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Objective·To investigate the value of hypoxia-inducible factor 1α (HIF-1α) in diagnosis and prognosis of acute decompensated chronic heart failure (CHF).Methods·32 patients with acute decompensated CHF (Group A),33 patients with stable CHF (Group B) and 30 controls (Group C) were included.HIF-1α,B-type natriuretic peptide (BNP) and other biochemical indicators in blood were detected.Length of stay and readmission frequency within 3 months of Group A were recorded.Correlations between HIF-1α and other indicators were analyzed.ROC curves of HIF-1α and BNP were developed to compare their diagnostic values.Results·The HIF-1α and BNP levels of Group A were both significantly higher than those of Group B and Group C (P＜0.05).HIF-1α was positively correlated with serum creatinine,hemoglobin,BNP,length of stay and readmission frequency within 3 months (P＜0.05).Areas under curves of HIF-1α and BNP showed no statistically difference (P＞0.05).Conclusion·HIF-1 α has a certain value in diagnosis and prognosis of acute decompensated CHF.
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To investigate the effects of telmisartan on body fat distribution and insulin sensitivity in patients with hypertension and obesity. In this prospective, randomized study, outpatients from the Sixth People's Hospital affiliated to Shanghai Jiaotong University, Shanghai, China were treated with telmisartan [n=23], or losartan [n=22] for 16 weeks between December 2009 to January 2011. Parameters such as waist and hip circumference, body mass index, fasting blood glucose, insulin, lipids, serum adiponectin, and tumor necrosis factor-alpha [TNF-alpha] were measured before and after treatment. The abdominal visceral fat area [VFA] and subcutaneous fat area [SFA] were determined by magnetic resonance imaging. Insulin sensitivity was estimated by homeostasis model assessment [HOMA-IR]. Compared with baseline, the systolic and diastolic blood pressure decreased significantly in both groups. However, the levels of HOMA-IR, serum adiponectin, and TNF-alpha only improved in the telmisartan group. Similarly, the VFA was reduced in the telmisartan group, while the SFA did not change in either group. Telmisartan improves both hemodynamic and metabolic abnormalities found in hypertensive patients with obesity. The additional benefits may be partly due to visceral fat remodeling
Subject(s)
Humans , Male , Female , Insulin Resistance , Hypertension , Adipose Tissue/drug effects , Obesity , Intra-Abdominal Fat/drug effectsABSTRACT
<p><b>OBJECTIVE</b>To assess the efficacy and safety of azosemide in patients with edema and ascites.</p><p><b>METHODS</b>A multicentral, randomized, double-blind, controlled clinical trial was applied. All 223 patients (cardiac edema 92, hepatogenic edema 63, renal edema 68) were randomized to azoesmide and furosemide group, and all patients were treated for 2 weeks. Patients with cardiac or renal edema took azosemide (30 mg/d) or furosemide (20 mg/d); patients with hepatogenic edema took azosemide (60 mg/d) or furosemide (40 mg/d). The dosage were adjusted to azosemide 60 mg/d (cardiac, renal edema), 90 mg (hepatogeic edema); or furosemide 40 mg/d (cardiac, renal edema), 60 mg (hepatogeic edema), if diuretic effects were not obtained at the end of third day.</p><p><b>RESULTS</b>At the end of the study, the weight changes were (2.87+/-3.10) kg and (2.81 +/-2.84) kg; the total effective rate of edema lessen was 89.19% and 89.81%; the total effective rate of heart function improvement was 64.44% and 66.66%; the 24 h urine output increased (321.85 +/-669.52) ml and (273.80 +/-645.72) ml for azosemide and furosemide, respectively. The total effective rate of ascites lessen (tested by B-ultrasound) was 89.28% and 86.66%; abdominal girth decreased (5.20 +/-3.58) cm and (5.03 +/-3.74) cm for azosemide and furosemide, respectively. The adverse event rate was 23.01% in azosemide group and 21.01% in furosemide group; the main adverse effects were hypokalemia, hyperuricemia, hypertriglyceridemia and thirsty.</p><p><b>CONCLUSION</b>Azosemide could effectively lessen edema, improve heart function and decrease ascitesûit is well tolerated and is particularly useful for the diuretic treatment.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Ascites , Drug Therapy , Diuretics , Therapeutic Uses , Double-Blind Method , Edema , Drug Therapy , Edema, Cardiac , Drug Therapy , Heart Failure , Kidney Diseases , Liver Cirrhosis , Sulfanilamides , Therapeutic UsesABSTRACT
Objective:To observe the effect of percutaneous tr ansluminal coronary angioplasty (PTCA) on coronary circulating tumor necrosis fa ctor-α (TNF-α) activity. Methods: Plasma TNF-α levls were measured with radioimmunoassay and bioactive assay respectively. Result s: Plasma TNF-α activity in femoral artery (AO) was significantly incr eased immediately after PTCA ［(15.86±3.75) U/ml vs （41.32±4.36） U/ml， P<0.01］, and plasma TNF-α activity in coronary sinus was remarkably incre ased immediately after PTCA ［(16.72±4.14） U/ml vs （65.61±6.25） U/ml, P<0.01］. There was no change in plasma TNF-α activity in AO 24 h after PT CA ［(18.32±5.12） U/ml vs （15.86±3.75） U/ml, P>0.05］. Conclu sion: The increase in plasma TNF-α activity after PTCA may be associat ed with the injury of coronary artery caused by PTCA, suggesting that TNF-α ma y be involved in the coronary occlusion and the development of coronary restenos is after PTCA.
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Objective: To investigate the efficacy and safety of naftopidil on patients with mild-to-moderate essential hypertension. Methods: A prospective, open study was performed in patients with hyp ertension. Forty patients were administered naftopidil for 8 weeks. Results:BP decreased significantly 2 weeks after administration an d reached to its trough at week 4. The magnitudes were 2.28 kPa (17.1 mmHg) and 1.43 kPa (10.7 mmHg) for SBP and DBP, respectively. The effect lasted to the end of experiment. HR had no change.The total effective rate was 82.05%.There was n o significant change in liver and renal function and electrocardiograph. Conclusion: Naftopidil has a stable hypotensive effect and the complia nce is good.
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Objective: To investigate the effects of pravastatin o n atherosclerotic plaque and cardiovascular events. Methods: Fifty- seven patients with coronary artery disease (44 male and 13 female, 58.4±11.3 y ears) were randommized into pravastatin and control groups. The patients in prav astatin group were administered 10 mg of pravastatin from the night of coronary angiography day. After 7.3 months (mean) of follow-up, plasma lipid parameters and coronary angiograph were repeated. Results: (1) A favorable effect on plasma lipid parameters was found. After administration, total choles terol(TC), low density lipoprotein cholesterol (LDL-C) and triglyceride(TG) red uced by 15.0% (P<0.01), 18.0% (P<0.01) and 6.0%, respectively. High den s ity lipoprotein cholesterol(HDL-C) increased by 10.6%. However, in control grou p, TC and LDL-C showed a tendency to reduce, but no significant difference was found between those of pre- and post-administration. (2)There was no significa nt difference in luminal diameter between pre- and post-administration in both groups. (3) Cardiovascular events in pravastatin group was significantly lower than those in control (P<0.05). (4) Pravastatin had no significant effect on HR, BP and left ventricular ejection fraction in both groups. Conclusio n: Pravastatin can stabilize coronary atherosclerostic plaque and reduce the incidence of cardiovascular events by improving plasma lipid parameters.
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Objective: To assess the effect of balloon angiopl asty on circulating endothelin (ET) and TNF-α levels and tissue endothelin in experimental atherosclerosis in rabbits. Methods: After 20 New Z ealand rabbits had a high cholesterol diet for at least 8 weeks, successful ball oon angioplasty was performed in rihgt iliac arteries in 18 rabbits. Circulatin g levels of ET and TNF-α were measured before as well as immediately and 24 h after balloon angioplasty. Tissue endothelin immunoreactivity in atherosclerotic iliac artery wall after balloon angioplasty was assessed by immunohistochemica l technique. Results: Plasma levels of ET and TNF-α were signi ficantly increased immediately after ballon angioplasty (76.40±13.58)pg/ml vs (92.67±11.38) pg/ml and (31.35±6.23) U/ml vs (56.26±7.37) U/ml, resp ectively (P<0.05) .There was no change in plasma ET and TNF-α levels 24 h after balloon angioplasty (77.13±12.87) pg/ml vs (76.40±13.58) pg/ml and (33.41±6.79) U/ml vs (31.35±6.23) U/ml， respectively (P>0.05). T issue endothelin immunoreactiuvity was markedly increased in right iliac artery wall after balloon angioplasty than that in opposite iliac artery wall. Conclusion: The increase of plasma ET, TNF-α levels and tissue ET-IR in iliac artery wall after balloon angioplasty may be associated with the injury of l ocal vascular intima, suggesting that ET and TNF-α may take part in the corona ry constriction and the development of coronary restenosis after percutaneous tr ansluminal coronary angioplasty.
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Objective: To investigate the changes of myo cardial contractile function during myocardial stunning in calcium overload rats and the protective effects of tetrandrine. Methods: Forty-six rats were randomized into control, myocardial ischemia, myocardial stunning, low and high dose of tetrandrine groups. Another 10 rats were used to identify the calcium overload. vitamin D3 (0.3 million Unit/kg) and nicotinic acid were adm inistered. After 16 d when calcium overload occured, left anterior descending ar tery was ligated. Twenty minutes of myocardial ischemia followed by 60 min of re perfusion was induced. The contractile function parameters were determined dynam ically. At the end of experiment, myocardial cytosolic ［Ca2+］i was deter mined in various groups. In tetrandrine groups, tetrandrine (62.2 or 93.6 μmol/ kg ) was administered by gastrogavage daily.After 16 d, the rats undergone the e xperiments mentioned above. Results: Sixteen days after vitamin D3 , nicotinic acid were given, ［Ca2+］i increased by 2.6 folds (146.8±10.8 ) vs (368.5±22.6) nmol/L, (P<0.01). Whereas, ［Ca2+］i in tetrand rine groups were (210.8±16.4) and (198.6±15.3) nmol/L, which were significantl y lower than that of calcium overload group. Twenty minutes of myocardial ische mia resulted in the decrease of dp/dtmax and Vmax in all groups with the most si gnificant in stunning and calcium overload groups. The contractile function rest ored gradually after reperfusion. At all time points, dp/dtmax and Vmax in both tetrandrine groups were higher than those in both stunning and calcium overload groups. And effect with higher dose of tetrandrine were more significant than in low dose of tetrandrine. After 60 min of reperfusion, dp/dtmax in stunning, cal cium overload, low and high dose of tetrandrine groups were 49.7%, 51.5%, 71.0% and 83.4% of that in control, respectively， and Vmax were 55.0%, 49.8%, 73.9% and 77.5% of that in control, respectively. Conclusion: T he myocardial contractile function in vitamin D3-induced calcium overload gro up is impaired. On basis of myocardiocyte calcium overload, transient ischemia l eads to myocardial stunning. At the stage of ischemia, the impaired degree of my ocardial contractile function is similar to that in stunning group, suggesting a t this stage the effect of ischemia on myocardial function is greater than that of calcium overload. Tetrandrine chronically improves the myocardial function in Vitamin D3-induced calcium overload rats.
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Objective:To observe the effect of percutaneous tr ansluminal coronary angioplasty (PTCA) on coronary circulating tumor necrosis fa ctor-α (TNF-α) activity. Methods: Plasma TNF-α levls were measured with radioimmunoassay and bioactive assay respectively. Result s: Plasma TNF-α activity in femoral artery (AO) was significantly incr eased immediately after PTCA ［(15.86±3.75) U/ml vs （41.32±4.36） U/ml， P<0.01］, and plasma TNF-α activity in coronary sinus was remarkably incre ased immediately after PTCA ［(16.72±4.14） U/ml vs （65.61±6.25） U/ml, P<0.01］. There was no change in plasma TNF-α activity in AO 24 h after PT CA ［(18.32±5.12） U/ml vs （15.86±3.75） U/ml, P>0.05］. Conclu sion: The increase in plasma TNF-α activity after PTCA may be associat ed with the injury of coronary artery caused by PTCA, suggesting that TNF-α ma y be involved in the coronary occlusion and the development of coronary restenos is after PTCA.
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Objective: To investigate the efficacy and safety of naftopidil on patients with mild-to-moderate essential hypertension. Methods: A prospective, open study was performed in patients with hyp ertension. Forty patients were administered naftopidil for 8 weeks. Results:BP decreased significantly 2 weeks after administration an d reached to its trough at week 4. The magnitudes were 2.28 kPa (17.1 mmHg) and 1.43 kPa (10.7 mmHg) for SBP and DBP, respectively. The effect lasted to the end of experiment. HR had no change.The total effective rate was 82.05%.There was n o significant change in liver and renal function and electrocardiograph. Conclusion: Naftopidil has a stable hypotensive effect and the complia nce is good.
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Objective: To investigate the effects of pravastatin o n atherosclerotic plaque and cardiovascular events. Methods: Fifty- seven patients with coronary artery disease (44 male and 13 female, 58.4±11.3 y ears) were randommized into pravastatin and control groups. The patients in prav astatin group were administered 10 mg of pravastatin from the night of coronary angiography day. After 7.3 months (mean) of follow-up, plasma lipid parameters and coronary angiograph were repeated. Results: (1) A favorable effect on plasma lipid parameters was found. After administration, total choles terol(TC), low density lipoprotein cholesterol (LDL-C) and triglyceride(TG) red uced by 15.0% (P<0.01), 18.0% (P<0.01) and 6.0%, respectively. High den s ity lipoprotein cholesterol(HDL-C) increased by 10.6%. However, in control grou p, TC and LDL-C showed a tendency to reduce, but no significant difference was found between those of pre- and post-administration. (2)There was no significa nt difference in luminal diameter between pre- and post-administration in both groups. (3) Cardiovascular events in pravastatin group was significantly lower than those in control (P<0.05). (4) Pravastatin had no significant effect on HR, BP and left ventricular ejection fraction in both groups. Conclusio n: Pravastatin can stabilize coronary atherosclerostic plaque and reduce the incidence of cardiovascular events by improving plasma lipid parameters.
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Objective: To assess the effect of balloon angiopl asty on circulating endothelin (ET) and TNF-α levels and tissue endothelin in experimental atherosclerosis in rabbits. Methods: After 20 New Z ealand rabbits had a high cholesterol diet for at least 8 weeks, successful ball oon angioplasty was performed in rihgt iliac arteries in 18 rabbits. Circulatin g levels of ET and TNF-α were measured before as well as immediately and 24 h after balloon angioplasty. Tissue endothelin immunoreactivity in atherosclerotic iliac artery wall after balloon angioplasty was assessed by immunohistochemica l technique. Results: Plasma levels of ET and TNF-α were signi ficantly increased immediately after ballon angioplasty (76.40±13.58)pg/ml vs (92.67±11.38) pg/ml and (31.35±6.23) U/ml vs (56.26±7.37) U/ml, resp ectively (P<0.05) .There was no change in plasma ET and TNF-α levels 24 h after balloon angioplasty (77.13±12.87) pg/ml vs (76.40±13.58) pg/ml and (33.41±6.79) U/ml vs (31.35±6.23) U/ml， respectively (P>0.05). T issue endothelin immunoreactiuvity was markedly increased in right iliac artery wall after balloon angioplasty than that in opposite iliac artery wall. Conclusion: The increase of plasma ET, TNF-α levels and tissue ET-IR in iliac artery wall after balloon angioplasty may be associated with the injury of l ocal vascular intima, suggesting that ET and TNF-α may take part in the corona ry constriction and the development of coronary restenosis after percutaneous tr ansluminal coronary angioplasty.
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Objective: To investigate the changes of myo cardial contractile function during myocardial stunning in calcium overload rats and the protective effects of tetrandrine. Methods: Forty-six rats were randomized into control, myocardial ischemia, myocardial stunning, low and high dose of tetrandrine groups. Another 10 rats were used to identify the calcium overload. vitamin D3 (0.3 million Unit/kg) and nicotinic acid were adm inistered. After 16 d when calcium overload occured, left anterior descending ar tery was ligated. Twenty minutes of myocardial ischemia followed by 60 min of re perfusion was induced. The contractile function parameters were determined dynam ically. At the end of experiment, myocardial cytosolic ［Ca2+］i was deter mined in various groups. In tetrandrine groups, tetrandrine (62.2 or 93.6 μmol/ kg ) was administered by gastrogavage daily.After 16 d, the rats undergone the e xperiments mentioned above. Results: Sixteen days after vitamin D3 , nicotinic acid were given, ［Ca2+］i increased by 2.6 folds (146.8±10.8 ) vs (368.5±22.6) nmol/L, (P<0.01). Whereas, ［Ca2+］i in tetrand rine groups were (210.8±16.4) and (198.6±15.3) nmol/L, which were significantl y lower than that of calcium overload group. Twenty minutes of myocardial ische mia resulted in the decrease of dp/dtmax and Vmax in all groups with the most si gnificant in stunning and calcium overload groups. The contractile function rest ored gradually after reperfusion. At all time points, dp/dtmax and Vmax in both tetrandrine groups were higher than those in both stunning and calcium overload groups. And effect with higher dose of tetrandrine were more significant than in low dose of tetrandrine. After 60 min of reperfusion, dp/dtmax in stunning, cal cium overload, low and high dose of tetrandrine groups were 49.7%, 51.5%, 71.0% and 83.4% of that in control, respectively， and Vmax were 55.0%, 49.8%, 73.9% and 77.5% of that in control, respectively. Conclusion: T he myocardial contractile function in vitamin D3-induced calcium overload gro up is impaired. On basis of myocardiocyte calcium overload, transient ischemia l eads to myocardial stunning. At the stage of ischemia, the impaired degree of my ocardial contractile function is similar to that in stunning group, suggesting a t this stage the effect of ischemia on myocardial function is greater than that of calcium overload. Tetrandrine chronically improves the myocardial function in Vitamin D3-induced calcium overload rats.