In order to find the cardiotonic constituents of lateral roots of Aconitum carmichaelii Debx., the investigation was carried out. Silica gel column chromatography, Sephadex LH-20, medium-pressure MCI and reverse phase ODS column chromatography were used to separate the 90% EtOH extract of the lateral roots of Aconitum carmichaelii Debx. The structures of the isolated compounds have been identified by chemical properties and spectroscopic analyses. Ten compounds were isolated and their structures were elucidated as benzoic acid-5-hydroxy-2-benzoyl-amino methyl ester (1), honokiol (2), pinoresinol (3), salicylic acid (4), p-hydroxy-cinnamic acid (5), songorine (6), karakoline (7), mesaconitine (8), hypaconitine (9) and 14-benzoylhypaconitine (10), separetely. Compound 1 is a new compound and its structure has been established by NMR, HR-ESI-MS, UV, IR and X-Ray. Compound 2-5 are isolated from the lateral roots of Aconitum carmichaelii Debx. for the first time.
Aconitum ; chemistry ; Cardiotonic Agents ; chemistry ; isolation & purification ; Plant Roots ; chemistry

No abstract available.
Mitochondria, Heart ; Gasotransmitters ; Adenosine Diphosphate ; Myocardial Reperfusion Injury ; Cardiotonic Agents ; Electron Transport Complex IV

The effect of drugs on calcium-binding to cardiac muscle membrane fragments and its turnover rate was studied. Ouabian, acetylcholine, isoproterenol and norepinephrine did not have any effect either on calcium-binding to membrane fragments or an washout ahnd release curves of previously bound calcium. Local anesthetics inhibited the calcium-binding. Tetracaine at concentrations of 1 and 10 mM inhibited the calcium-binding by 30% and 54%, respectively, while 10 mM lidocaine inhibited it by 17%. Propranolol, a well-known adrenergic beta-blocker, also inhibited calcium-binding at the external calcium concentration of 10(-3) M. This effect of propranolol may be attributed to its local anesthetic-like action, rather than to the adrenergic blocking effect.
Anesthetics, Local/pharmacology* ; Animal ; Calcium/metabolism* ; Cardiotonic Agents/pharmacology* ; Cell Membrane/metabolism ; In Vitro ; Myocardium/metabolism*

The effect of drugs on calcium-binding to cardiac muscle membrane fragments and its turnover rate was studied. Ouabian, acetylcholine, isoproterenol and norepinephrine did not have any effect either on calcium-binding to membrane fragments or an washout ahnd release curves of previously bound calcium. Local anesthetics inhibited the calcium-binding. Tetracaine at concentrations of 1 and 10 mM inhibited the calcium-binding by 30% and 54%, respectively, while 10 mM lidocaine inhibited it by 17%. Propranolol, a well-known adrenergic beta-blocker, also inhibited calcium-binding at the external calcium concentration of 10(-3) M. This effect of propranolol may be attributed to its local anesthetic-like action, rather than to the adrenergic blocking effect.
Anesthetics, Local/pharmacology* ; Animal ; Calcium/metabolism* ; Cardiotonic Agents/pharmacology* ; Cell Membrane/metabolism ; In Vitro ; Myocardium/metabolism*

BACKGROUND: Lipid-emulsion propofol (LP) has cardioprotective effects against ischemia-reperfusion injury, but it has lipid-related side effects. Microemulsion propofol (MP) is a lipid-free propofol emulsified with 10% purified poloxamer 188 (PP188). PP188 is a nonionic surfactant and has cardioprotective effects. However, some reports have suggested that reduced cardioprotective effects were observed when the cardioprotective agents were used in combination even though each cardioprotective agent has cardioprotective effects. The aims of this study were to examine and compare the cardioprotective effects of MP and LP. METHODS: 50 isolated rat hearts were perfused with modified Kreb's solution. They were divided into 4 groups and underwent 30 minutes of ischemia and 60 minutes of reperfusion. Control group: ischemia-reperfusion was performed without treatment. LP, MP and PP groups: LP, MP and PP188 were infused during the pre-ischemic and reperfusion period, respectively. Hemodynamic parameters and coronary effluent flow rate (CEFR) were measured. Infarct size was determined using triphenyl-tetrazolium staining. RESULTS: In the MP group, systolic pressure was maintained near baseline, the systolic pressure was higher than that in the other groups and HR was lower than that in the other groups during reperfusion. Diastolic pressure was transiently increased in the PP group after treatment and at 5 minutes after reperfusion compared with that in the control group and in the the LP group. There were no differences in dP/dtmax and CEFR between groups. Infarct size in the LP, MP and PP groups was smaller than that in the control group, but there were no significant differences between these three groups. CONCLUSIONS: MP has cardioprotective effects similar to those of LP. MP can be used for cardiac anesthesia in cases with ischemia-reperfusion injury to avoid the lipid-related side effects of LP.
Anesthesia ; Animals ; Blood Pressure ; Cardiotonic Agents ; Heart ; Hemodynamics ; Ischemia ; Poloxamer ; Propofol ; Rats ; Reperfusion ; Reperfusion Injury

OBJECTIVE: To explore the synergic mechanism of ginsenoside Rg₁ (Rg₁) and aconitine (AC) by acting on normal neonatal rat cardiomyocytes (NRCMs) and pentobarbital sodium (PS)-induced damaged NRCMs. METHODS: The toxic, non-toxic, and effective doses of AC and the most suitable compatibility concentration of Rg₁ for both normal and damaged NRCMs exposed for 1 h were filtered out by 3- (4,5)-dimethylthiahiazo (-z-y1)-3,5-diphenytetrazoliumromide, respectively. Then, normal NRCMs or impaired NRCMs were treated with chosen concentrations of AC alone or in combination with Rg₁ for 1 h, and the cellular activity, cellular ultrastructure, apoptosis, leakage of acid phosphatase (ACP) and lactate dehydrogenase (LDH), intracellular sodium ions [Na⁺], potassium ions [K⁺] and calcium ions [Ca²⁺] levels, and Nav1.5, Kv4.2, and RyR₂ genes expressions in each group were examined. RESULTS: For normal NRCMs, 3000 µ mol/L AC significantly inhibited cell viability (P<0.01), promoted cell apoptosis, and damaged cell structures (P<0.05), while other doses of AC lower than 3000 µ mol/L and the combinations of AC and Rg₁ had little toxicity on NRCMs. Compared with AC acting on NRCMs alone, the co-treatment of 3000 and 10 µ mol/L AC with 1 µ mol/L Rg₁ significantly decreased the level of intracellular Ca²⁺ (P<0.01 or P<0.05), and the co-treatment of 3000 µ mol/L AC with 1 µ mol/L Rg₁ significantly decreased the level of intracellular Ca²⁺ via regulating Nav1.5, RyR₂ expression (P<0.01). For damaged NRCMs, 1500 µ mol/L AC aggravated cell damage (P<0.01), and 0.1 and 0.001 µ mol/L AC showed moderate protective effect. Compared with AC used alone, the co-treatment of Rg₁ with AC reduced the cell damage, 0.1 µ mol/L AC with 1 µ mol/L Rg₁ significantly inhibited the level of intracellular Na⁺ (P<0.05), 1500 µ mol/L AC with 1 µ mol/L Rg₁ significantly inhibited the level of intracellular K⁺ (P<0.01) via regulating Nav1.5, Kv4.2, RyR₂ expressions in impaired NRCMs. CONCLUSION Rg₁ inhibited the cardiotoxicity and enhanced the cardiotonic effect of AC via regulating the ion channels pathway of [Na⁺], [K⁺], and [Ca²⁺].
Aconitine/pharmacology* ; Animals ; Apoptosis ; Cardiotonic Agents/pharmacology* ; Cardiotoxicity/drug therapy* ; Cell Survival ; Ginsenosides/pharmacology* ; Rats

Although symptomatic carbon dioxide (CO2) embolism is rare, it recognized as a potentially fatal complication of laparoscopic surgery. Sudden hemodynamic instability could be a CO2 embolism especially during insufflation. A 65-year-old man received laparoscopic prostatectomy for 5 hours under CO2 pneumoperitoneum without any problem. After resection of prostate, it was stopped following deflation. Thirty minutes later, peumoperitoneum was re-induced to continue the operation. Shortly after re-insufflation, the patient revealed hemodynamic instability suggested a CO2 embolism; severe hypotension, tachyarrythmia, hypoxemia, increased CVP, and changed end-tidal CO2. Gas insufflation was stopped. He was managed with Durant's position, fluid and cardiotonics for 20 minutes. The residual was completed by open laparotomy. Re-insufflation, inducing gas entry through the injured vessels, might be a risk factor for CO2 embolism in this case. The risk to the patient may be minimized by the surgical team's awareness of CO2 embolism and continuous intra-operative monitoring of end-tidal CO2.
Aged ; Anoxia ; Carbon Dioxide ; Cardiotonic Agents ; Embolism ; Hemodynamics ; Humans ; Hypotension ; Insufflation ; Laparoscopy ; Laparotomy ; Pneumoperitoneum ; Prostate ; Prostatectomy ; Risk Factors

BACKGROUND: It has been known that internal thoracic artery grafting has a better patency rate compare to other graft conduits in coronary revascularization. Better patency rates can be expected in more coronary arteries with the use of bilateral internal thoracic artery. However, there were some debates on the complications after the use of bilateral internal thoracic artery. The purpose of our study was to reveal the results of bilateral internal thoracic artery. MATERIAL AND METHOD: The 26 coronary artery bypass operations with bilateral internal thoracic artery were performed from July 2001 to May 2002. We compared the results of 8 diabetic patients to those of 18 non-diabetic patients. We compared the results of BITA (bilateral internal thoracic artery) group to those of SITA (single internal thoracic artery) group that were 20 patients and performed during same period. RESULT: There was no mortality. There was one wound complication in the diabetic group and one in the non-diabetic group. There were no significant differences in operation time, duration of mechanical ventilation, amount of bleeding, infusing duration of cardiotonics, and complication between two groups. There were no significant differences in results between the BITA group and the SITA group. CONCLUSION: There were no significant differences in early results between the BITA group and the SITA group, and there were no significant differences in results between the diabetic group and the non-diabetic group. We think coronary artery bypass grafting with the use of bilateral internal thoracic artery is considered in diabetic patients.
Cardiotonic Agents ; Coronary Artery Bypass ; Coronary Vessels ; Hemorrhage ; Humans ; Mammary Arteries* ; Mortality ; Respiration, Artificial ; Transplants ; Wounds and Injuries

OBJECTIVETo study the chemical constituents of Periploca forrestii.

METHODThe constituents were separate using such various column chromatographic techniques as silica gel, RP-18 silica gel, MCI and Sephadex LH-20. Their structures were identified by such methods as spectral analysis.

RESULTTen compounds were isolated and identified as periforgenin A-3-O-beta-digitoxopyranoside (1), beta-sitosterol (2), periforoside I (3), ursolic acid (4), periplogenin (5), periplocin (6), glycoside E (7), periplocoside M (8) , daucosterol (9), 2alpha, 3alpha, 23-trihydroxy-urs-12-en-28-oic acid (10).

CONCLUSIONCompound 1 was a new cardiac glycoside and compound 8 was reported for the first time from this plant.

Cardiotonic Agents ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Glycosides ; chemistry ; isolation & purification ; Molecular Structure ; Periploca ; chemistry

OBJECTIVETo conduct a meta-analysis of the effect of levosimendan on B-type natriuretic peptide (BNP) levels and evaluate the therapeutic effect of levosimendan on advanced heart failure.

METHODSA meta-analysis was performed on the selected data to analyze the effect of levosimendan on BNP levels.

RESULTSLevosimendan decreased BNP by a mean of 337.66 [95%CI (-296.30, -379.02)] pg/ml 24 h after the administration, and by 259.92 [95%CI (-195.76, -324.08)] pg/ml at 48 h, and by 123.09 [95%CI(-53.32,-195.86)] pg/ml at 1 week. Levosimendan resulted in improvements of the cardiac function by about 29%, 22%, and 10% at 24 h, 48 h and 1 week after the administration.

CONCLUSIONLevosimendan produces favorable effects on the cardiac functions and BNP levels.

Cardiotonic Agents ; therapeutic use ; Heart Failure ; blood ; drug therapy ; Humans ; Hydrazones ; therapeutic use ; Natriuretic Peptide, Brain ; blood ; Pyridazines ; therapeutic use