Objective: To observe the effects of procyanidins on myocardial apoptosis and related protein expressions of caspase-3, Bcl-2 and Bax in experimental rats with ischemia reperfusion (I/R) injury and to explore the possible mechanism. Methods: A total of 40 male SD rats were randomly assigned to 4 groups: Sham group, IR group, Low-dose procyanidin (50 mg?kg-1) group, and High-dose procyanidin (100 mg?kg-1) group. n=10 in each group and the rats were pre-treated by intra gastric drug administration once/day for 2 weeks, then left anterior descending artery (LAD) occlusion was conducted for 30 minutes followed by reperfusion for 120 minutes to establish IR model. Blood levels of CK-MB activity and myocardial infarction (MI) size were examined; protein expressions of caspase-3, Bcl-2 and Bax were determined by Western blot analysis; myocardial apoptotic index was measured by TUNEL method. Results: Compared with Sham group, IR group presented the higher CK-MB activity, enlarged MI size, increased index of apoptosis, elevated protein expressions of caspase-3 and Bax, while reduced protein expression of Bcl-2 and the ratio of Bcl-2/Bax, P<0.05. Compared with IR group, both Low-dose and High-dose procyanidin groups had the lower CK-MB activity, smaller MI size, decreased index of apoptosis, reduced protein expressions of caspase-3 and Bax, while elevated protein expression of Bcl-2 and the ratio of Bcl-2/Bax,P<0.05. Conclusion: Procyanidin could reduce myocardial apoptosis index in experimental IR rats, which might be related to decreased protein expressions of caspase-3 and Bax, increased protein expression of Bcl-2 and the ratio of Bcl-2/Bax.

Objective This study was conducted to investigate the clinical outcomes and safety of percutaneous coronary intervention (PCI) to the single-opened vessel lesion among patients with severe left ventricular systolic dysfunction. Methods Twenty-seven patients with severe left ventricular systolic dysfunction (ejection fraction≤35%) undergoing PCI were included. All the patients received PCI only to the single-opened vessel lesion under the conditions of: (1) There were limitations to open chronic total occlusion (CTO);(2) Single-opened vessel lesion was not calcified and tortuous. Clinical outcomes, including success rate of PCI, changes of symptoms in-hospital, brain natriuretic peptide (BNP) and left ventricular ejection fraction (LVEF) pre-and one week post-PCI, the major adverse cardiac events (MACE, including death, myocardial infarction and target vessel revascularization) at 30-days after discharged were observed. Results The success rate of PCI was obtained in all 27 patients(100%), and all the patients received drug eluting stent implantation. The symptoms improvement occurred in all patients and the NYHA class improved from grade Ⅳto grade Ⅲin 22 patients(81.5%) in-hospital. Significant differences were noted in the mean BNP and LVEF between pre-PCI and one week post-PCI, BNP[(2699.6±1104.7) pg/ml vs. (737.0 ± 261.7) pg/ml, P<0.05],LVEF[(26.9±5.7)%vs. (36.0±3.41)%, P<0.05)]. No MACE happened in-hospital and at 30-days follow up. Conclusions PCI only to the single-opened vessel lesion among patients with severe left ventricular systolic dysfunction under the condition of limitations to open CTO is safe and can significantly improve clinical outcomes in-hospital and at 30-days follow up, but it must be emphasized that single-opened vessel lesion not with obvious calcification and tortuosity.