Effects of Intracoronary Administration of Autologous Adipose Tissue-Derived Stem Cells on Acute Myocardial Infarction in a Porcine Model

PURPOSE: Adipose-derived stem cells (ADSCs) are known to be potentially effective in regeneration of damaged tissue. We aimed to assess the effectiveness of intracoronary administration of ADSCs in reducing the infarction area and improving function after acute transmural myocardial infarction (MI) in a porcine model. MATERIALS AND METHODS: ADSCs were obtained from each pig's abdominal subcutaneous fat tissue by simple liposuction. After 3 passages of 14-days culture, 2 million ADSCs were injected into the coronary artery 30 min after acute transmural MI. At baseline and 4 weeks after the ADSC injection, 99mTc methoxyisobutylisonitrile-single photon emission computed tomography (MIBISPECT) was performed to evaluate the left ventricular volume, left ventricular ejection fraction (LVEF; %), and perfusion defects as well as the myocardial salvage (%) and salvage index. At 4 weeks, each pig was sacrificed, and the heart was extracted and dissected. Gross and microscopic analyses with specific immunohistochemistry staining were then performed. RESULTS: Analysis showed improvement in the perfusion defect, but not in the LVEF in the ADSC group (n=14), compared with the control group (n=14) (perfusion defect, -13.0+/-10.0 vs. -2.6+/-12.0, p=0.019; LVEF, -8.0+/-15.4 vs. -15.9+/-14.8, p=0.181). There was a tendency of reducing left ventricular volume in ADSC group. The ADSCs identified by stromal cell-derived factor-1 (SDF-1) staining were well co-localized by von Willebrand factor and Troponin T staining. CONCLUSION: Intracoronary injection of cultured ADSCs improved myocardial perfusion in this porcine acute transmural MI model.

Hyperbaric oxygen on left ventricular ejection fraction preserved by the influence of left ventricular remodeling in patients with heart failure / 实用医学杂志

Objective To study hyperbaric oxygen on left ventricular ejection fraction preserved by the influence of left ventricular remodeling in patients with heart failure. Methods A total of 110 patients with heart failure and normal ejection fraction were randomly allocated into the control group (n=55) and the HBO group (n=55). The control group were given the routine therapy, the HBO group were treated with hyperbaric oxygen on the basis of conventional drug. The application of color doppler ultrasound before and after treatment for 3 months left ventricular structure indicators. Results Left ventricular structure indicators were significantly decreased (LVDd、IVSD、LVPWD、LVMI)(P<0.01). Compared with the control group the difference was statistically significant (P<0.05). Follow-up of 3 months, The treatment group composite cardiovascular events was fewer than the control group and had significant difference (P<0.05). Conclusion Hyperbaric oxygen therapy can significantly improve left ventricular ejection fraction preserved by heart failure of left ventricular diastolic and systolic function and reverse left ventricular remodeling,And can reduce the happening of cardiovascular events.

The Inflammatory Response and Cardiac Repair After Myocardial Infarction

One of the most important therapeutic targets of current cardiology practice is to determine optimal strategies for the minimization of myocardial necrosis and optimization of cardiac repair following an acute myocardial infarction. Myocardial necrosis after acute myocardial infarction induces complement activation and free radical generation, triggering a cytokine cascade initiated by tumor necrosis factor-alpha (TNF-alpha) release. When reperfusion of the infarcted area is initiated, intense inflammation follows. Chemokines, cytokines and the complement system play an important role in recruiting neutrophils in the ischemic and reperfused myocardium. Cytokines promote adhesive interactions between leukocytes and endothelial cells, resulting in transmigration of inflammatory cells into the site of injury. The recruited neutrophils have potent cytotoxic effects through the release of proteolytic enzymes, and they interact with adhesion molecules on cardiomyocytes. In spite of the potential injury, reperfusion enhances cardiac repair; this may be related to the inflammatory response. Monocyte chemoattractant protein (MCP)-1 is upregulated in reperfused myocardium and can induce monocyte recruitment in the infarcted area. Monocyte subsets play a role in phagocytosis of dead cardiomyocytes and in granulation tissue formation. In addition, the transforming growth factor (TGF)-beta plays a crucial role in cardiac repair by suppressing inflammation. Resolution of inflammatory infiltration, containment of inflammation and the reparative response affecting the infarcted area are essential for optimal infarct healing. Here, we review the current literature on the inflammatory response and cardiac repair after myocardial infarction.

Relationship between Left Ventricular Remodeling and Systolic Function Assessed by Left Ventricular Mid-wall Fractional Shortening / 中国康复理论与实践

@#Objective To investigate the correlation between left ventricular remodeling and systolic function by mid-wall fractional shortening(mFS).Methods 51 cases of hypertension and 47 cases of healthy volunteers were enrolled and systolic parameters were measured as ejection fraction(EF), fractional shortening(FS) and mFS. Acorrding to left ventricular remodeling parameteres inclulding LVMI and RWT, hypertension group was divided into four subgroups. The correlation among these parameters were analyzed.Results Thicker left ventricular wall and lower mFS in patient with hypertension compaired with those in controll (P<0.05). There were negative correlation between mFS and RWTr=-0.42, P<0.05) and positive correlation between mFS and LVMI r=-0.67, P<0.01).Conclusion mFS is a valuable parameter compared with traditional parameteres such as EF and FS. There is a linear association between parameteres of ventricular remodeling and systolic function assessed by mFS in early stage of hypertension.

Effects of Losartan on Expression of TNF-? in Myocardium in Renovascular Hypertensive Rats / 中华高血压杂志

Objective To investigate the effect of angiotensin Ⅱ-1 receptor antagonist losartan on expression of tumor necrosis factor-alpha (TNF-?) in the ventricular myocardium in the renovascular hypertension rats. Methods Renovascular hypertension model was obtained by clip left renal artery in Sprague-Dawley(SD) rats. After operation the rats were divided into 3 groups: sham group, two-kidney one clip (2K1C) group, and losartan treatment group(2K1C and losartan 20 mg/kg?d by drinking). Tail blood pressure was determined every week. Animals were euthanized after treatment with losartan for four weeks. Cardiac index(CI)was calculated by HW/BW, and TNF-? protein of ventricle myocardium was determined by ELISA and immunohistochemistry. Results Losartan significantly decreased blood pressure(P