Investigação da Relação entre Índice de Triglicerídeos-Glicose e Fluxo Lento Coronariano: Um Estudo Retrospectivo de Caso-Controle / Investigation of the Relationship Between Triglycerides-Glucose İndex and Coronary Slow Flow: A Retrospective Case-Control Study

Resumo Fundamento O fluxo lento coronariano (FLC) refere-se à opacificação retardada dos vasos distais na ausência de estenose da artéria coronária epicárdica. O mecanismo etiopatogênico do FLC ainda não está claro. Objetivos Este estudo investiga a relação entre o FLC e o índice de triglicerídeos-glicose (TyG). Métodos A amostra do estudo consistiu de 118 pacientes com FLC e 105 pacientes com fluxo coronariano normal (FCN). A taxa de fluxo coronariano foi medida por medio do método de contagem de quadros (TFC) Thrombolysis in Myocardial Infarction (TIMI) em todos os pacientes. O índice TyG foi calculado como o logaritmo do valor [triglicerídeos em jejum (mg/dL)×glicose em jejum (mg/dL)]/2. Adotou-se como estatisticamente significativo o nível de significância < 0,05. Resultados O índice TyG, lipoproteína de baixa densidade (LDL), índice de massa corporal (IMC), relação neutrófilo-linfócito (RNL) e valores de TFC, proporção masculina e proporção de fumantes foram maiores, enquanto os níveis de lipoproteína de alta densidade (HDL) foram significativamente menores no grupo FLC em comparação com o grupo FNC (p<0,05). A análise de correlação revelou que o FLC estava significativamente correlacionado com os valores do índice TyG, IMC, RNL e HDL. A mais forte dessas correlações foi entre o FLC e o índice TyG (r= 0,57, p<0,001). Além disso, a análise multivariada revelou que o índice TyG, IMC, razão RNL e sexo masculino foram preditores independentes para FLC (p<0,05). A análise da curva ROC (Receiver Operating Characteristic) indicou que um valor de corte ≥ 9,28 para o índice TyG previu FLC com sensibilidade de 78% e especificidade de 78,1% [Área sob a curva (AUC): 0,868 e 95% intervalo de confiança (IC): 0,823-0,914]. Conclusão Os achados deste estudo revelaram uma relação muito forte entre o FLC e o índice TyG.

Abstract Background Coronary slow flow (CSF) refers to delayed distal vessel opacification in the absence of epicardial coronary artery stenosis. The etiopathogenic mechanism of CSF is still unclear. Objectives This study investigates the relationship between CSF and the triglyceride-glucose (TyG) index. Methods The study sample consisted of 118 CSF patients and 105 patients with normal coronary flow (NCF). The coronary flow rate was measured via the Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) method in all patients. The TyG index was calculated as the logarithm of the [fasting triglyceride (mg/dL)×fasting glucose (mg/dL)]/2 value. A significance level of < 0.05 was adopted as statistically significant. Results The TyG index, low-density lipoprotein (LDL), body mass index (BMI), neutrophil-to-lymphocyte ratio (NLR) and TFC values, male ratio, and the ratio of smokers were higher, whereas high-density lipoprotein (HDL) levels were significantly lower in the CSF group compared to the NCF group (p<0,05). The correlation analysis revealed that CSF was significantly correlated with TyG index, BMI, NLR, and HDL values. The strongest of these correlations was between CSF and TyG index (r= 0.57, p<0.001). Additionally, the multivariate analysis revealed that TyG index, BMI, NLR ratio, and male gender were independent predictors for CSF (p<0.05). Receiver operating characteristic (ROC) curve analysis indicated that a cut-off value of ≥ 9.28 for the TyG index predicted CSF with a sensitivity of 78% and a specificity of 78.1% [Area under the curve (AUC): 0.868 and 95% Confidence Interval (CI): 0.823-0.914]. Conclusion The findings of this study revealed a very strong relationship between CSF and TyG index.

Performance Diagnóstica da FFR por Angiotomografia de Coronárias através de Software Baseado em Inteligência Artificial / Diagnostic Performance of a Machine Learning-Based CT-Derived FFR in Detecting Flow-Limiting Stenosis

Resumo Fundamento A quantificação não invasiva da reserva fracionada de fluxo miocárdico (FFR TC ) através de software baseado em inteligência artificial em versão mais atualizada e tomógrafo de última geração (384 cortes) apresenta elevada performance na detecção de isquemia coronariana. Objetivos Avaliar o desempenho diagnóstico da FFR TC na detecção de doença arterial coronariana (DAC) significativa em relação ao FFRi, em tomógrafos de gerações anteriores (128 e 256 cortes). Métodos Estudo retrospectivo com pacientes encaminhados à angiotomografia de artérias coronárias (TCC) e cateterismo (FFRi). Foram utilizados os tomógrafos Siemens Somatom Definition Flash (256 cortes) e AS+ (128 cortes). A FFR TC e a área luminal mínima (ALM) foram avaliadas em software (cFFR versão 3.0.0, Siemens Healthineers, Forchheim, Alemanha). DAC obstrutiva foi definida como TCC com redução luminal ≥50% e DAC funcionalmente obstrutiva como FFRi ≤0,8. Todos os valores de p reportados são bicaudais; e quando <0,05, foram considerados estatisticamente significativos. Resultados Noventa e três pacientes consecutivos (152 vasos) foram incluídos. Houve boa concordância entre FFR TC e FFRi, com mínima superestimação da FFR TC (viés: -0,02; limites de concordância: 0,14 a 0,09). Diferentes tomógrafos não modificaram a relação entre FFR TC e FFRi (p para interação = 0,73). A FFR TC demonstrou performance significativamente superior à classificação visual de estenose coronariana (AUC 0,93 vs. 0,61, p <0,001) e à ALM (AUC 0,93 vs. 0,75, p <0,001) reduzindo o número de casos falso-positivos. O melhor ponto de corte para a FFR TC utilizando um índice de Youden foi de 0,85 (sensiblidade, 87%; especificidade, 86%; VPP, 73%; NPV, 94%), com redução de falso-positivos. Conclusão FFR TC baseada em inteligência artificial, em tomógrafos de gerações anteriores (128 e 256 cortes), apresenta boa performance diagnóstica na detecção de DAC, podendo ser utilizada para reduzir procedimentos invasivos.

Abstract Background The non-invasive quantification of the fractional flow reserve (FFRCT) using a more recent version of an artificial intelligence-based software and latest generation CT scanner (384 slices) may show high performance to detect coronary ischemia. Objectives To evaluate the diagnostic performance of FFRCT for the detection of significant coronary artery disease (CAD) in contrast to invasive FFR (iFFR) using previous generation CT scanners (128 and 256- detector rows). Methods Retrospective study with patients referred to coronary artery CT angiography (CTA) and catheterization (iFFR) procedures. Siemens Somatom Definition Flash (256-detector rows) and AS+ (128-detector rows) CT scanners were used to acquire the images. The FFRCT and the minimal lumen area (MLA) were evaluated using a dedicated software (cFFR version 3.0.0, Siemens Healthineers, Forchheim, Germany). Obstructive CAD was defined as CTA lumen reduction ≥ 50%, and flow-limiting stenosis as iFFR ≤0.8. All reported P values are two-tailed, and when <0.05, they were considered statistically significant. Results Ninety-three consecutive patients (152 vessels) were included. There was good agreement between FFRCT and iFFR, with minimal FFRCT overestimation (bias: -0.02; limits of agreement:0.14-0.09). Different CT scanners did not modify the association between FFRCT and FFRi (p for interaction=0.73). The performance of FFRCT was significantly superior compared to the visual classification of coronary stenosis (AUC 0.93vs.0.61, p<0.001) and to MLA (AUC 0.93vs.0.75, p<0.001), reducing the number of false-positive cases. The optimal cut-off point for FFRCT using a Youden index was 0.85 (87% Sensitivity, 86% Specificity, 73% PPV, 94% NPV), with a reduction of false-positives. Conclusion Machine learning-based FFRCT using previous generation CT scanners (128 and 256-detector rows) shows good diagnostic performance for the detection of CAD, and can be used to reduce the number of invasive procedures.

Effect of electroacupuncture on myocardial infarct size and expression of inflammatory cytokines and sympathetic-active substances in the myocardial ischemic tissue of rats / 针刺研究

OBJECTIVE: To investigate the effect of electroacupuncture (EA) on the expression of interleukin-8 (IL-8), interleukin-10 (IL-10), tyrosine hydroxylase (TH), β3-adrenergic receptor (β3AR), and endothelial nitric oxide synthase (eNOS) in myocardial tissue in ischemic myocardial injury rats, so as to reveal its underlying mechanisms in myocardial protection via anti-inflammation and sympathetic nerve remodeling. METHODS: A total of 48 male Sprague-Dawley rats were randomly divided into sham-operation (sham, n＝9), sham ＋EA (n＝9), model (n＝15) and EA (n＝15) groups. The myocardial ischemia (MI) model was established by ligation of the left anterior descending branch of the left coronary artery. EA (2 Hz/15 Hz，1.5－2 mA) was applied to bilateral "Neiguan" (PC6) for 30 min, once daily for 4 days. The myocardial infarct size was detected by 2, 3, 5 triphenyltetrazolium chloride (TTC) staining, myocardial histopathological changes and inflammatory infiltration were assessed by H．E. staining, and the expression of IL-8, IL-10, TH, β3AR, and eNOS in the myocardium was determined by using Western blot. RESULTS: Compared with the sham group, a marked myocardial infarction was found in the left ventricle tissue, accompanied with disordered arrangement of myocardial fibers and higher degree of inflammatory cell infiltration, and increased expression of IL-8, TH, β3AR and eNOS in the myocardium in the model group (P0.05). After EA intervention and in comparison with the model group, the myocardial infarct size was significantly reduced (P<0.01), the severity of inflammatory cell infiltration and disordered arrangement of myocardial fibers were relieved, and the expression of IL-10 and eNOS proteins were significantly up-regulated (P<0.05), and the markedly up-regulated expression of IL-8, TH, and β3AR were significantly suppressed in the EA group (P<0.01)．. CONCLUSION: EA intervention can reduce the myocardial infarct size (protective effect) in MI rats possibly by reducing inflammatory reaction and sympathetic nerve remodeling.

Protective Effect of Glycyrrhetinic Acid on Myocardial Ischemia/Reperfusion Injury / 中国药学杂志

OBJECTIVE: To explore the protective effect of glycyrrhetinic acid (GA) on myocardial ischemia/reperfusion injury. METHODS: Forty-eight healthy male SD rats were randomly and averagely divided into six groups: sham, control, and control with tanshinone ⅡA sodium injection, GA at low, median and high dosages. The rats were subjected to 30 min of ischemia, followed by 180 min reperfusion. The influence of GA on arrhythmic during reperfusion period was observed. At the end of reperfusion period, the concentrations of CK-MB and LDH in serum were measured with assay kits, and the myocardial infarct size was measured with colouring method. RESULTS: At the time of myocardial ischemia and reperfusion, the HR, MAP and PRI in any GA group were not significantly different compared with the control group. At the end of the reperfusion period, the myocardial infarct sizes were decreased significantly in median and high dosage GA groups compared with the control group (P < 0.05); the CK-MB concentration in serum in all the GA groups were much lower (P < 0.05); the LDH concentrations in serum were much lower in median and high dosage GA groups (P < 0.05). CONCLUSION: GA exerts protection against myocardial ischemia/reperfusion as shown by a significant reduction in infarct size and decreased concentrations of CK-MB and LDH in serum.

Preparation of puerarin-loaded PEGylated mesoporous silica nanoparticles and its protection on the acute myocardial ischemic rats / 中草药

Objective To prepare the puerarin-loaded PEGylated mesoporous silica nanoparticles (PUE@PEG-MSNs) and evaluate its protection on the acute myocardial ischemic rats. Methods PEG-MSNs functionalized mesoporous silica nanoparticles were achieved by the condensation method, and then they were loaded by PUE. The morphology of PUE@PEG-MSNs was examined by detection methods of particle diameter, Zeta potential, transmission electron microscope (TEM), and Fourier transform infrared spectra (FTIR). Moreover, the drug loading and encapsulation rate were measured by HPLC. Sixty acute ischemic myocardial model rats were prepared by coronary artery ligation, and then they were randomly divided into six groups: Sham, MIRI model, puerarin injection, low-, mid-, and high-dose PUE@PEG-MSNs groups. Different doses of PUE@PEG-MSNs and puerarin injection were given 5 min after the ligation. Monitoring the changes of ST, the blood was collected at the end of reperfusion for detecting the changes of serum creatine kinase (CK), lactic dehydrogenase (LDH), aspartate aminotransferase (AST), and malondialdehyde (MDA). The myocardial infarct size was also determined. Results PUE@PEG-MSNs presented uniform spherical morphology and particle size distribution. The particle size and Zeta potential was 300 nm and -30 mV respectively. The drug loading and entrapment efficiency was 14.7% and 67.8% respectively. Both puerarin injection and PUE@PEG-MSNs could reduce the ST-elevation of electrocardiogram, decrease the contents of CK, LDH, AST, and MDA, and reduce the myocardial infarct size. The efficacy of mid- and high-dose PUE@PEG- MSNs groups was better than that of puerarin injection group. Conclusion PUE@PEG-MSNs were successfully prepared and exerted the protective effects on the acute myocardial ischemic rats.

Protective Effect of Total Saponins in Stems and Leaves of Panax notoginseng on Myocardial Ischemic Reperfusion Injury in Rats / 世界科学技术-中医药现代化

Objective To explore the protective effect of saponins in stems and leaves of Panax notoginseng onmyocardial ischemic reperfusion injury in rats. Methods The rats were divided into six groups (the sham operation group, model group, DAXXK group, PNSSL 40, 80, 160 mg·kg-1 group) and continuous oral administration for 7 days. The ratmodel of myocardial ischemic reperfusion injury (MIRI) was developed by ligation of the left anterior descending coronaryartery the electrocardiogram (ECG), myocardial infarct size, staining with hematoxylin and eosin were observed. Theactivities of LDH、CK、AST、ALT in serum and SOD、GSH-Px、MDA in cardiac muscle tissue were detected by kit.Results Saponins in stems and leaves of Panax notoginseng in each dose (40, 80, 160 mg · kg-1) group significantlyreduced the myocardial infarct size and improved the ECG on ST segment, the myocardial damage was obviously reducedfrom the pathological section. Stems and leaves of Panax notoginseng in a dose of 160 mg · kg-1 lowered the serumactivities of LDH、CK and AST, contents of SOD and GSH-Px in a dose of 80 mg·kg-1 significantly lowered. Conclusions The results indicates that PNSSL have the effect against myocardial ischemic reperfusion injury and that the mechanismof pharmacological action related to the improvement of ECG changes, the stability of cell membrane, eliminate oxygenfree radicals and the reducing of inflammatory infiltration.

Protective roles of fibroblast growth factor-21 on cardiovascular diseases / 医学研究生学报

Fibroblast growth factor 21 (FGF21) is regarded as an important metabolic regulator playing a therapeutic role in diabetes and its complications.Recently, growing evidence showed that heart is a key target as well as a source of FGF21 which is involved in heart development and also induces beneficial effects in cardiovascular diseases.Strong evidences showed that the development of cardiovascular diseases including atherosclerosis, atherosclerosis, coronary heart disease, myocardial ischemia, cardiac hypertrophy, and diabetic cardiomyopathy is associated with increased serum FGF21 levels which was regarded as a compensatory response to induced cardiac protection.This review tries to illuminate the underlying relationship between FGF21 and cardiovascular diseases and the possible mechanisms.

Effects of Hongqi formular combined with exercise preconditioning against myocardial ischemic reperfusion injury in rats / 中国康复医学杂志

Objective:To study the effects and mechanisms of Hongqi formular combined with exercise preconditioning against myocardial ischemic reperfusion injury in rats.Method:Fifty health male SD rats were randomly divided into sham,IR,EP,HP and EHP group.After establishing of EP animal model,the rats were ligated ramus descendens coronary artery to induce myocardial ischemic reperfusion model.The serum cardiac troponin Ⅰ (cTn Ⅰ),myocardium IL-6,TNF-α were detected by enzyme linked immunosorbent assay (ELISA).The myocardium MDA was detected by chemical colorimetry method.The myocardium SOD was detected by xanthine hydrocarbonylation.The serum ET,6-k-PGF1α,TXB2 density were detected by radioimmunoassay,and the myocardium Ca2+ density was detected by atom absorption spectrophotometry.Result:①As compared with the group IR,the serum cTn Ⅰ decreased significantly in groups EP,HP and EHP;As compared with the group EHP,the cTn Ⅰ level in serum was increased in groups EP and HP.②As compared with the group IR,the Ca2+ level in myocardial sarcoplasmic reticulum was decreased significantly in groups EP,HP and EHP;As compared with the group EHP,the Ca2+ level in myocardial sarcoplasmic reticulum was decreased significantly in group EP.③As compared with the group IR,the ET in serum were decreased significantly in groups EP,HP and EHP;As compared with the group EHP,the ET,TXB2 in serum were increased significantly in groups EP and the 6-k-PGF1αin serum were decreased significantly in groups EP.④As compared with the group IR,the IL-6 and TNF-α in cardiac muscle were decreased in groups EP,HP and EHP;As compared with the group EHP,the IL-6 and TNF-α in cardiac muscle were increased in groups EP and HP.⑤As compared with the group IR,the SOD in cardiac muscle was increased significantly in groups EP,HP and EHP and the MDA in cardiac muscle was decreased significantly in groups EP,HP and EHP;As compared with the group EHP,the SOD in cardiac muscle was decreased significantly in groups EP and the MDA in cardiac muscle was decreased significantly in group EP.Conclusion:Hongqi formular combined with exercise preconditioning produces cardio-protective effect during myocardial ischemic reperfusion,which may be related with the enhanced anti-oxidant ability,the decreased blood cell damage,the maintainace of vascular endothelium function,the improved microcirculation and the decreased calcium overloading.

Pharmacokinetics of Tongmai granule in acute myocardialischemic model beagles / 中国中药杂志

Tongmai granule (TM) is composed of Puerariae Lobatae Radix (Gegen), Salviae Miltiorrhizae Radix et Rhizoma(Danshen) and Chuanxiong Rhizoma(Chuanxiong). It has been used to treat ischemic cardio-cerebrovascular diseases for decades. For the purpose of elucidating its pharmacodynamic material foundation, the absorption and pharmacokinetic property of TM were investigated in acute myocardial ischemic model beagles. All serum samples were extracted before analysis with ethyl acetate after being acidified by hydrochloric acid. Under negative ESI detection mode, the chromatographic separation was carried out with monolithic C₁₈ column for gradient elution. A simultaneous quantitative analysis was made on 15 polyphenols, including 8 from Gegen, 5 from Danshen and 2 from Chuanxiong, in 8.5 min. The validation result demonstrated the specificity, accuracy and precision of the method in line with the bioanalysis requirements. After TM solution was administrated to acute myocardial ischemic model beagles through duodenum injection, serum samples were collected after 6 h. The quantitative detection proved the prompt absorption of TM, all of the components were detectable in the blood samples 5 min later, and reached peak respectively at 0.18-3.83 h after administration. The components presented large variabilities. The most components were exposed in serum with puerarin and salvianic acid A, followed by 3'-methoxypuerarin, mirificin, and 3'-hydroxypuerarin. The study proves puerarin and salvianic acid A are dominating active components of TM in acute myocardial ischemic model beagles.

Protective Effect of Acetyl-11-keto-β-boswellic Acid on Myocardial Ischemia Induced by Isoproterenol Hydrochloride in Rats / 中国药师

Objective:To study the effects and mechanisms of acetyl-11-keto-β-boswellic acid ( AKBA) in myocardial ischemic model induced by isoproterenol hydrochloride ( ISO) in rats. Methods:The SD rats were randomly divided into the sham group, model group, AKBA low dose group and AKBA high dose group. Myocardial injury model was induced by subcutaneous injection of ISO (100 mg·kg-1 ) . The change of ST segment in ECG was observed. Creatine kinase ( CK-MB) , cardiac troponin I ( cTnI) , lactate dehydro-genase( LDH) , malondialdehyde( MDA) and superoxide dismutase( SOD) in the blood were detected by ELISA. The change of histo-logical tissue was determined by HE staining, and cell apoptosis was analyzed by TUNEL assay. Results: Serum CK-MB, cTnI and LDH were decreased significantly in AKBA high dose group when compared with those in the model group. Compared with that in the model group, MDA content was lowered and the SOD activity was increased in AKBA high dose group. Furthermore, AKBA high dose group improved the pathologic changes of myocardium. TUNEL assay revealed significant reduction of cardiomyocytes apoptosis in the hearts of the ischemic rats in AKBA high dose group. Conclusion:AKBA has excellent cardioprotective effect on myocardial ischemic induced by ISO and protection of myocardial cells from injury.

Effect and Mechanism of Helix B Surface Peptide on Reducing Myocardial Ischemia Reperfusion Injury in Experimental Mice / 中国循环杂志

Objective: To investigate the effect and mechanism of helix B surface peptide (HBSP) on myocardial ischemia reperfusion injury (MIRI) in experimental mice. Methods: The MIRI model was established by ligation of anterior descending coronary artery of the mice for 45 min and followed by corresponding treatment at 5 min before reperfusion. A total of 64 male ICR mice were randomly assigned to 4 group:①Sham group,②MIRI group, the mice received normal saline at 5 min before reperfusion,③HBSP group, MIRI mice received HBSP at 5 min before reperfusion and④HBSP+PD98059 group, MIRI mice received PD98059 (a speciifc blocker of ERK1/2) at 20 min before reperfusion and followed by HBSP at 5 min before reperfusion.n=16 in each group, all animals were treated for 2 hours. The area of myocardial infarction (MI) was detected by TTC-EB double staining method, the myocardial apoptosis rate was examined by TUNEL method, the levels of protein expression of ERK1/2 and phosphorylation of ERK1/2 were measured by Western blot analysis. Results: Compared with MIRI group, HBSP group presented decreased MI area, decreased myocardial apoptosis rate and increased phopsphorylation level of ERK1/2, allP Conclusion: HBSP may reduce the MI area via inhibiting myocardial apoptosis and therefore, protecting the experimental mice from MIRI; the mechanism might be related to the activation of ERK1/2 pathway.

Research on the Model of Combining Myocardial Ischemic Coronary Disease with Syndrome of Kidney Deficiency and Blood Stasis / 中国中医药信息杂志

Objective To discuss the feasibility of establishing the model of combining myocardial ischemic coronary disease with syndrome of kidney deficiency and blood stasis by surgical method.Methods Non-disease of kidney deficiency and blood stasis syndrome model was built by taking the methods of fright, being placed in a cold environment and injection of hydrocortisone. The model of combining the myocardial ischemic coronary disease with the syndrome of kidney deficiency and blood stasis was established through ligating the left anterior descending branch of artery and injecting hydrocortisone. The rats were divided into kidney deficiency and blood stasis group, combination of disease and syndrome group, and normal group, 5 rats in each group. The temperature, weight, heart rate, breathing rate and whole blood viscosity, casson viscosity of the rats in the two groups before and after modeling were observed. According to TCM clinical diagnosis criteria of kidney deficiency and blood stasis syndrome, TCM syndrome characteristics of the two groups were compared.ResultsCompared with normal groups and before modeling, rat temperature dropped and breathing rate increased in kidney deficiency and blood stasis group, combination of disease and syndrome group (P<0.05). Compared with normal group, rat weight decreased or grew slowly, and whole blood viscosity and casson viscosity increased (P<0.05, P<0.01). There were statistical significant differences in whole blood viscosity and electrocardiogram between the two groups (P<0.05).Conclusion There is no obvious difference between TCM syndrome characteristics of the two groups. They all meet the TCM clinical diagnosis criteria of kidney deficiency and blood stasis syndrome.

Protection of water extract from paeoniae radix rubra against myocardial ischemia in mice induced by isoproterenol / 中草药·英文版

Objective: To study the protective effect of the water extract from Paeoniae Radix Rubra (WEPRR) against myocardial ischemia in mice induced by isoproterenol (ISO). Methods: The mice were randomly divided into six groups: positive control, normal control, model, low-, mid-, and high-dose [0.3, 0.6, and 1.2 g/(kg·d)] WEPRR groups. The mice in WEPRR groups were ig administered with WEPRR, the mice in the positive control group were ig administered with 0.98% Di'ao Xinxue Kang [(0.195 g/(kg·d)], and the mice in normal and model groups were ig administered with the same volume of physiological saline once daily for consecutive 11 d. On the day 7 from the beginning of the ig administration, the mice in the model and WEPRR groups were ip perfused with 0.02 g/(kg·d) ISO. After 15 min of the last medication, the mice were anesthetized with isoflurane gas, the blood was collected through venous sinus of eye orbit, then the mice were killed. The heart tissues were rapidly removed from the mice, washed in physiological saline, soaked in filter paper, and stored in -80 C until use. The activities of lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB), creatine kinase (CK) in serum, superoxide dismutase (SOD), and the contents of malondialdehyde (MDA) in the heart of mice were determined, respectively. Results: Compared with the model group, the activities of LDH, CK-MB, and CK in serum, and the SOD of mice in the positive control and WEPRR groups were increased and the content of MDA in heart was decreased. Conclusion: The WEPRR has the cardioprotective activities on ISO-induced myocardial ischemia. © 2013 Tianjin Press of Chinese Herbal Medicines.

Sesame oil enhances endogenous antioxidants in ischemic myocardium of rat

The present study was designed to evaluate the potency of antioxidant activity of sesame oil in-vitro model of myocardial ischemic reperfusion injury of rat. Sesame oil was administered orally to Wistar albino rats (180-200 g) in two different doses (n=6), by gastric gavage at a dose of 5 mL/kg b.w. (S1) and 10 mL/kg b.w (S2) daily for thirty days. Control and sesame oil treated rat hearts were subjected to invitro global ischemic reperfusion injury (5 min perfusion, 9 min noflow and 12 min reperfusion). A significant rise in TBARS and decrease of GSH, catalase, LDH, CK and AST occurred in the hearts subjected to in-vitro myocardial ischemic reperfusion injury indicate the myocardial damage through oxidative stress. In sesame oil treated rats there was a significant decrease in TBARS and significant increase in endogenous antioxidants and myocardial marker enzymes in all the groups. In 10 mL/kg treatment group, a significant rise in the levels of GSH, SOD and catalase were observed with marker enzymes, and it shows better recovery profile than the other groups subjected to in-vitro ischemic reperfusion injury. In histological studies, control rats which subjected to IR injury show extensive myocardial damage and all the treatment groups, shows preserved myocardium. The effect of sesame oil was compared with reference compound captopril. The present study demonstrates that the sesame oil treated by the dose 10 mL/kg augments endogenous antioxidant compounds of the rat heart and also prevents the myocardium from in-vitro model of myocardial ischemic reperfusion injury.

The long-term follow-up result of surgical non-transplantation treatment of ischemic heart disease / 中华胸心血管外科杂志

Objective The aim of this study is to review the experience of using non-transplantation procedure treating ischemic heart disease. Methods Between Jan of 2000 and Jan of 2008, 74 patients with ischemic heart disease comprised the study group, including 66 males and 8 females. The age of the group ranged from 36-79 years, mean 63.3 ±9.28years. The patients underwent non-transplantation procedure according to the preoperative tests. To evaluate the aimed vessels and the survival myocardial viability, coronary angiography, echocardiography, radioisotope scanning and dobutamine-stress echo-test were used. The cardiac function data were analyzed before and after operation. Results Seventy-one cases underwent coronary artery bypass [mean (3.26 ± 1.14) grafts/case], containing 54 arterial grafts and 177 veinuos grafts. The mechanical assistance was applied in 51 cases including 1ABP 50 cases(67.6% ), IABP and ECMO 1 case(1.4%). Postoperative complication contained re-thoracotomy for bleeding 1 case ( 1.4% ), wound infection 3 cases (4.1%), renal dysfunction 3 cases(4.1%), low cardiac output 11 cases(14.9 %). The in-hospital mortality was 10.8% ( 8 cases ). The follow-up time ranged from 17 to 107 months, mean (47.47±24.51 ) months. The follow-up mortality rate was 3.0%. The re-hospitalization for cardiovascular events taken place in 6 cases(9.1% ). The cardiac function improved postoperatively. EF increased from preoperative 0.33 to postoperative 0.47. The diameter of the left ventricular decreased markedly. The left ventricular end-systolic diamension decreased from preoperative 47.6 mm to postoperative 43.4 mm. Conclusion Selected patients with ischemic heart disease, potentially eligible for transplantation, can be managed by the non-transplantation surgery. In those patients post-operative quality of life is satisfactory, with comparable survival and low risk of re-hospitalization.

Effects of TCM Preconditioning of Warming Yang and Supplementing Heart Qi on Myocardial Ultrastructure of Rats with Acute Myocardial Ischemia / 中国中医药信息杂志

Objective To observe the effects of TCM preconditioning of warming Yang and supplementing heart Qi on the myocardial ultrastructure of rats with acute myocardial ischemia, and discuss its protection on the ischemia reperfusion myocardium and relation with myocardial ischemic preconditioning. Method Male Wistar rats were randomly divided into 4 groups, 3 of which were fed normally, one of which was administered with TCM, and myocardial infarction model was established after 10 days. IR group were reperfused 48 hours after 45 min of ischemia. TCM group were treated with prophylactic administration of 0.36 g/100 g body weight for 10 days before the same ischemia and reperfusion as IR group. IP group were also performed the same ischemia and reperfusion as IR group after 5 min of ischemia and 5 min of reperfusion three times. The myocardial ultrastructure of rats was observed by electron microscope. Results In IR group:sarcolemma damaged, myofilament dissolved and fragmented, arranged loosely, mitochondria arranged confused, some mitochondria looked like cavitation or partly cavitation, some also presented coacervation state, glycogen decreased. And the myocardium damaged badly, it proved that part of the myocardium damaged after the ischemia reperfusion. In TCM and IP groups:the state of the cardiocytes were improved relatively and the sarcolemmas were integrated, the cardiocytes’ nucleoli presented to be oval-shape, and the nucleoli looked obviously, the mitochondria were showed relatively obviously, myofilaments were well arranged, the bright and dark bands of the sarcomeres looked apparently, mitochondria arranged in good order between the myofibrils, but still some myofilaments were broke and part of the mitochondria presented cavitation state. Conclusion The myocardial ischemic preconditioning and TCM preconditioning of warming Yang and supplementing heart Qi both can protect the ischemic myocardium through mitigating the damages of the myocardial ultrastructure, and they have the similar protection effects on the damaged myocardial ultrastructure of the rats with ischemia reperfusion.

Effect of Breviscapine on Rabbit's Cardiac Muscles after Ischemic Preconditioning / 中国康复理论与实践

@#ObjectiveTo explore the effect of the Breviscapine (Bre) on rabbit's cardiac muscles after ischemic preconditioning (IP).MethodsThe myocardial ischemic reperfusion model was made with 32 New Zealand white rabbits by silk thread passed around the left circumflex coronary artery and the apex. Model animals were randomly divided into four groups: myocardial ischemia-reperfusion (I/R) group, Bre+I/R group, IP group and Bre+IP group. The changes of the endothelin (ET), nitrous oxide (NO) and the enzymes of the cardiac muscle were measured, and the areas of myocardium infarction were analyzed.ResultsBre and IP could decrease the content of ET, the enzymes of the cardiac muscle and myocardial infarction area; increase the content of the NO. Bre+IP could strengthen the role of protecting the ischemic myocardial cells.ConclusionThe Bre can protect the ischemic cardiac muscle. The Bre+IP can strengthen the protective effect of the IP.

Evaluation of relevant informations in myocardial ischemic rats with qi-deficiency syndrome / 中华中医药杂志

Objective: To investigate the syndrome property of myocardial Ischemic, and evaluate the relevant informations of qi-deficiency. Methods: SD rats were subjected to either proximal LAD ligation or sham operation. The respiratory rate in both resting state and post-stress were counted. 20 rats (10 in each group) were subjected to forced swimming test (FST) to measure the exhaustive swimming time in every time point Echocardiography was used to evaluate the cardiac function in rats at each time point. Results: Compared with sham operation group, the respiratory rate in the resting state was slower, but faster under post-stress, the exhaustive swimming time was shorter, and the cardiac function of rats was significant decreasing in model group during the period from 7th day to 60th day after operation. The exhaustive swimming time was much shorter, and the relevant information of blood stasis was abnormal in the model group during the period from 7th day to 28th day after operation, when compared with the sham group. Conclusion: Myocardial ischemic rats induced by LAD ligation had both qi-deficiency and blood stasis indications, can be diagnosed as the syndrome of qi-deficiency and blood stasis during the period from 7th day to 28th day after operation. The model rats only had the qi-deficiency indications during the period from 45th day to 60th day after operation, so can be diagnosed as the qi-deficiency syndrome.

Mitochondrial permeability transition pore and myocardial ischemia-reperfusion injury / 医学研究生学报

Ischemia-reperfusion of the heart leads to the opening of mitochondrial permeability transition pore(MPTP).Transient opening and subsequent closure of the MPTP may lead to the release of cytochrome c and other proapoptotic molecules.If unrestrained,this will lead to the loss of ionic homeostasis and initiate the cascade of necrotic cell death.Direct or indirect inhibition of MPTP provides protection against ischemia-reperfusion injury.Recent researches have shown that transient low-conductance pore opening also provides protection against reperfusion injury.This review gives summarization of the components,molecular mechanism of MPTP,permeability transition in myocardial ischemia-reperfusion and the relationship between MPTP and ischemic preconditioning.This may lead to better protective strategies against myocardial ischemia-reperfusion injury in the future.