group, the neutrophil infiltration and the infiltration of lymphocytes was obviously observed in the cardiac matrix, Masson Stain:In normal group, there were a little collagen fiber in the myocardial interstitium.Collagen fiber staining indicated that the collagen deposition in.the stress group (46.67±5.75)%was more significant than that in the control group (14.10±1.85)%(P<0.01).There was significantly difference between normal and stress group from (22.10±2.42,30.10±1.59,43.40±1.57) to (13.70±1.82,23.60±2.22,32.00±1.76, P<0.01) in GAP-43, TH, CHAT. There was no significantly difference between normal and therapy group in the myocardial tissue after 3 weeks GAP-43, TH, CHAT were significantly difference between normal and therapy group (16.20±1.32,27.17±3.88,37.50±4.97, P<0.01).3. There was a significantly difference in P wave of stress and therapy group, their P wave length[(35.09±3.23) ms, (35.43±3.41) ms] was longer than that of control group (25.43±1.27) ms (P<0.05). Field action potential duration (FPD) of thoracic spinalcord 1～5 nerves between stress and therapy group increased from baseline[500mv (79.56±8.01) ms and1000mv (86.17±4.61) ms]to highline[500mv (144.25±12.63) ms, (134.32±11.23) ms and 1000mv (152.38±10.86) ms, (142.67±18.78) ms] (P<0.01).there was significantly difference in atrium FPD between stress, therapy control group[(11.17±0.60), (11.34±1.00)]ms and control group (10.25±1.94) ms (P<0.05).Local action potential of left, right atrium of stress and therapy group [(125.09±6.22) ms, (189.89±14.68) ms and (122.90.43±19.34) ms, (172.56±26.45) ms]were longer than that of control group[(92.59±7.61), (105.18±15.94)] ms (P<0.05). Dispersion of stress group and therapy group[(629.82±90.68),(620.46±86.93)] ms was longer than that of control group (345.72±62.38) ms (P< 0.05).4. the depressive group [depressive scale[(47.71±1.25)], the anxious group[anxious scale (47.26±2.03)], the comorbidity[depressive (48.77±1.07), anxious scale (49.72±1.03)] were higher than that of control group [depressive scale (33.21±1.26),anxious scale (32.26±2.49)] (P <0.01), these values were significantly difference (P<0.01).There was significantly difference between the depressive group[SDNN (88.30±15.24), SDANN (78.70±12.51), rMSSD (22.04±2.63), PNH50 (15.26±1.07)], anxious group[SDNN (84.87±.13.21), SDANN (79.33±13.01), rMSSD (22.28±3.21), PNH50 (15.43±1.22)], comorbidity group[SDNN (85.73±14.34), SDANN (77.66±13.53), rMSSD (23.83±2.47), PNH50 (15.44±1.28)] and normal group[SDNN (128.89±16.34), SDANN (120.37±12.74),rMSSD (45.61±5.57),PNH50 (34.72±3.53)] (P<0.01), patient group[SDNN (100.53±10.25),SDANN (97.55±10.13),rMSSD(39.51±3.07),PNH50 (25.32±2.01)] (P<0.05). there was significantly difference in the score of life events and health total scale between control group and the depressive group, the anxious group, the patient group.There was significantly difference in the score of positive life events between control and depressive group (P<0.01). There was significantly difference in the score of negative life events between between control group and the depressive group, the anxious group, the patient group (P<0.01). There was significantly difference in the score of life events, positive life events, negative life events, health scale between control group[(20.56±2.78), (9.78±3.52), (13.48±2.47)], (128.73±17.68)] and the comorbidity group[(39.35±12.46), (4.27±1.24), (35.11±2.99)], (90.93±12.46)] (P< 0.01). The total score of subjective support and total social support were higher significantly in the anxiety group[(48.86±2.30), (29.20±1.42)] and comorbidity group[(43.65±1.05), (25.52±0.68)] than the normal group[(38.34±2.61), (21.57±1.37)] (P<0.01). Sleep quality (1.53±0.18) and total score of sleep (7.39±0.69) in comorbidity groupwas higher than that of control group (0.65±0.04), (4.89±0.-72) (P<0.01). There was difference in the score of whole sleep, sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances between control and arrhythmia patients (P<0.05). Conclusions:1. diversity and unpredictability of stress factor was key for CUMS rat model.The decreased locomotion, loss of interest and anhedonia founded in the CUMS animal model are similar to the feature of human depression.the behavioral changes produced by CUMS can maintain a long time and antidepressant drugs was effect. Thus, this animal model of depression seems indeed meet medical research.2. It is possible organic foundation of myocardial tissue electric excitation change for the infiltration of lymphocytes and the neutrophil and myocardial fibrosis in the myocardial tissue by stress.It is possible sympathetic nerve remodeling organic foundation by longing FPD of thoracic spinalcordl-5 nerves, increasing GAP-43, TH, CHAT of heart and extending atrium FPD for stress arrhythmia.3. the Arrhythmia Patients with anxiety and depression is lower significantly in HRV time domain indexes (SDNN, SDANN, rMSSD, PNN50), it is indicated that the functional status of vegetative nerve of patients is unbalance and function is dysfunction.it is possible that the function of vegetative nerve will be more serious in comorbidity group for psychological disorder of health, sleep quality, life events stress, social support.lt is easily to malignancy arrhythmia. Anxiety is also an important and influent factor of arrhythmia.