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OBJECTIVE:To study the effect of Shenfu injection(SFI)on the expression profile of myocardial miRNA in rats with chronic congestive heart failure (referring to heart failure). METHODS:40 rats were randomly divided into sham operation group (normal saline,ip),model group (normal saline,ip),valsartan group (positive control,10 mg/kg,ig) and SFI group (0.75 mL/kg,im),10 in each group. Except for sham operation group,another groups were reduced heart failure. After modeling, rats in other groups received related medicines,once a day. Affymetrix miRNA V4.0 chip technology was conducted to analyze the miRNA expression in myocardial tissue of rats with heart failure after administration for 28 d,and screen the miRNA on common differential expression in myocardial tissue of rats in each group. The miRNA associated with heart failure was analyzed by thresh-old of differential gene expression multiple value greater than or equal to 1.1. Gene Ontology (GO) analysis was used to analyze functional classification and biological signaling pathway of differentially expressed genes. RESULTS:There were totally 29 miR-Nas on common differential expression and 7 miRNAs associated with heart failure (rno-miR-30c-1-3p, rno-miR-125b-5p, rno-miR-133a-5p,rno-miR-199a-5p,rno-miR-221-3p,rno-miR-146a-5p and rno-miR-1-3p). SFI can significantly downregulate the expressions of rno-miR-125b-5p,rno-miR-133a-5p,rno-miR-221-3p,rno-miR-1-3p in myocardial tissue of rats (P<0.05 or P<0.01). Results of GO analysis showed,miRNAs on differential expression were mainly related to signal transduction,cytoplasm and nucleotide binding. CONCLUSIONS:SFI plays the role of anti-heart failure by participating in the downregulation of miRNAs associated with heart failure process and then affecting related signal pathways transduction after the combination of cyto-plasm and nucleotide.
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AIM: To observe the expression of corticotropin releasing hormone (CRH) within the paraventricular nucleus of hypothalamus (PVN) and to explore the relationship between the activated CRH-containing neurons and sympathetic activity in rats with heart failure (HF).METHODS: Healthy male Sprague-Dawley (SD) rats were subjected to coronary artery ligation to induce HF, and chronic intracerebroventricular (ICV) infusion was performed by osmotic pump for 4 weeks.The rats in sham group and HF group were given vehicle (VEH;artificial cerebrospinal fluid 0.25 μL/h).The rats in HF plus treatment group were treated with CRH competitive inhibitor αh-CRH (15 mg/h).Meanwhile, the Lewis rats and Fischer 344 rats for control study also underwent coronary ligation to induce HF or sham surgery.After 4 weeks, left ventricular end-diastolic pressure (LVEDP) and maximum positive/negative change in pressure over time (±dp/dtmax) were determined.The right ventricular-to-body weight (RV/BW) and lung-to-body weight (lung/BW) ratios were calculated.The renal sympathetic nerve activity (RSNA) was recorded and the plasma norepinephrine (NE) level was measured.The expression of CRH in the PVN combined with the plasma adrenocorticotrophic hormone (ACTH) levels were measured.RESULTS: Compared with the sham-SD rats, the HF-SD rats had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased), accompanied by decreased ±dp/dtmax and increased RSNA, plasma NE, LVEDP, lung/BW and RV/BW.However, ICV treatment with αh-CRH attenuated these changes in the HF-SD rats (P<0.05).Compared with the sham-Fisher 344 rats, the HF-Fisher 344 rats also had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased).In addition, they had significantly increased RSNA and plasma NE level, higher LVEDP, RV/BW and lung/BW, and lower ±dp/dtmax (P<0.05).Compared with the SHAM-Lewis rats, the HF-Lewis rats had not significantly changed in the above parameters.CONCLUSION: In CHF, the CRH-containing neurons in PVN are activated, thus aggravating cardiac function by increasing sympathoexcitation.
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Objective To analyze the effect ofbetaloc combined with lotensin on cardiac function and N-terminal B type natriuretic peptide (NT-proBNP) level in patients with chronic congestive heart failure (CHF).Methods 210 CHF patients in People's Hospital in Qinghai Province from December 2015 to December 2016 were divided into three groups by random number table,70 cases in each.Three group were given routine examination,cardiotonic and diuretic treatment,and on this basis,control A group purely added lotensin,control B group purely added betaloc,observation goup took betaloc combined with lotensin.The cardiac function,exercise tolerance,NT-proBNP level,concentration of hemoglobin (Hb),heart rate,blood pressure,clinical efficacy and safety before and after treatment were compared among the three groups.Results Before treatment,there was no statistical difference in the cardiac function,NT-pro BNP level and Hb content among three groups;After treatment,the cardiac function and exercise tolerance of observation group were significantly better than those of control A and B group (P ＜ 0.05) The NT-pro BNP level,heart rate and blood pressure of observation group were significantly lower than those of control A and B group (P ＜ 0.05) The Hb content of observation group was higher than that of control A and B group (P ＜ 0.05).The total effective rate of observation group was significantly higher than that of control A and B group (P ＜ 0.05).There was no statistical difference in the incidence of adverse reactions among three groups.Conclusion Betaloc combined with lotensin in treatment of CHF can effectively improve cardiac function,relieve heart failure and increase exercise tolerance of patients,which has clinical application value.
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Objective To investigate the clinical efficacy of combined use of beta blocker in the treatment of chronic severe congestive heart failure (CHF). Methods 78 patients with severe chronic congestive heart failure in patients from November 2015 to January 2017 were randomly divided into study group (n=39) and control group (n=39). The control group was treated with routine treatment of chronic severe congestive heart failure, and the study group was treated with beta blocker metoprolol on the basis of routine treatment. The changes of DBP, SBP, LVEF, LVEDD and the incidence of adverse reactions were recorded before and after treatment in two groups. Results After the analysis of the two groups before treatment, DBP, SBP, LVEF, LVEDD and other indicators compared no significant difference; after the treatment of DBP, SBP, LVEDD group index decline and increase of LVEF were better than the control group, comparing the data with significant difference (P<0.05); drug therapy in the treatment of severe chronic group occurred during the study period the rate of adverse reactions in patients with congestive heart failure and there is no significant difference compared with control group. Conclusion The use of routine regimen based on the use of beta blocker metoprolol can significantly improve the clinical efficacy of patients with chronic severe congestive heart failure, and is conducive to the protection of their prognosis and quality of life.
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Objective To investigate the clinical efficacy of combined use of beta blocker in the treatment of chronic severe congestive heart failure (CHF). Methods 78 patients with severe chronic congestive heart failure in patients from November 2015 to January 2017 were randomly divided into study group (n=39) and control group (n=39). The control group was treated with routine treatment of chronic severe congestive heart failure, and the study group was treated with beta blocker metoprolol on the basis of routine treatment. The changes of DBP, SBP, LVEF, LVEDD and the incidence of adverse reactions were recorded before and after treatment in two groups. Results After the analysis of the two groups before treatment, DBP, SBP, LVEF, LVEDD and other indicators compared no significant difference; after the treatment of DBP, SBP, LVEDD group index decline and increase of LVEF were better than the control group, comparing the data with significant difference (P<0.05); drug therapy in the treatment of severe chronic group occurred during the study period the rate of adverse reactions in patients with congestive heart failure and there is no significant difference compared with control group. Conclusion The use of routine regimen based on the use of beta blocker metoprolol can significantly improve the clinical efficacy of patients with chronic severe congestive heart failure, and is conducive to the protection of their prognosis and quality of life.
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OBJECTIVE:To observe the efficacy and safety of atorvastatin calcium combined with metoprolol in the treatment of chronic congestive heart failure (CHF). METHODS:207 CHF patients were randomly divided into control group (102 cases) and observation group (105 cases). Control group received cardiac,diuretic,vasodilating and oxygen inhalation,Metoprolol tar-trate tablet with initial dose of 6.25 mg,2-3 times a day,then increased 6.25-12.5 mg based on the improvement,2-3 times a day. Observation group additionally received 80 mg Atorvastatin tablet,twice a day. The treatment course for both groups was 16 w. Clinical efficacy,cardiac functions [left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),mi-tral early diastolic and late diastolic peak flow velocity ratio(E/A)],blood lipids [lipoprotein(a)Lp(a),triglyceride(TG),total cholesterol(TC)] levels before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant (P0.05). Af-ter treatment,the LVEF and E/A in 2 groups were significantly higher than before,and observation group was higher than control group,LVESD,Lp(a),TG and TC were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P0.05). CONCLUSIONS:Based on conventional treatment,the efficacy of atorvastatin calcium combined with metoprolol is su-perior to metoprolol in the treatment of CHF,with better safety.
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OBJECTIVE:To observe the clinical efficacy and safety of Buzhong yiqi wuling decoction combined with western medicine in the treatment of chronic congestive heart failure(CHF). METHODS:120 CHF patients were divided into observation group and control group by random number table method,with 60 cases in each group. Control group received conventional western medicine treatment as rest,low salt diet and diuretics. Observation group was additionally given Buzhong yiqi wuling decoction,one dose a day,at twice,on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. Average TCM symptom score, level of plasma NT-proBNP,6 min walk test(6MWT)distance before and after treatment,clinical efficacy and the occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in average TCM symptom score,level of plasma NT-proBNP and 6MWT distance between 2 groups(P>0.05). After treatment,average TCM symptom score and level of plasma NT-proBNP of 2 groups were decreased significantly,and the observation group was more significant than the control group,with statistical significance(P<0.05);6MWT distance of 2 groups were improved significantly compared to before treatment,and the observation group was significantly longer than the control group,with statistical significance(P<0.05). After treatment,total effective rate of observation group(93.33%)was significantly higher than that of control group(83.33%),with sta-tistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Buzhong yiqi wuling decoction is an ef-fective prescription to treat CHF,and can relieve clinical symptoms,improve the cardiac function,decrease NT-proBNP level and en-hance the patient exercise tolerance with good safety.
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Objective: To analyze the effect of cardiac resynchronization therapy (CRT) in patients with chronic heart failure (CHF) combining left bundle branch block (LBBB) conformed to new diagnostic standard. Methods: A total of 19 CHF patients who received CRT in our hospital from 2005-06 to 2013-05 were studied. The patients were divided into 2 groups: True LBBB group,n=13 patients conformed to new diagnostic standard and False LBBB group, n=6 patients conformed to traditional diagnostic standard. Pre- and Post-operative LVEF, LVEDD, QRS duration (QRSd) and IVMD were compared in all patients; post-operative LVEF, LVEDD, QRSd, IVMD and Tmsv16-SD, Tmsv16-Dif were compared between 2 groups. Results: The post-operative LVEF, LVEDD, QRSd and IVMD were improved than pre-operative condition in both groups. Compared with False LBBB group, the improvements were more obvious in True LBBB group as LVEDD by mm (5.95±0.72 vs 7.13±0.78), IVMD by ms (22.45±8.00 vs 27.63±13.09), and QRSd by ms (140.38±5.80 vs 153.68±14.38), all P<0.01. The post-operative LVEF and Tmsv16-SD, Tmsv16-Dif were similar between 2 groups. Conclusion: CHF patients combining either true or false LBBB could be beneift from CRT, while the patients with true LBBB may receive better clinical outcomes from CRT.
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Objective: To study the influence and curative effect of carvedilol on serum matrix metalloproteinase -2, 9 and 10 (MMP-2, 9 and 10) in the patients with chronic congestive heart failure (CHF). Methods:Totally 76 patients with CHF were select-ed and randomly divided into the observation group and the control group. All the patients were given routine medical treatment, inclu-ding cardiotonic treatment ( digoxin) , diuresis ( thiadiazide) , vascular dilation ( nitrate ester) and so on. The patients in the observa-tion group were additionally given carvedilol for 6 months. The changes of serum MMP-2, 9 and 10 levels in the patients before the treatment and 6 months after the medical treatment were observed, and the curative effect and safety were studied as well. Results:Af-ter the 6-month medical treatment, the serum MMP-2, 9 and 10 levels in all the patients were obviously declined(P<0. 05), and the declining rates in the observation group were much higher than those in the control group(P<0. 05). Meanwhile, the total clinical effi-ciency of the observation group was 94. 74%, which was higher than that of the control group (78. 95%) (P<0. 05). Conclusion:Carvedilol has favorable curative effect and safety in the treatment of CIF, and the underlying mechanism may be relative to the de-crease of serum MMP-2, 9 and 10 levels.
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Objective To explore the therapeutic effect of erythropoietin (EPO)combined oral iron in patients with chronic congestive heart failure( CHF)accompanied by anemia. MethodsNinety six patients with CHF accompanied by anemia, whom were consecutively hospitalized from January 2007 to December 2009, were enrolled into this study. They were randomly divided into treatment group accepted routine anti-heart failure therapy combined EPO and oral iron, and control group solely accepted routine anti-heart failure therapy. After 6 months follow up, the changes of hemoglobin ( Hb ), cardiac function classification, left ventricular ejection fraction(LVEF) ,6-minute walking distance,readmission rate of CHF and cardiac death were compared between two groups. ResultsCompared with those before therapy, we found significant improvements of hemoglobin level ( [ 120. 12 ± 10. 42 ] g/L vs [ 86.40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2. 65 ± 0. 67 vs 3. 13 ±0. 61, P ＜ 0. 01 ), LVEF ( [ 37.21 ± 4. 96 ]％ vs [ 33. 92 ± 7. 28 ]％, P ＜ 0. 01 ), 6-minute walking distance ( [ 443.52 ± 97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in treatment group after EPO combined oral iron administration. After 6 months follow up, we also found significant improvements of Hb level ( [ 120. 12 ±10. 42 ] g/L vs [ 86. 40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2.65 ± 0. 67 vs 2. 98 ± 0. 81,P＜0.01),LVEF([37.21 ± 4.96]％ vs [34.67 ±4.10]％,P ＜ 0. 01),6-minute walking distance ( [443.52 ±97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in the comparison between treatment and control group. The readmission rate of CHF fell significantly in treatment group compared to control (20. 83％ vs 39. 58％ ,P ＜ 0. 05 ). However, we found no significant difference in cardiac death rate ( 0％ vs 4. 17％, P ＞0. 05). ConclusionTreatment of EPO combined oral iron could significantly improve the cardiac function,increase exercise tolerance,lower the readmission rate of CHF in patients with chronic congestive heart failure (CHF)accompanied by anemia.
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Objective:To analyze gene expression profiling of left ventricular myocardium in patients with chronic congestive heart failure(CHF)caused by rheumatic heart disease(RHD)with the normal controls in order to identify CHF associated target genes. Methods:The gene expression profiles of left ventricular myocardium from patients with CHF by RHD and normal controls were obtained from six human whole-genomic oligonucleotide microarrays(Affymetrix HG U133 Plus 2.0 GeneChip). GeneSpring software was used to identify the differentially expressed genes in both groups,and bioinformatic analysis was applied to analyze the target genes associated with CHF. Real-time PCR was carried out to validate the expression of three target genes. Results:We identified 102 target genes associated with CHF which were classified into 7 gene clusters. Microarray results were further confirmed by real time PCR for three genes. ATF3 was markedly down-regulated,IGFBP2 and NPPB were notably up-regulated in the left ventricular myocardium samples from CHF patients. Conclusion:A lot of differentially expressed genes,obtained by using the whole-genomic expression profiling technology,might be a contributory factor for the initiation and progression of CHF and it helpful for the understanding of underlying pathophysiological implications. Further investigation on these genes would provide a strategy to identify genetic markers and molecular events associated with CHF caused by RHD.
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Objective To summarize the nursing methods for patients with chronic congestive heart failure treated with local renal nerve block. Methods 10 cases of patients with chronic congestive heart failure were treated with renal nerve block. The blood and urine electrolytes, plasma neuroendocrine hor-mones, the 24-hour urine volume were measured before and after the renal nerve block to calculate the rate of excretion of urinary sodium. The changes of the heart rate and blood pressure and the improvement of the dyspnoea, swelling and other symptoms of heart failure were monitored continuously before and after the re-nal nerve block. Results There was a significant increase in the 24-hour urine volume and the rate of excretion of urinary sodium in the patients with heart failure after the renal nerve block (P<0.05),and there was a significant decrease in the amount of plasma neuroendocrine hormones after the renal nerve block (P<0.01);there was no signifieant changes in the heart rate and the average blood pressure with improvement of dyspnoea, swelling and other symptoms of heart failure. No significant complications were found. Conclusions The nursing measures taken by the nurses in the clinical application of local renal nerve block as a new treatment modality to the treatment of patients with chronic congestive heart failure are safe, effective and feasible.
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AIM: To investigate the influence of aspirin on the efficacy of captopril in the treatment of chronic congestive heart failure (CHF). METHODS: 74 cases of CHF were divided into 2 groups depending on whether aspirin was administrated before captopril was given, then all patients were given captopril 12.5 - 25 mg , tid, for 28 days. RESULTS: In aspirin group, marked effective rate was 46.7 %, and total effective rate was 70%, superior to that in no aspirin group (P
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0.05) between the two groups.The 24 h volume of urine was significantly increased in both groups.The incidence rates of adverse drug reactions(ADR) of torasemide injection and furosemide injection were 3.88% and 2.88% respectively.CONCLUSION: Torasemide injection is an effective and safe drug for the treatment of congestive heart failure with edema.
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AIM: To estimate the efficacy of milrnone in treatment of congestive heart failure. METHODS: 122 cases of chronic congestive heart failure with different etiology were divided into milrinone group and dabutamine group randomly. Milrinone group accepted milrinone (10 mg?d -1 ) for 5 days, and dabutamine group accepted dabutamine (160 mg?d -1 ) for 5 days. The efficacy of treatments was evaluated. RESULTS: The effectiveness rates of cardiac function improvement were 93.9 % and 76.7 % in milrinone group and dabutamine group, respectively (P
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OBJECTIVE: To observe the effect of Wenxin granules on heart function of patients with chronic congestive heart failure (CHF). METHODS: 82 CHF patients were randomly divided into treatment group and control group (n=41). Both groups were given routine treatment(alternative use digitalis,diuretic,vasodilator, ACEI, Beta-blockers according to patient’s condition). Treatment group were additionally administered with Wenxin granules for four weeks. The symptom and improvement of heart function of two groups were compared. RESULTS: The symptom and heart function of patients in both groups were improved remarkably. Treatment group was significantly superior to control group in curative effect (P
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OBJECTIVE:To investigate the curative effect of metoprolol in treating chronic congestive heart failure (CCHF) and to discuss its administration technique.METHODS:A total of 72 patients with CCHF were randomly divided into treatment group and control group. The patients in the control group were treated with conventional therapy for heart failure,while those in the treatment group were treated with additional metoprolol at an initial dose of 6.25mg bid but gradually increased to 100mg bid for 24 weeks apart from the conventional therapy.RESULTS:The total responsive rate(RR) in the treatment group(88.9%) was significantly higher than in the control group(63.9%)(P
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Aim To develop the animal model of guinea pig chronic heart failure and detect effects of chronic heart failure on contractile/diastolic function and calcium transient in guinea pig ventricular myocytes by video-based motion edge-detection system simultaneously.Methods The chronic congestive heart failure(CHF) model was produced in guinea pig by a procedure that descenting aorta was constricted.The contrasting indexes in 8 weeks include: with or without dyspnea,hemodynamics,the mass ratio of left ventricle to body,the mass ratio of lung to body,and the width of left ventricle.Left ventricular myocytes were enzymatically isolated.Then the contractile and calcium transient of a single cell from both normal and failure hearts were assessed in guinea pigs by a video-based motion edge-detection system simultaneously.Results The models with dyspnea showed striking increasing in left ventricular systolic pressure and left ventricular end diastolic pressure,as well as the mass ratio of left ventricle to body,the mass ratio of lung to body and the width of left ventricular hypertrophy.The left ventricular pressure maximal rising and declining velocity significantly decreased.Compared with normal cells,the value of shorting,the contractile and diastolic velocity of myocytes decreased significantly.The diastolic calcium increased,the extent of calcium transient[FL(2K2] decreased and the time to 50% diastolic calcium lengthen.But systolic calcium,the time to peak calcium were unchanged.Conclusions The dyspnea is a important parameter for evaluating the animal CHF model of guinea pig formed by constricting the descending aortas of guinea pigs after 8 weeks.The chronic heart failure may decrease contractile and calcium transient extent in ventricular myocytes detected by video-based motion edge-detection system simultaneously,which might be helpful for the further studying the mechanism of the development of CHF.
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China-made amrinone (AMR) was orally administered to 10 patients with chro- nic congestive heart failure(CHF) for 72 hours, its mitral valve blood flow spectral shift was observed by pulsed Doppier echocardiograp hy(PDE). We found that peak A decreased, and peak A/peak E ratio decreased significantly. It suggested that AMR could improve left ventricular diastolic function. Early diastolic drag acceleration increased, it is one index of left ventricular diastolic function, its elevation suggested that left ventricular diastolic function had some improvement. These observation suggested that AMR could improve left ventricular diastolic function for hypertensive heart disease, coronary artery disease, congestive cardiom-yopathy with limited left ventricular diastolic function
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A total of 88 patients with chronic heart failure were divided into 2 groups: the carvedilol group( n =40) and the control group( n =48). Patients in 2 groups were all treated with routine regime,the experimental group also received carvedilol treatment.Before and 7 months after treatment, their left ventricular ejection fractions (EF%) and the rate of left ventricular drawing back on short axis contration were recorded to evaluate the effects of carvedilol. The values of EF% and short axis were higher in both groups after 7 months follow up ( P