Clinical study on microcirculation resistance index for predicting major adverse cardiac events after PCI operation in patients with ST segment elevation myocardial infarction / 重庆医学

Objective To investigate the clinical value of the index of microcirculation resistance(IMR) in the prediction of major adverse cardiac events after PCI in the patients with ST segment elevation myocardial infarction.Methods Forty-eight inpa tients with acute ST segment elevation myocardial infarction(STEMI) in the cardiology department CCU of our hospital from December 2013 to June 2015 were selected,including 38 males and 10 females,and divided into 3 groups according to the measured IMR value after PCI operation:the group A,IMR≤25(n=18);group B,IMR 25 ～ 32 (n =16);group C,IMR≥32 (n =14).Serum NT-ProBNP was collected,and the data in cardiac color ultrasound after PCI and at postoperative 1 year:left ventricular ejection fraction(LVEF) and left ventricular end diastolic diameter(LVEDD),and major adverse cardiac events within 1 years after PCI were also collected.Results The serum of concentrations NT-ProBNP were compared among the three groups[(2 734.83 ± 1 009.40) vs.(4 929.68±611.52) vs.(7 480.64±2 082.78)],and the difference among 3 groups was statistically significant (F=35.449,P=0.000).The difference of LVEF among the three groups had statistal significance[(54.00-±-5.99) vs.(52.31 ± 4.35)vs.(49.29 ±4.68),F=3.376,P=0.043)],and there was no statistical difference among the three groups in LVEDD(P＞0.05).The difference of LVEF at postoperative 1 year among 3 groups had statistical significance[(57.28 ± 5.21)vs.(54.43 ±3.69)vs.(46.43±5.33),F=16.744,P=0.000],and the difference of LVEDD (48.94±1.95)vs.(50.63±2.68)vs.(52.14±2.69) among 3 groups was statistically significant(F=6.875,P=0.002).The differences in the major adverse cardiac events,cases of cardiac death and cases of heart failure after postoperative 1 year among 3 groups were statistically significant(x2 value=6.707,P=0.035;x2 value=6.084,P=0.048);the occurrence of again ACS,again PCI and malignant arrhythmia had no statistical difference among 3 groups(P＞0.05).Conclusion Measurement of IMR after PCI in the patients with STEMI can effectively predict the heart function and the risk of major adverse cardiac events within 1 year.

Effect of compound Danshen dripping pills combined with atorvastatin on restenosis after angioplasty in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of compound Danshen dripping pills and atorvastatin on restenosis after abdominal aorta angioplasty in rabbits.</p><p><b>METHODS</b>Rabbit models of abdominal aorta restenosis after angioplasty were established and treated with saline (group A), compound Danshen dripping pills (group B), atorvastatin (group C), or compound Danshen dripping pills plus atorvastatin (group D). HE staining was used to determine the thickness of arterial intimal hyperplasia and assess the morphological changes of the narrowed artery. Immunohistochemistry was employed to detect the expression of nuclear factor-κB (NF-κB) and monocyte chemoattractant protein-1 (MCP-1).</p><p><b>RESULTS</b>Compared with group A, the 3 treatment groups showed significant increased vascular cavity area and reduced intimal area and percentage of intimal hyperplasia (P<0.05). The vascular cavity area, intimal area and percentage of intimal hyperplasia levels differed significantly between group D and groups B and C (P<0.05). Immunohistochemistry showed a significant reduction of the expression rate of NF-κB and MCP-1 in the 3 treatment groups compared with group A (P<0.05), and the reduction was especially obvious in group D (P<0.05).</p><p><b>CONCLUTIONS</b>Compound danshen dripping pills combined with atorvastatin produces better effects than the drugs used alone in inhibiting vascular smooth muscle cell proliferation in rabbits after abdominal aorta angioplasty possibly due to a decreased expression of MCP-1 as a result of NF-κB inhibition.</p>

Paeonol inhibits vascular smooth muscle cell proliferation by regulating proliferating cell nuclear antigen and P27kip1 expression / 中华老年医学杂志

Objective To study the preventive effect of paeonol on restenosis after angioplasty in rabbit balloon injury model and its mechanism.Methods Male New Zealand white rabbits with clean grade were selected.Balloon injury rabbit abdominal aorta combined with high cholesterol diet were used to establish rabbit atherosclerosis model.We used balloon to dilate the narrow abdominal aorta.The animals were randomly divided into four groups (control group,low concentration paeonol group,high concentration paeonol group and rapamycin group).Animals in different group were orally given normal saline 2 ml · kg-1 · d-1,low concentration of paeonol 75 mg · kg-1 · d-1,high concentration of paeonol 150 mg · kg-1 · d-1,rapamycin administrated with 1.25 mg · kg-1 · d-1 for six weeks respectively.After 6 weeks,the animals were killed by air embolism,and immediately dissected to remove the abdominal aorta.We used hematoxylin and eosin(HE) staining and Masson staining to detect the thickness of the arterial intimal hyperplasia and the gross morphological changes of the narrow artery.Immunohistochemical staining was used to detect changes of proliferating cell nuclear antigen (PCNA) expression level.Western blotting was used to discover P27kip1 protein expression in the narrow artery.Results Paeonol and rapamycin reduced the degree of intimal hyperplasia.The neointima areas in the control group,low concentration paeonol group,high concentration paeonol group and rapamycin group were (0.16±0.03),(0.09±0.01),(0.05±0.01) and (0.04±0.01) respectively; the ratio of neointimal area to media area was (90.62 ±3.43),(42.30 ±2.94) (33.72±3.19) and (28.78±6.67) respectively; the intimal area proliferation rate was (33.3 ± 3.1) ％,(23.2 ± 2.2) ％,(17.5 ± 1.5) ％ and (16.2 ± 1.7) ％ respectively.There were significant differences in the neointima area,ratio of neointimal area to media area,and the intimal area proliferation rate among the four groups (F=47.98,257.25,74.60,all P＜0.05).The expression level of PCNA and P27kip1 protein were (0.20±0.04),(0.06±0.02),(0.05±0.02) and (0.08± 0.02),and (0.47±0.09),(0.78±0.20),(1.29±0.12) and (1.83±0.13) in the control group,low concentration paeonol group,high concentration paeonol group and rapamycin group respectively,and the differences were statistically significant between the four groups (F=37.22 and 107.69,both P＜0.01).Conclusions Paeonol plays a role in anti-vascular smooth muscle cell proliferation.This effect may be through inhibiting the expression of PCNA,and increasing the expression of P27kip1 in the cell cycle.