Value of evaluating diastolic function with the single-beat E/(e'×s) obtained by dual doppler echocardiograph in coronary heart disease patients with preserved left ventricular systolic function / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the value of E/(e'×s) in estimating left ventricular diastolic dysfunction in patients with coronary heart disease by dual Doppler echocardiograph.</p><p><b>METHODS</b>Seventy-seven consecutive coronary heart disease patients with preserved systolic function underwent echocardiographic study were included. The E, e'and s were obtained by the dual Doppler echocardiography and E/(e'×s), E/e' were calculated. All patients underwent left ventricular catheterization to measure left ventricular end diastolic pressure (LVEDP). The relationship between E/(e'×s), E/e' and LVEDP were analyzed. Patients were divided into normal diastolic function (LVEDP < 12 mmHg, 1 mmHg = 0.133 kPa) and diastolic dysfunction group (LVEDP ≥ 12 mmHg) .</p><p><b>RESULTS</b>(1) Pearson correlation analysis showed that both E/(e'×s) and E/e' correlated well with LVEDP (r = 0.68 and r = 0.79, both P < 0.01). (2)Using receiver operating characteristic analysis, the optimal cut-off for E/(e'×s) was 1.2(sensitivity was 80%, specificity was 77%,AUC was 0.85) and for E/e' was 9.2(sensitivity was 74%, specificity was 81%,AUC was 0.87) to predict left ventricular diastolic dysfunction. When combined cut-offs of E/(e'×s) ≥ 1.2 and E/e' ≥ 9.2, the sensitivity and specificity of predicting left ventricular diastolic dysfunction were 83% and 71% respectively, and AUC was 0.87.</p><p><b>CONCLUSIONS</b>E/(e'×s) can correctly reflect diastolic function status in patients with coronary artery disease. However, combined use of E/(e'×s)and E/e' does not add the prediction value on diastolic dysfunction in this patient cohort.</p>

GRK 2 level in peripheral blood lymphocytes of elderly patients with acute myocardial infarction / 老年心脏病学杂志（英文版）

Objective To investigate the G protein-coupled receptor kinase 2 (GRK 2) level in peripheral blood lymphocytes with cardiac func-tion in elderly patients with acute myocardial infarction. Methods This study enrolled 40 patients with acute ST-segment elevation myo-cardial infarction (STEMI) and 40 patients with unstable angina. All patients were 65 years or older. Cardiac function was evaluated by echocardiography, and the GRK 2 level in peripheral blood lymphocytes was measured. Patients with STEMI were followed up for 2 years. Results The GRK 2 level in peripheral blood lymphocytes was significantly higher in patients with STEMI than in patients with unstable angina, and was negatively correlated with left ventricular ejection fraction, cardiac output, stroke volume, and left ventricular fractional shortening. The GRK 2 level was significantly elevated in some patients with acute STEMI and poor cardiac function. Conclusions In-creased GRK 2 level in patients with acute STEMI may contribute to poor myocardial systolic function and myocardial remodeling. Meas-urement of the GRK 2 level in peripheral blood lymphocytes may assist in the evaluation of cardiac function and myocardial remodeling in elderly patients with acute STEMI.

Protective effect of amlodipine against contrast agent-induced renal injury in elderly patients with coronary heart disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the protective effect of amlodipine against contrast agent-induced renal injury in elderly patients with coronary heart disease.</p><p><b>METHODS</b>A total of 189 elderly patients (>60 years) with coronary heart disease undergoing coronary artery angiography were randomly assigned into amlodipine group and control group to receive amlodipine or placebo, respectively, before and after administration of the contrast agent. At 24 h, 48 h and 5 days after contrast agent administration, the parameters of renal function were measured including serum cystatin C, urea nitrogen, creatinine, creatinine clearance rate, urine β2-microglobulin, and urine N-acetyl-β-glucosaminidase.</p><p><b>RESULTS</b>In both groups, the contrast agents obviously affected the renal functions of the patients (P<0.05). At 24 h after contrast administration, the levels of serum cystatin C, urine β2-microglobulin and urine NAG were significantly lower in amlodipine group than in the control group, but the other functional parameters showed no significant difference. At 48 h after contrast administration, the glomerular and tubular functional parameters were all superior in amlodipine group (P<0.05). At 5 days, the two groups showed significant differences in such glomerular and tubular functional parameters as urea nitrogen, creatinine, creatinine clearance rate, urine β2-microglobulin, and urine NAG (P<0.05), but not in serum cystatin C level. The incidence of contrast agent-induced nephropathy was significantly lower in amlodipine group than in the control group (5/95 vs 10/94, P<0.05).</p><p><b>CONCLUSIONS</b>Amlodipine offers protection against radiographic contrast agent-induced renal injury in elderly patients with coronary heart disease.</p>

Short-and middle-period therapeutic effects of recombinant adeno-associated viral gene transfer of sarcoplasmic reticulum Ca2+ ATPase on chronic congestive heart failure rats / 中国组织工程研究

BACKGROUND:In chronic congestive heart failure (CHF),both protein expression and activity of sarcoplasmic reticulum (SR) Ca2+ ATPase (SERCA2a) are decreased, which results in abnormal regulation of calcium ion and systole and diastole dysfunction.OBJECTIVE:To observe the short-and middle-term therapeutic effects of adeno-associated viral gene transfer of SERCA2a in treatment of CHF in rats,and to investigate the possible mechanisms.DESIGN:Randomized-controlled design.SETTING:Department of Geriatric Cardiology and Department of Pathophysiology,General Hospital of Chinese PLA.METHODS:Male Sprague-Dawiey rats,were randomized into 4 groups:sham-operation group,CHF group,CHF+ green fluorescent protein (GFP) group and CHF+SERCA2a group. Gene transfer 10 and 30 days two time points were set in each group.CHF rat models were established by coarctation of abdominal aorta.At postoperative 18 to 20 weeks,the successful rats in CHF group were intraperitoneally injected with 500 μL aseptic normal saline,and those in the CHF+ GFP group and CHF+ SERCA2a group were injected with the same dose of Adeno-associated viral gene with GFP and SERCA2a gene respectively.MAIN OUTCOME MEASURES:①At 10 and 30 days after gene transfer,hemodynamic parameters,the SERCA2a protein expression was analyzed by Western Blot,and SERCA2a activity was carded out by modified Jones method.②The difference of proteome of hearts was detected by expression proteomics in between CHF+ SERCA2a group and CHF group at 30 days.③Electrophoretic separation and quantitation of cardiac myosin heavy chain(MHC) isoforrns were done at 30 days.RESULTS: ①In CHF group and CHF+GFP group, SERCA2a expression and activity were lower than those in sham-operation group.At 10 days after gene transfer.SERCA2a expression was increased by 80.7%and still lower than that of sham-operation group,and activity was also increased by 89.9%,but still lower than that of sham-operation group.And at 30 days,the SERCA2a protein expression and activity in the CHF+SERCA2a group reached to levels of sham-operation group. ②At day 10,LVSP and LV +dp/dtmax and LV-dp/dtmax were increased and LVEDP was decreased dramatically,but they still did not reach to the levels of sham-operation group.At day 30,the parameters were normalized back to control levels.There were no significant differences in each index between CHF+SERCA2a group and sham-operation group.③Overexpression of SERCA2a increased some energy metabolic enzymes of hearts at 30 days.④There were a downregulation of α-MHC and an upregulation of 3-MHC in failing hearts.Overexpression of SERCA2a increased the expression of α-MHC and decreased the expression of β-MHC to the levels of sham-operation group at 30 days.CONCLUSION: Adeno-associated viral gene transfer of SERCA2a can enhance SERCA2a functions, maintain calcium homeostasis,improve cardiac energy metabolism,and normalize the expression of MHC isoforms in CHF rats.As a result,the heart functions can be improved. So adeno-associated viral gene transfer of SERCA2a has good therapy effects on CHF rats in short and relatively long periods.

Intrapericardial injection with a trans-diaphragmatic approach in rats / 医学研究生学报

Objective:To study the feasibility,safety and effectiveness of intrapericardial injection with a trans-diaphragmatic approach in rats and its value in the study of heart diseases. Methods:Blue-black ink,recombinant adeno-associated virus carrying enhanced green fluorescent protein((eGFP)) gene,0.9% sodium chloride solution were respectively injected into pericardium of rats in three different groups(Group ink,Group eGFP and Group sodium chloride) by intrapericardial injection with a trans-diaphragmatic approach.Autopsy was done and hemodynamic parameters were measured and cryosection was analyzed by fluorescence microscopy. Results:The injection was proved successful in all rats in Group ink.Green fluorescence was detected in cryosection of all hearts in Group eGFP and the expression of green fluorescent protein was ubiquitously,but not homongeneous.No rat died during and after the operation among the operated rats(rats in Group eGFP and Group sodium chloride).There was no difference between hemodynamic parameters of the operated rats and those of the controls.Conclusion:The intrapericardial injection with a trans-diaphragmatic approach is a simple,feasible,safe and valid operation and suitable for small experimental animals.And it suggests an easy, safe,efficient and cheap technique in the study of heart diseases.

The value of intrapericardial injection with a trans-diaphrag matic approach in the gene therapy of chronic heart failure rats / 中国病理生理杂志

AIM: To study the feasibility, security a nd validity of the intrapericardial injection with a trans-diaphragmatic approach in chronic heart failure rats and its value in the study of gene therapy for hea rt diseases, and further investigate whether adeno-associated virual gene transf er of sarcoplasmic reticulum Ca 2+-ATPase (SERCA2a) gene can improve ven tricular function in chronic heart failure (HF) rats. METHODS: An animal model of heart failure was obtained by creati ng descending aortic constriction in rats. Recombinant adeno-associated virus, c arrying enhanced green fluorescent protein (EGFP) gene and recombinant adeno-ass ociated virus carrying SERCA2a gene, were respectively injected into pericardium of heart failure rats in different groups (group HF+EGFP and group HF+SERCA2a) by intrapericardial injection with a trans-diaphragmatic approach. After 30 days , hemodynamic parameters were measured and analyzed. Cryosection was analyzed by fluorescence microscopy to examine the expression of green fluorescent protein, and Western blotting was performed to detect the expression of SERCA2a. RESULTS: Green fluorescence was detected in cryosection of the h earts in all rats in group HF+EGFP and the expression of green fluorescent prote in was ubiquitously. The expression of SERCA2a in all rats in group HF+SERCA2a w as more than those in group HF and group HF+EGFP. And overexpression of SERCA2a improved the systolic and diastolic function of heart failure rats significantly and the hemodynamic parameters were similar with those of the controls. CONCLUSION: The intrapericardial injection with a trans-diaphrag matic approach suggests a simple, safe, efficient and cheap technique for the ge ne therapy of chronic heart failure. Gene thransfer of SERCA2a may be a new appr oach for the treatment of chronic heart failure.

Short-term effects of adeno-associated viral gene transfer of SRCA2a on chronic heart failure in rats / 解放军医学杂志

Objective To study the short-term therapeutic effects of adeno-associated viral gene transfer of sarcoplasmic reticulum Ca2+-ATPase (SRCA2a) on chronic heart failure (CHF). Methods The rats were divided into four groups: control group, CHF group, CHF+eGFP group and CHF+SRCA2a group. CHF rats were obtained by creating descending aortic constriction. 0.9% sodium chloride solution, recombinant adeno-associated virus carrying enhanced green fluorescent protein (eGFP) gene, and recombinant adeno-associated virus carrying SRCA2a gene, were respectively injected into pericardium of heart failure rats in different groups by intrapericardial injection via trans-diaphragmatic approach. 10 days after gene transfer, hemodynamic parameters, the protein expression of SRCA2a and the SRCA2a activity were measured and analyzed respectively. Results 10 days after gene transfer, the protein expression and activity of SRCA2a were increased by 80.7% and 89.9% respectively, but still lower than those in the control rats. The heart function was also improved along with the increase of SRCA2a expression and activity. The left ventricular systolic pressure and the maximal rate of decline of left-ventricular pressure in CHF+SRCA2a group were similar with those of the controls. The left ventricular end-diastolic pressure and the maximal rate of rise of left-ventricular pressure were much improved, but did not reach the level of the controls. Conclusions SRCA2a protein levels and activity are significantly decreased in CHF rats. Adeno-associated viral gene transfer of SRCA2a can improve the function of the heart in short term.