Effect of CETP polymorphism on atorvastatin lipid-regulating effect and clinical prognosis of patients with coronary heart disease.

BACKGROUND: The aim of this study was to investigate the influence of genetic polymorphism of cholesteryl ester transfer protein (CETP) gene polymorphism -629C/A on the therapeutic effect of atorvastatin and clinical outcome in Han Chinese patients with coronary heart disease (CHD). MATERIAL AND METHODS: From October 2011 to December 2012, 348 patients with angiographically confirmed CHD were recruited. CETP gene polymorphism was determined by polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) method. Serum level of CETP was determined with enzyme-1inked immunosorbent assay (ELISA). Lipid 1evel in all patients was determined at baseline and after 12 months of treatment with 20 mg/d of atorvastatin. All the patients were followed-up at least 12 months. Major adverse cardiac events, including death, non-fatal infarction, revascularization, and stroke (MACE), were recorded. RESULTS: The frequency of the -629A allele was 0.412. Compared with CC or CA genotypes, individuals with AA genotype had lower CETP levels (P=0.026) and higher high-density lipoprotein cholesterol (HDL-C) levels (P=0.035). After 12 months of atorvastatin therapy, carriers with CC genotype had greater reduction of low-density lipoprotein cholesterol (LDL-C) (P<0.001), reduced LP (a) (P=0.005), and elevated HDL-C (P=0.045) compared with CA or AA genotypes. The incidence of MACE after a mean follow-up of 17.3±5.2 months was 8.8%. The cumulative MACE-free survival rates were 90.1%, 85.2%, and 71.1% for CC, CA, and AA genotypes, respectively. CONCLUSIONS: Our results suggest that the AA variant of the -629A allele of CETP gene had higher HDL-C levels and reduced CETP levels, but patients with CC genotype appeared to have benefited more from statin therapy with reduction in LDL-C and LP (a) levels. Long-term clinical prognosis was, however, not affected by the 3 genotypes.

Research progress on mechanism of action of Radix Astragalus in the treatment of heart failure.

This paper reviewed the retrieved literature published in the last 10 years, regarding the mechanism of Radix Astragalus in treating heart failure, in aspects of myocardial contraction improvement, cardiac muscle cell protection, neuro-endocrinal system regulation, relative cytokine regulation, and left ventricular remodeling inhibition, etc.

Effects of liandou qingmai recipe (see text) on endothelin-1, nitric oxide, interleukin-6 and interleukin-10 levels in patients with coronary heart disease.

OBJECTIVE: To observe effects of Liandou Qingmai Recipe (see text) on endothelin-1 (ET-1), nitric oxide (NO), interleukin-6 (IL-6) and IL-10 levels in patients with coronary heart disease. METHODS: Total 101 cases with coronary heart disease were randomly divided into a treatment group (n = 45) treated by Liandou Qingmai Recipe and a standard treatment group (control group, n = 56), with a normal group of 16 health persons set up. Changes of ET-1, NO, IL-6 and IL-10 levels were measured before treatment and after treatment for two weeks. And the data were analyzed by SPSS 16.0 statistic software. RESULTS: Before treatment, the levels of ET-1, IL-6 and IL-10 levels were significantly higher and NO was significantly lower in the patients with coronary heart disease than those in the normal group (90.7 +/- 12.7 ng/L vs 41.8 +/- 13.5 ng/L, 9.17 +/- 0.18 ng/L vs 1.10 +/- 0.08 ng/L, 1.94 +/- 0.26 ng/L vs 1.09 +/- 0.06 ng/L, and 92.2 +/- 17.7 micromol/L vs 124.5 +/- 27.2 micromol/L; all P < 0.05), with no significant differences in the levels of ET-1, NO, IL-6 and IL-10 between the treatment group and the control group (P > 0.05); After treatment, ET-1 and IL-6 significantly decreased in the treatment group and the control group, and NO increased in the treatment group; And IL-6 level was significantly lower and NO level was higher in the treatment group than those in the control group (4.48 +/- 1.22 ng/L vs 5.13 +/- 1.85 ng/L, 117.4 +/- 22.3 micromol/L vs 92.4 +/- 17.1 micromol/L; both P < 0.05); There was a positive correlation between IL-6 and IL-10, and a negative correlation between NO and IL-10 (r = 0.142, r = -0.152; both P < 0.05). CONCLUSION: Liandou Qingmai Recipe can decline IL-6, IL-10 and ET-1 levels, and raise NO level in patients with coronary heart disease on the basis of standard treatment, so as to inhibit endothelial inflammatory response, improve vascular endothelial function, with stronger anti-AS action; And vascular endothelial lesion is related with inflammatory response.

Progress in the research of Radix Astragali in treating chronic heart failure: effective ingredients, dose-effect relationship and adverse reaction.

Radix Astragali, a Chinese herbal medicine possessing important cardiovascular pharmacologic effects, is widely applied for the treatment of chronic heart failure (CHF) in clinical practice. This paper summarizes briefly the researches in the last 10 years on its chemical compositions, effective ingredients for improving cardiac function, dose-effect relationship in treating CHF, and adverse reactions that occurred in clinical practice.

Clinical effect of Astragalus granule of different dosages on quality of life in patients with chronic heart failure.

OBJECTIVE: To explore the dose-effect relationship of Astragalus granule (AG) on improving the quality of life (QOL) of the patients with chronic heart failure (CHF). METHODS: Ninety CHF patients of Fei ()-qi-deficiency and/or Xin ()-Shen () yang-deficiency syndromes were equally randomized divided with a random number table into three groups; they received the high (7.5 g), moderate (4.5 g), and low dosage (2.25 g) of AG orally taken twice a day, respectively, and 4 mg of perindopril tablet once a day for 30 successive days. The heart function grade, patients' left ventricular ejection fraction (LVEF) and walking distance in 6 min (6mWD) were measured before and after treatment, and the patients' QOL was scored by the Minnesota Questionnaire for QOL evaluation in the patients with CHF at the same time. RESULTS: The heart function grades of all the three groups after treatment were improved compared with those before treatment, but the improvements in high-dose group and moderate dose group were better than that in the low dose group (P<0.05). LVEFs were increased significantly in all the three groups, but the improvements in the high-dose group (59.42%±7.50%) and moderate dose group (61.98%±6.82%) were better than that in the low dose group (51.45%±6.80%, P<0.01); the 6mWDs in the all groups were also significantly increased (P<0.01), up to 419.80±36.23 m, 387.15±34.13 m, and 317.69±39.97 m, respectively; and Minnesota scores in them were lowered to 29.59±4.69 scores, 35.74±5.89 scores, and 42.78±6.06 scores, respectively; comparisons in aspects on 6mWD and Minnesota score showed that the effectiveness with high dose is the most effective, moderate dose as the second, and low dose as the lowest (P<0.01). CONCLUSIONS: AG was sufficient to display an optimal effect on improving heart contraction at the moderate dose. In aspects of improving the QOL of CHF patients, the effectiveness of AG showed a dose-dependent trend. It should be applied discriminatively depending on the actual condition of patients and the aim of treatment in clinic.

[Effects of astragalus on cardiac function and serum tumor necrosis factor-alpha level in patients with chronic heart failure].

OBJECTIVE: To explore the effects of Astragalus on cardiac function and serum tumor necrosis factor-alpha (TNF-alpha) level in patients with chronic heart failure (CHF). METHODS: Forty-five patients of Xin-qi deficiency or Xin-yang deficiency types were assigned to the Chinese medicine (CM) group and the Western medicine (WM) group by a randomizing digital table. Standard treatment for correcting heart failure, including digoxin, diuretics, etc. was administered to both groups, but to the CM group oral medication of Astragalus granule was given additionally at the dosage of 2.25 g twice a day, the treatment for both was continued for two weeks. NYHA cardiac functional grading, serum TNF-alpha level, left ventricular ejection fraction (LVEF) and walk distance in 6 min (WD) were measured before and after treatment, and a correlation analysis was carried out. RESULTS: After therapy, the level of TNF-alpha in the two groups decreased (P < 0.05) and it was lower in the CM group [(54.77 +/- 9.34) microg/L] than in the WM group [(62.10 +/- 9.94) microg/L] (P < 0.05); LVEF in the two groups increased (P < 0.05) and it was higher in the CM group [(64.45 +/- 12.47)%] than that in the WM group [(56.03 +/- 13.33)%] (P < 0.05); both groups' WD increased (P < 0.05) and it was longer in the CM group [(446.97 +/- 68.82) m] than in the WM group [(345.40 +/- 63.62) m] (P < 0.05); the improvement of cardiac functional grading in the CM group was outstriper than the WM group (P < 0.05). The improvement in cardiac function was negatively correlated with TNF-alpha level. CONCLUSION: Astragalus can alleviate the calcium overload-induced myocardial damage and improve both systolic and diastolic functions of heart in patients with CHF.

[Effect of yiqi wenyang huoxue recipe on bone marrow stem cells' mobilization and its influence on heart function in patients with myocardial infarction].

OBJECTIVE: To observe the effect of Yiqi Wenyang Huoxue Recipe (YWHR) on bone marrow stem cells' mobilization and heart function of myocardial infarction (MI) patients. METHODS: Sixty acute MI patients were equally assigned to the treatment group and the control group randomly according to the numeration table. Standard therapy composed of subcutaneous injection of 0.4 mL low molecular heparin every 12 h for 7 successive days combined with continuously orally taken of enteric-coated aspirin tablets 0.1 g, Perindopril 4 mg and Atorvastatin 10 mg once a day (if there was no contraindication), was given to all patients. But to the treatment group, one dose of YWHR was given every day additionally, which consisted of Panax ginseng 10 g, Radix Astragali 15 g, Radix Aconiti lateralis preparata 5 g, Radix Ilex pubesceus 30 g and Herbal Leonuri 10 g for 10 successive days. The change of CD34+ cells' count was observed. The infarcted area size was estimated with QRS scoring system at the end of the 3rd week after onset, and the heart function parameters, including left ventricular ejection fraction (LVEF), left ventricular end-systolic volume index (LVESVI), left ventricular end-diastolic volume index (LVEDVI) and wall motion score index (WMSI), were measured with ultrasonic cardiogram. RESULTS: On the fifth and tenth day, the peripheral CD34+ cell count in the treatment group (48.26 +/- 5.74 and 34.18 +/- 6.70) were significantly higher than that on the day of admission (20.33 +/- 6.01), also higher than the corresponding count in the control group (22.45 +/- 5. 31 and 19.89 +/- 5.93), showing statistical difference (P < 0.01). The QRS score (2.68 +/- 0.41) and infarcted area (22.54 +/- 2.49)% in the treatment group were lower than those in the control group (3.96 +/- 0. 34 and 29.38 +/- 2.59) respectively. Comparison of heart function parameters between groups showed that LVEF (0.59 +/- 0.07 vs. 0.50 +/- 0.07) was higher LVEDVI (68.92 +/- 11.52 vs. 78.46 +/- 13.16), LVESVI (27.47 +/- 7.86 vs. 36.71 +/- 8.85), and WMSI (2.10 +/- 0.11 vs. 2.98 +/- 0.12) were lower in the treatment group than those in the control group respectively, also showing statistical difference (all P < 0.01). CONCLUSION: YWHR has a good effect on bone marrow stem cell mobilization, it can reduce the infarcted area and improve the heart function of patients with acute MI.