2008 Vol. 5, No. 2
Objective Heart failure is a major disease seriously threatening human health. Once left ventricular dysfunction develops, cardiac function usually deteriorates and progresses to congestive heart failure in several months or years even if no factors which accelerate the deterioration repeatedly exist. Mechanism though which cardiac function continually deteriorates is still unclear. Cardiomyocytic apoptosis can occur in acute stage of ischemic heart diseases and the compensated stage of cardiac dysfunction. In this review, we summarize recent advances in understanding the role of cardiomyocytic apoptosis in heart failure.
Objective Patients with aortic dissection have a significant incidence of coronary artery disease. The purpose of this study is to evaluate the safety and feasibility of percutaneous coronary stent in patients who have undergone endovascular stent, and to assess the effect of anti-coagulant and anti-platelet treatment on patients’ thrombosis process. Methods From January 2005 to July 2007, 8 patients who had undergone endovascular stent-graft during the past 1 to 7 months for type B aortic dissection repair, underwent PCI because of coexisting coronary artery disease. Anti-coagulant and anti-platelet treatments were administrated after PCI according to the standard protocol. Patients were followed up for a mean period of 23 months. Clinical and false lumen status data were collected during the follow-up. Results PCI were technically successful in all 8 patients and no severe complications such as death, paraplegia, renal failure occurred during hospitalization. Complete false lumen thrombosis was observed in 5 patients and incomplete false lumen thrombosis in the remained 3 patients at the end of follow up. There were no major complications such as death, dissection rupture or aneurysm development occurred during the follow-up period. Conclusion Our data implied that PCI can be safely performed in patients with type B aortic dissection who have undergone endovascular stent-graft, without interrupting the thrombosis process.
Abstract Objective To study the different therapeutic proportion of the patient populations undergone coronary angiography (CAG) in the era of development in multislice spiral computed tomography(MSCT). Methods Two hundred and fifty four consecutive patients(mean age 59.24±10.65) , who underwent CAG at daxing hospital from February 2007 through October 2007, were enrolled, 160 patients were male and 94 were female. By evaluating from the coronary angiogram, the patients were not diagnosed to have coronary heart disease(CHD) with less than 50% diameter stenosis of coronary artery; the patients to have CHD with more than or equal to 50% stenosis of coronary artery; the patients were performed the procedure of percutaneous coronary intervention with more than or equal to 70% stenosis; the patients were proposed to have coronary aortic bypass graft(CABG) surgery with left main coronary artery lesions or diffuse triple coronary artery Lesions. Results In the two hundred and fifty four consecutive patients, 59 patients(23.2%)had not been diagnosed to have CHD; 195(76.8%)to have CHD, of these patients with CHD, 49 patients (19.3%)were not indicated for PCI (including the patients receiving follow-up coronary angiography after stenting), 81(31.9%)had been performed the procedure of stent implantation, 57(22.4%)proposed to have CABG, 8(3.1%)the procedure of PCI had not been successful, or had not been performed because of patients opposing to this therapy. Conclusion Multislice spiral computed tomography can be applied as a non-invasive screening tool to exclude the presence of CHD, to increase the positive proportion of the populations with CHD in all patients receiving coronary angiograhpy, to avoid the use of CAG in a subset of patients.
Objective To compare knowledge about hypertension between elderly Chinese urban patients with preferences for either traditional Chinese medicine (TCM) or Western medicine (WM). Methods Elderly (>65 years old) patients with hypertension who prefer TCM treatment (n=112) or WM (n=126) were questioned about hypertension. Their answers were compared. Results Only 32.6% of participants correctly identified hypertension as a main risk factor of coronary heart disease and stroke, 22.3% of patients answered that the main purpose of hypertension control was preventing cardiovascular disease. Other major reasons for these patients to seek medical treatment for their hypertension included: persuasion by physicians or their family members (21.6%), alleviating symptoms such as headache and dizziness (16.8%), lowering blood pressure without knowing specific reason (12.4%). The predictors for poor knowledge of hypertension were similar irrespective of preference for WM or TCM treatment, and included those with lower levels of education and older age. Television and newspaper (46.8%) were the most frequent sources of hypertension information for both groups. Among those who preferred TCM treatment, “TCM has fewer side effects than WM” and “TCM cures disease while WM only alleviates symptoms” were common beliefs held. Conclusion This study shows that knowledge of hypertension is similar among Chinese urban patients with preferences for either WM or TCM treatment and that misunderstandings about hypertension are common among the elderly patients. In order to control hypertension effectively, public health education is necessary. This should target those with a lower level of education and older age.
Objective To investigate the correlation between augmentation index (AI) of the radial artery and diastolic heart function in patients with hypertension. Method Echocardiographs were obtained for 305 patients with hypertension. AI, pulse wave velocity (PWV) of peripheral arteries and serum pro-brain natriuretic peptide (proBNP) levels were determined. Correlations and receiver operating characteristic (ROC) curves were drawn between AI values and impaired diastolic function. Results AI levels were significantly increased in patients with impaired diastolic function diagnosed by ultrasound. Assessment of diastolic heart function based on proBNP levels revealed that AI and aortic pulse wave velocity were significantly elevated in patients with impaired diastolic function. The operating curve indicated that AI may be a more accurate and efficient index for the evaluation of impaired diastolic function compared to PWV. Correlation analysis also showed that proBNP levels had altered in parallel with changes in AI and PWV. After adjusting for various factors including age, gender, blood pressure and blood lipid, a positive correlation was observed between proBNP and AI with a correlation coefficient of 0.3697 (P =0.003). However, no correlation between proBNP and aortic PWV was seen after adjustment. Conclusion Changes in radial AI levels may reflect parallel changes in diastolic cardiac function in patients with hypertension, suggesting that AI may be utilized as a non-invasive clinical indicator of diastolic heart function.
Objective To investigate the effects of simvastatin on membrane ionic currents in left ventricular myocytes of rabbit heart suffering from acute myocardial infarction(AMI),so as to explore the ionic mechanism of statin treatment for antiarrhythmia. Methods Fourty-five New Zeland rabbits were randomly divided into three groups: AMI group, simvastatin intervention group (Statin group) and sham-operated control group (CON). Rabbits were infarcted by ligation of the left anterior descending coronary artery after administration of oral simvastatin 5 mg?kg-1?d-1 (Statin group) or placebo (AMI group) for 3 days. 24 h later, single ventricular myocytes were isolated enzymatically from the epicardial zone of the infracted region .Whole cell patch clamp technique was used to record membrane ionic currents, including sodium current (INa), L-type calcium current (ICa-L) and transient outward potassium current (Ito). Results There was not significant difference in serum cholesterol concentration among three groups. The peak INa current density(at –30 mV) was significantly decreased in AMI group (–23.26±5.18,n=12),) ompared with CON (–42.78±5.48 , n=16), P<0.05,while it was significantly increased in Statin group (–39.23±5.45 pA/pF, n=13) compared with AMI group, P<0.01;The peak ICa-L current density (at 0 mV) was significantly decreased in AMI group (–3.23±0.91 pA/pF, n=12) compared with CON (–4.56±1.01 pA/pF,n= 15),P<0.05,while it was significantly increased in Statin group (–4.18±0.95 pA/pF, n= 12) compared with AMI group, P<0.05; The Ito current density(at +60 mV) was significantly decreased in AMI group (10.41 ±1.93 pA/pF, n=12) compared with CON (17.41± 3.13 pA/pF , n=15), P<0.01, while it was significantly increased in Statin group (16.21 ± 2.42 pA/pF , n=13) compared with AMI group, P<0.01. Conclusions AMI induces significant down-regulation of INa, ICa-L and Ito pretreatment with simvastatin could attenuate this change without lowering the serum cholesterol level, suggesting that simvastatin could reverse this electrical remodeling, thus contributing to the ionic mechanism of statin treatment for antiarrhythmia .
Abstract Objective This study was performed to investigate the effect of high mobility group box-1 protein (HMGB1) on immune function of human T lymphocytes in vitro and explore its potential role in cell-mediated immune dysfunction. Methods Fresh blood was obtained from healthy adult volunteers and peripheral blood mononuclear cells (PBMCs) were isolated, then rhHMGB1 was added to PBMCs. Four-color flow cytometric (FCM) analysis was used for the measurement of intracellular cytokine including interleukin IL-4 and interferon IFN-|? ELISA kits were employed for the determination of IL-2 and sIL-2R protein levels in cell culture supernatants. Results (1) Different stimulating time and dosage of rhHMGB1 did not alter the number of IFN-? positive cells (Th1). rhHMGB1 stimulation provoked a dose-dependent and time-dependent increase in Th2 subset and decrease in ratio of Th1 to Th2. (2) Compared with the untreated cells, when the cells were coincubated with rhHMGB1 (10-100ng/ml) for 12 hrs, protein release of IL-2 and sIL-2R were significantly up-regulated. At 48 hrs, in contrast, protein production were relatively lower in cells after exposure to 100-1000 ng/ml rhHMGB1. Conclusions These findings demonstrated that HMGB1 had a dual influence on immune functions of human T lymphocytes.
Aim To define the heterogeneous changes of ion channels in the noninfarcted myocardium after myocardial infarction in rabbit and effects of imidapril. Mehods Rabbits with left coronary artery ligation were prepared and allowed to recover for 8 wk. Myocytes were isolated from subendocardial, midmyocardial and subepicardial regions of the noninfarcted left ventricular free wall. Ion currents were recorded with whole-cell patch clamp way. Results The densities of the transient outward K+ currents (Ito) and the inward rectifier K+ currents (IK1) were greatly reduced in midmyocardium and subepicardium while two currents reduced gently in subendocardium. The densities of the delayed rectifier K+ currents (IK) were reduced in noninfarcted three layers similarly. Imidapril could reverse the changes of membrane currents in healed myocardial infarction cells and depress the dispersion of repolarization. Conclusions The heterogeneities of K currents were enhanced in noninfarcted area. Normalization of heterogeneous changes of repolarizing after treatment with imidapril was observed.
Objective The aim of this study was to determine if isoflavone genistien had protective effects against high glucose-induced cell apoptosis in human aortic endlthelial cells, and investigate the possible mechanism for this protection. Methods Human aortic endothelial cells subjected to normal (5mM) or high glucose (25mM) were treated with genistein at 0, 50, 100nM. Parallel experiments were performed with 100nM 17b-estradiol, and also in the presence and absence of the pure anti-estrogen ICI-182,780 (100nM). The effects on cell apoptotic DNA fragmentation were determined using cell death ELISA, and the effects on cellular proliferation were determined using tritiated thymidine incorporation assay. Estrogen receptor expression was detected by Taqman quantitative PCR. Results 100nM Genistein significantly reduced high glucose-induced DNA fragmentation, and reversed cell DNA synthesis inhibition (P <0.001) after 24 hours’ incubation. The effect of genistein was completely blocked by ICI-182,780 administration. Estrogen receptor beta, but not alpha was found to be expressed in these cells. Conclusion Isoflavone genistein gave protection against high glucoseinduced cell damage through estrogen receptor beta, reducing apoptotic DNA damage and protecting from the inhibition of cell proliferation.
Objective To investigate the role of hydrogen sulfide (H2S) synthases / H2S pathway in the pathogenesis of renovascular hypertension. Methods Wistar rats were subdivided into 4 groups: (1) 2-kidney, 1-clip (2K-1C group, n=7), (2) control (n=7), (3) sham (n=7), and (4) 2K-1C plus sodium hydrosulfide (NaHS) (NaHS-treated group, n=7). The systolic blood pressure (SBP) was measured by a tail-cuff method using a pulse transducer once a week. Four weeks later, all rats were killed and the concentration of plasma hydrogen sulfide (H2S), the activity of the H2S synthases in the kidneys on both sides, the plasma angiotensin￠òconcentration, and the left-to-whole heart weight ratio were measured. Results The SBP was significantly increased in the 2K-1C group(185.4±14.0mmHg) comparing with those in the sham group ( 112.9±6.5mmHg, , or the NaHS-treated group(134.8±9.5mmHg) (both P<0.01). At 4 weeks, the angiotensin ￠òconcentration in the plasma was increased in the 2K-1C and NaHS-treated group, comparing with the control and the sham group (306.92±7.03 pg/ml and 240.73±13.22 pg/ml vs 122.6±25.49 pg/ml and 125.95±10.55 pg/ml, respectively, both P<0.05). The plasma H2S concentration and the activity of H2S synthases in the left kidney were decreased in the 2K-1C group comparing with those in the sham and the control groups. There was no difference of the activity of the H2S synthases in the right kidneys among the 4 groups. The left-to-whole heart weight ratio was increased in the 2K-1C and the NaHS-treated group camparing with that in the sham and natural control groups. Conclusion Dysfunction of the H2S synthases/H2S pathway was involved in the 2K-1C-induced renovascular hypertension in rat. Exogenous administration of H2S donor can attenuate the development of hypertension. These findings suggest that the H2S synthases/H2S pathway participates in the pathogenesis of renovascular hypertension.
Objective The purpose of the present study was to investigate the effect of Puerarin (Pur) on the myocardial perfusion and ventricular wall motion in patients with acute coronary syndrome (ACS). Methods Thirty-seven patients with ACS were randomly divided into two groups: conventional group (n=17, 11 men and 6 women, with a range of age from 32 to 80 years, and with a mean age 60.9±4.9 years) and Pur group (n=20, 12 men, 8 women, with a range of age from 40 to 76 years, and with a mean age 62.7±3.5 years). Course of treatment for all patients was 10 days. Real-time myocardial contrast echocardiography (RT-MCE) was applied to two groups before and after the therapy to evaluate myocardial microcirculation and ventricular wall motion by observing the change of myocardial perfusion index (MPI) and ventricular wall motion index (VWMI). Results The level of MPI increased and VWMI decreased after 10 days of the therapy, which is significant difference between the Pur group and conventional group (P<0.05). Conclusions Puerarin can increase the level of MPI and decrease the level of VWMI in patients with ACS. Myocardial microcirculation perfusion and ventricular wall motion could be improved probably in patients with ACS treated by Puerarin.
Objective We aimed to investigate whether magnetic stent has preventive effect on in-stent restenosis by observing expressions of MMP2, MMP9, TIMP1 and TIMP2 after balloon angioplasty, bare and magnetic stent implantation in rabbits. Methods Rabbits underwent balloon angioplasty, bare and magnetic stent implantation in the left iliac arteries. The changes of MMPs and TIMPs were examined at various time points in the injured arteries using the methods of zymography, Western blot analysis, reverse transcriptionpolymerase chain reaction (RT-PCR) and morphometric analysis. Results Balloon angioplasty group (BA) and magnetic stent group (MS) showed lower intrinsic gelatinolytic activity and higher expression of TIMPs with less intimae hyperplasia;Whereas bare stent group (BS) exhibited higher intrinsic gelatinolytic activity and lower expression of TIMPs with significant intimae hyperplasia. Conclusion Magnetic stent probably has preventive effect on in-stent restenosis by changing intrinsic matrix metalloproteinases activity and expression of TIMPs.