Effect of Astragalus injection on cardiomyocyte apoptosis, endoplasmic reticulum stress and expression of connexin in cardiomyopathy rats induced by adriamycin / 中国应用生理学杂志

OBJECTIVES@#To investigate the effect of Astragalus injection on cardiomyocyte apoptosis, endoplasmic reticulum stress and connexin protein in cardiomyopathy rats induced by adriamycin.@*METHODS@#Thirty-six male Wister rats were randomly divided into control group (=12), adriamycin(ADR) group (=12) and Astragalus group (=12). The normal saline (10 ml/kg body weight) was injected intraperitoneally in control group rats, ADR (2 mg/kg body weight) was injected intraperitoneally in ADR group rats, ADR (10 ml/kg body weight) and Astragalus injection (10 ml/kg body weight) were injected intraperitoneally in rats of astragalus group, one time a week, totle 3 times. By the end of the 7 week, the left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were measured by echocardiography. Then the rats in the three groups were sacrificed and the left ventricle section was stained by HE, Masson, uranyl acetate/lead citrate respectively, the cardiomyopathy and ultrastructural changes were observed under light microscope and transmission electron microscope. The apoptosis of rat cardiomyocyte were analyzed by TUNEL. The expression of connexin Cx43 and p-Cx43 was detected by immunohistochemistry. The expression of glucose-regulated protein 78 (Grp78),activating transcription factor 4 (ATF-4) and C/EBP homologous protein (CHOP) were detected by real time PCR.@*RESULTS@#Compared with control group, LVEDD, LVESD increased and LVEF decreased, myocardial fibers were disordered and edematous, infiltrated by lymphocytes, the mitochondria were destroyed and vacuolized, and the number of cardiomyocyte apoptosis was increased(<0.01) in ADR group. The expression of Grp78, ATF-4, CHOP and p-Cx43 were increased, and the expression of Cx43 was decreased in ADR group. However, compared with ADR group, LVEDD, LVESD decreased and LVEF increased, the cardiomyopathy and ultrastructural changes were significantly improved, the number of cardiomyocyte apoptosis was significantly decreased (<0. 01); the expression of Grp78, ATF-4, CHOP and p-Cx43 decreased (<0.01); the expression of Cx43 increased in Astragalus group (<0.01).@*CONCLUSIONS@#Astragalus injection may effectively improve the myocardial damage induced by adriamycin, its mechanism may be related to the inhibition of endoplasmic reticulum stress (ERS) and the decrease of phosphorylation of CX43 in cardiomyopathy rats induced by adriamycin.

The clinical study of circumferential ablation around orifice of pulmonary vein by radiofrequency energy with chronic atrial fibrillation undergoing rheumatic valvular heart surgery / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficiency of circumferential ablation around orifice of pulmonary vein by radiofrequency (RF) energy in the cure of chronic atrial fibrillation (AF) in patients with rheumatic valvular disease.</p><p><b>METHODS</b>Radiofrequency catheter ablation was performed in 20 patients with rheumatic valvular disease and chronic AF who underwent heart valve surgery. The ablation temperature was 50 - 60 degrees C and the linear RF ablations were performed encircling the four openings of pulmonary veins and connecting the posterior mitral annulus with the probe made by ourselves especially for this ablative procedure. And amiodarone was given from the third day before the surgery and lasted for 3 months thereafter. Twenty patients with chronic AF who underwent valvular surgery but refused RF ablation were considered as the control group.</p><p><b>RESULTS</b>Sinus rhythm (SR) restored in 19 patients either spontaneously or after intraoperative direct current cardioversion, immediately after the operation, as compared with 16 patients in the control group. During the follow-up (24 +/- 3) months, 16 of 20 patients (80%) remained in sinus rhythm in patients received ablation, but in control group, SR was presented in only 7 of 20 patients (35%).</p><p><b>CONCLUSIONS</b>Circumferential ablation around orifice of pulmonary vein by RF energy is safe and effective in restoration and maintenance of SR in patients with rheumatic valvular disease and chronic AF.</p>