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Saponins are the major extracts of Panax notoginseng, which is one of the most commonly used herbal medicine in East Asia. Increasing evidences suggest that Panax notoginseng saponins(PNS) have various therapeutic effects on cardiovascular diseases. The therapeutic effects of PNS is through the complex combination of saponins. Notoginsenoside R1, ginsenosides Rb1, Rg1, Rd and Re are the major components of PNS, which have been studiedthoroughly in recent years. In this review the authors summarize and compare the cardiovascular-related effects and mechanisms of these five saponins respectively. Anti-atherosclerosis, anti-inflammatory, anti-apoptosis are the most shared functions. But some of the functions are contradictory, such as GRb1 inhibit the endothelial tube formation and angiogenesis, while GRg1 promote the VEGF synthesis and angiogenic tube formation. Even GRg1 itself functions contradictory in angiogenesis. The comprehensive summary of the effects and mechanisms of saponins shed lights on the understanding of the diverse functions PNS exert, and lay groundwork for the development and utilization of saponins in cardiovascular diseases
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Objective To assess the clinical value of serum uric acid levels in patients with acute ST-elevation myocardial infarction(STEMI).Methods A total of 502 consecutive patients with STEMI were enrolled from January 2005 to December 2010 for retrospective study.The level of serum lipid,echocardiographic data and in-hospital major adverse cardiovascular events(MACE)in patients with hyperuricemia(n =119)were compared with those in patients without hyperuricemia(n =383).The relationship between the level of serum uric acid and the degree of diseased coronary artery was analyzed.All data were analyzed with SPSS version 17.0 software to make t test and x2 test and Pearson correlation analysis.Results Serum uric acid level was positively correlated with serum triglyceride level.Compared with non-hyperuricemia patients,hyperlipidemia was more commonly found among hyperuricemia patients (43.7％ vs.33.7％,P =0.047),and serum triglyceride level was significantly higher in hyperuricemia patients[(2.11 ± 1.24)mmol/L vs.(1.78 ± 1.38)mmol/L,P =0.014].But a significant association between serum uric acid level and one or more diseased vessels was not observed(P ≥ 0.05).Leftventricular end-diastolic diameter(LVEDd)was found to be larger in hyperuricemia patients than non-hyperuricemia patients[(53.52 ±6.19)mm vs.(52.18 ±4.89)mm,P =0.041].Higher incidence in left systolic dysfunction and diastolic dysfunction was discovered in hyperuricemia patients(36.4％ vs.15.1％,P ＜0.01; 68.2％ vs.55.8％,P =0.023).Also,hyp-eruricemia patients had more in-hospital MACE(P ＜ 0.05).Conclusions Serum uric acid level is positively correlated with serum triglyceride level,but not with the severity of coronary artery disease.Hyperuricemia patients after STEMI tended to have higher incidence in left systolic dysfunction and diastolic dysfunction,and have more in-hospital MACE.
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Objective To assess the value of real-time myocardial contrast echocardiography (RTMCE) and intermittent triggered myocardial contrast echocardiography (ITMCE) in the detection of myocardial no-reflow phenomenon after reperfusion in acute myocardial infarction on mini-swine models. Methods Thirty close-chest mini-swines were used to create acute myocardial infarction and reperfusion model through interventional method. RTMCE and ITMCE were performed at baseline, 2 h after occlusion of left anterior descending coronary artery and 3 h after reperfusion. The myocardial perfusion defects after occlusion was measured as risk area (RA) and that after reperfusion was measured as no-reflow area (NRA). NRA/RA was calculated and compared with pathological findings. Results The whole study protocol was successfully performed in 27 mini-swines. NRA/RA obtained from RTMCE, ITMCE and pathological staining was (47.94±21.29)%, (38.20±21.04)% and (30.07±14.62)% , respectively. NRA/RA had no significant difference by ITMCE and pathological staining (P=0.124), RTMCE and ITMCE (P=0.071). The correlation coefficient of RTMCE and staining was 0.700 (P<0.001), ITMCE and staining was 0.765 (P<0.001), RTMCE and ITMCE was 0.897 (P<0.001). The sensitivity, specificity and accuracy in the detection of myocardial no-reflow was 100%, 58.33% and 79.17% for RTMCE, 91.67%, 73.33% and 81.48% for ITMCE. Conclusion Both RTMCE and ITMCE could be used as noninvasive methods to reveal the myocardial perfusion and quantitatively detect myocardial no-reflow after reperfusion therapy.
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Objective To investigate the level of platelet activating factor (PAF) in acute myocardial infarction (AMI) in minipig model and patients, and to study the relationship between PAF and lethal arrhythmia referring to ventricular fibrillation and ventricular tachycardia. Method ( 1 ) The levels of PAF in minipig models ( n = 20) were measured by using ELISA before and 1h after occlusion of left anterior descending coronary artery with balloon at the junction of 1/3 middle and distal portion. The lethal arrythmia was recorded by using electrocardiography. (2) In patients with AMI (n = 72), the levels of PAF were measured on arrival, and 24 h,48 h and 72 h later. The lethal arrythmia, acute heart failure and cardiogenic shock were documented. Results ( 1 ) In minipigs with occlusion of coronary artery for one hour, the mean level of PAF increased from (4.66± 2.89)ng/mL to (6.00±2.82) ng/mL,and thus the increment in PAF was (1 .34± 1.40) ng/mL (P ＜ 0.05). In 13 minipigs with lethal anythmia after occlusion of coronary artery for one hour, the increment in mean level of PAF was ( 1.92 ± 1 .34) ng/mL, whereas the increment in mean level of PAF in other 7 minipigs without lethal arrythmia after occlusion of coronary artery for one hour was as low as (0.28 ± 0. 74 ) ng/mL ( P ＜ 0. 05 ). ( 2 ) In patients, the mean levels of PAF on arrival, 24 h,48 h,and 72 hous after admission were (0.47 ± 0.05) ng/mL,(2.38±0.12) ng/mL,(3.65±0.15) ng/mL and (3.02±0.10) ng/mL, respectively. Of 72 ACI patients, 40 (55%) had complication of lethal arrythnia, heart failure or cardiogenic shock and their mean level of PAF 48 h after admission was (4.72 ± 0.16) ng/mL, whereas mean level of PAF in other 32 (44.44%) without complications was (2.31 ±0.03) ng/mL ( P ＜0.05). Conclusions The level of PAF increased after acute myocardial infarction, and the minipigs and AMI patients complicated with lethal arrythmia had higher levels of PAF.
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Objective To investigate the method and the efficacy of applying irrigated tip catheter in radiofrequency ablation Methods The study included 6 patients (M/F 4/2, mean age 34 2?16 7), 2 patients had common atrial flutter, 2 had right outflow tract ventricular tachycardia (ROVT) and other 2 had epicardial atrioventricular accessory pathways All patients failed ablation with conventional radiofrequency (RF) ablation An irrigated tip catheter ablation was performed on these patients Results Bidirectional isthmus block was achieved in 2 patients with common atrial flutter; the successful ablation was achieved in 2 patients with ROVT; V A dissociation was appeared in 2 patients with epicardial atrioventricular accessory pathway, the mean application was 3 4?1 2, the mean time of procedure was 92 4?30 3 minutes, the mean exposure time of X ray was 29 3?12 6 minutes No side effects and no coronary damage was observed Conclusion Irrigated tip catheter ablation is safe and effective for achieving successfully ablation of tachycardia when conventional RF energy has failed