ABSTRACT
Heart failure (HF) is a global public health problem with high morbidity and mortality. Numerous studies have shown that HF is caused by severe disturbance of energy metabolism, resulting in insufficient cardiac energy supply. This lack of energy could lead to a failure of the heart to pump blood and a failure of energy metabolism in other organs throughout the body. Currently, therapeutics of HF work by reducing heart rate and cardiac preload and afterload, symptomatic treatment, or delaying the progression of the disease. However, drugs targeting heart energy metabolism have not been developed. the main characteristics of cardiac energy metabolism, metabolic changes during HF were summarized and drugs that improve cardiac function through energy metabolism were discussed, which could provide a new research direction for the development and application of drugs in treatment of heart failure.
ABSTRACT
The quality of Astragali Radix (AR) was closely related to the growth period. However, the current commodity grades of AR were only divided by diameter but not directly related to the growth period, which leads to the contradiction between the grade standard and the quality evaluation index. Therefore, solving this problem will be the key for the quality evaluation of AR. The present study established a potential quality evaluation approach for the absolute growth years' wild Astragali Radix (WAR) and transplanted Astragali Radix (TAR) based on the chemical components and anti-heart failure efficacy through adopting a bare-handed sections approach to rapidly identify the growth years of WAR. In this study, the absolute growth years of WAR were obtained by identifying the growth rings of 1-6 growth years root through the methods. The contents of flavonoids and saponins in 2-6 growth years' WAR were determined by HPLC-UV-ELSD. The contents of 12 chemical components and the anti-fatigue failure effects of WAR (4-year-old) and TAR were compared on rat models of heart failure induced by doxorubicin. Meanwhile, NMR-based untargeted metabolomics studies were performed to investigate the regulative effects of WAR and TAR. The result shows that the numbers of growth rings were consistent with the actual growth periods of AR. The HPLC-UV-ELSD determination indicated that the content of total flavonoids in WAR was significantly higher than that in TAR. Pharmacodynamics analysis revealed that the effects of WAR on cardiac function parameters (EF, FS and LVIDs), contents of serum CK and BNP were superior to those of TAR. 13 metabolites of heart were identified that had a higher rate of change in WAR group than TAR. Overall, a rapid identification method for the growth years of WAR was established, and the fact that WAR were significantly better than TAR in the heart failure rats was first proved in the paper. This study provided a scientific basis for establishing a novel commodity specification and grade of AR for clinical rational drug use.
ABSTRACT
Objective To investigate the efficacy of metoprolol in the emergency treatment of chronic congestive heart failure.Methods From January 2016 to September 2018,300 cases of chronic congestive heart failure with acute attack in Zhoushan Hospital were selected.According to random number table method ,the patients were divided into two groups,with 150 cases in each group.The control group was given conventional heart failure treatment ,the observation group received conventional heart failure therapy combined with metoprolol.The clinical efficacy,heart color ultrasound indicator ,6 minutes walking distance ,NT－proBNP level,life quality score and adverse reactions were compared between the two groups.Results (1) The total effective rate of the observation group was 96.00%(141／150),which was higher than 87.33%(131／150) of the control group ( χ2 ＝7.375,P＜0.05).( 2) After treatment,the LVEDD[(58.12 ±3.89)mm],LVESD[(44.39 ±6.17) mm],NT－proBNP[(378.32 ±27.82)ng／mL] in the observation group were lower than those in the control group (t＝10.646,9.966,9.283,all P＜0.05),the LVEF [(49.36 ±6.25)%],SV[(76.29 ±6.24)mL] in the observation group were higher than those in the control group (t＝9.092,8.739,all P＜0.05).The 6－minute walking distance [(452.37 ±61.75) m] of the observation group was longer than that of the control group (t＝7.717,P＜0.05).The quality of life scores in the emotional field [(6.47 ± 1.29)points],physical field[(10.46 ±1.65)points],other fields[(10.51 ±1.32)points] and comprehensive score [(27.44 ±4.26) points] of the observation group were lower than those of the control group ( t＝9.030,9.024, 9.299,9.114,all P＜0.05).(3) During the treatment,no obvious adverse reactions occurred in the two groups. Conclusion In the emergency treatment of patients with chronic congestive heart failure,the application of conventional anti－heart failure treatment regimen metoprolol can effectively improve the patients＇heart function,and is conductive to improving their clinical efficacy and quality of life,with fewer adverse drug reactions and good safety.
ABSTRACT
Objective@#To investigate the efficacy of metoprolol in the emergency treatment of chronic congestive heart failure.@*Methods@#From January 2016 to September 2018, 300 cases of chronic congestive heart failure with acute attack in Zhoushan Hospital were selected.According to random number table method, the patients were divided into two groups, with 150 cases in each group.The control group was given conventional heart failure treatment, the observation group received conventional heart failure therapy combined with metoprolol.The clinical efficacy, heart color ultrasound indicator, 6 minutes walking distance, NT-proBNP level, life quality score and adverse reactions were compared between the two groups.@*Results@#(1)The total effective rate of the observation group was 96.00%(141/150), which was higher than 87.33%(131/150) of the control group (χ2=7.375, P<0.05). (2) After treatment, the LVEDD[(58.12±3.89)mm], LVESD[(44.39±6.17)mm], NT-proBNP[(378.32±27.82)ng/mL] in the observation group were lower than those in the control group (t=10.646, 9.966, 9.283, all P<0.05), the LVEF[(49.36±6.25)%], SV[(76.29±6.24)mL] in the observation group were higher than those in the control group(t=9.092, 8.739, all P<0.05). The 6-minute walking distance[(452.37±61.75)m] of the observation group was longer than that of the control group(t=7.717, P<0.05). The quality of life scores in the emotional field[(6.47±1.29)points], physical field[(10.46±1.65)points], other fields[(10.51±1.32)points]and comprehensive score[(27.44±4.26)points] of the observation group were lower than those of the control group(t=9.030, 9.024, 9.299, 9.114, all P<0.05). (3)During the treatment, no obvious adverse reactions occurred in the two groups.@*Conclusion@#In the emergency treatment of patients with chronic congestive heart failure, the application of conventional anti-heart failure treatment regimen metoprolol can effectively improve the patients' heart function, and is conductive to improving their clinical efficacy and quality of life, with fewer adverse drug reactions and good safety.
ABSTRACT
To investigate the spectrum-effect relationship between the fingerprint in plasma of Heishunpian (black-processed pieces of Aconit Lateralis Radix Praeparata) and its pharmacodynamic parameters (blood pressure and heart rate) after ig administration to rats, and to elucidate its effective substances. Ultra performance liquid chromatography with quadrupole and time-of-flight mass spectrometry (UPLC-QTOF/MS) was used for fingerprint profiling by analyzing plasma samples obtained after ig administration of the ethanol extract from Heishunpian to rats. Meanwhile, the blood pressure and heart rate of heart-failure rats were continuously monitored and recorded. The relationship between the absorbed fingerprint and pharmacodynamic parameters of Heishunpian was established by correlation analysis with partial least square regression (PLSR) method. A total of 13 alkaloids were detected in rat plasma, among which hypaconine, benzoylmesaconitine, benzoylhypaconitine, and 3, 13-deoxybenzoylaconitine were found to be significantly and positively related to the pharmacodynamic data with VIP > 1. Hypaconine, benzoylmesaconitine, benzoylhypaconitine, and 3, 13-deoxybenzoylaconitine are potential effective substances with anti-heart failure effects of Heishunpian.