OBJECTIVETo evaluate the effect of Xuezhikang (XZK) on cardiac function and serum C-reactive protein (CRP) in patients with chronic heart failure (CHF).

METHODSSixty-eight CHF patients were randomly assigned to two groups, the control group (30 cases) treated with angiotensin converting enzyme inhibitor, beta-receptor inhibitor, digoxin and diuretic, and the treated group (38 cases) with the above treatment plus XZK for six months. The changes of cardiac function and serum CRP level were measured by echocardiography and enzyme-linked immunosorbent assay (ELISA) respectively before and after treatment.

RESULTSCompared with those before treatment, the NYHA cardiac function grade, the left ventricular dimension end diastole (LVDd), and the left ventricular dimension end systole (LVDs) decreased significantly (P < 0.05), and the ejection fraction (EF) and E/A ratio increased significantly in both groups after treatment (P < 0.05) , however, the decrement or increment was more significant in the treated group than that in the control group respectively (P < 0.05); the serum CRP level decreased significantly in the treated group after treatment and showed a level obviously lower than that in the control group (P < 0.05), which changed insignificantly after treatment.

CONCLUSIONXuezhikang could improve cardiac function and decrease serum CRP level at the same time.

Adrenergic beta-Antagonists ; therapeutic use ; Adult ; Aged ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; C-Reactive Protein ; metabolism ; Cholesterol ; blood ; Digoxin ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart Failure ; blood ; drug therapy ; physiopathology ; Humans ; Lipoproteins ; blood ; Male ; Middle Aged ; Phytotherapy ; Ventricular Function, Left ; drug effects

OBJECTIVETo investigate the association between serum cardiac troponin I (cTnI) and cardiac function/structure in patients with chronic heart failure.

METHODSOne hundred and twenty patients with decompensated chronic heart failure were included. The patients were divided into cTnI normal group (cTnIn; n = 80) and cTnI elevated group (cTnIe; n = 40). Systolic dimension of the left atrium (LAd), the maximal width of the left ventricle (LVd), the thickness of the interventricular septum (IVS) and posterior wall (LVPW) during diastole, left ventricle ejection fraction (LVEF), E and A wave velocities ratio (E/A) were determined. Bivariate correlation analysis was applied to show the correlation of serum cTnI level with above indices. Partial correlation analysis was performed followed by multivariate logistic regression.

RESULTSLAd and LVd dimensions were significantly higher (P < 0.05), IVS, LVPW, LVEF and E/A ratio were significantly lower (P < 0.05) in cTnIe group than in cTnIn group. Moreover, serum cTnI was positively correlated with LAd, LVd, and inversely correlated with IVS, LVPW, LVEF and E/A ratio (P < 0.05). The correlation persistent after adjusting with sex, history of heart failure, NYHA functional class and treatment. In multivariate modeling, cTnI was positively associated with LAd, LVd and the history of heart failure, and negatively related with the treatment with angiotensin-converting enzyme inhibitor.

CONCLUSIONSerum cTnI correlated with cardiac structure and function. Intensively serum cTnI monitoring and suitable therapy strategy may be helpful to attenuate the cardiac remodeling in patients with chronic heart failure.

Adult ; Chronic Disease ; Female ; Heart Failure ; blood ; physiopathology ; Humans ; Male ; Middle Aged ; Myocardium ; chemistry ; Troponin I ; blood ; Ventricular Remodeling

Objective This study was designed to examine the impact of the antioxidant metallothionein (MT) on cardiac contractile, intracellular Ca2+ function and oxidative stress in lipopolysaccharide (LPS)-treated mice. Methods Weight and age matched adult male FVB and cardiacspecific MT-overexpressing transgenic mice were injected intraperitoneally with 4 mg/kg Escherichia Coli LPS dissolved in sterile saline or an equivalent volume of pathogen-free saline ( control groups). Six hours following LPS or saline injection, cardiac geometry and function were evaluated in anesthetized mice using the 2-D guided M-mode echocardiography. Mechanical and intracellular Ca2+ properties were examined in hearts. Cell shortening and relengthening were assessed using the following indices: peak shortening (PS)-indicative of the amplitude a cell can shorten during contraction; maximal velocities of cell shortening and relengthening ( ± dl/dt) -indicative of peak ventricular contractility; time-to-PS (TPS) -indicative of systolic duration; time-to-90% relengthening ( TR90 )-indicative of diastolic duration ( 90% rather 100%relengthening was used to avoid noisy signal at baseline concentration). The 360 nm excitation scan was repeated at the end of the protocol and qualitative changes in intracellular Ca2+ concentration were inferred from the ratio of fura-2 fluorescence intensity (FFI) at two wavelengths (360/380). Fluorescence decay time was measured as an indicator of the intracellular Ca2+ clearing rate. Glutathione/glutathione disulfide ratio and ROS generation were detected as the markers of oxidative stress. Results Heart rate was increased while EF was reduced in LPS-FVB mice and heart rate was reduced and EF increased in MT-LPS transgenic mice [(528 ±72) beats/min vs (557 ±69) beats/min, (66 ± 14)% vs (42 ± 10)%, P ＜0.05].Cardiomyocytes from the LPS treated FVB mice displayed significantly reduced peak shortening (PS) and maximal velocity of shortening/relengthening ( ± dl/dt ) associated with prolonged time-to-90%relengthening (TR90), these effects were attenuated in cardiomyocytes from the MT-LPS mice [PS (5 ±1.1 )% vs (7.2 ± 0. 8)%, dl/dt (160 ± 15) μm/s vs (212 ± 36) μm/s, - dl/dt (175 ± 32) μm/s vs (208 ±29)μm/s, TR90 (0.24 ±0.03)s vs (0.19 ±0.02) s, P ＜0.05].LPS treated mice showedsignificantly reduced peak intracellular Ca2 + and electrically- stimulated rise in intracellular Ca2 + as well as prolonged intracellular Ca2+ decay rate without affecting the basal intracellular Ca2+ levels, again, these effects were significantly attenuated in MT-LPS transgenic mice. Metallothionein overexpression also ablated oxidative stress [reduced ROS generation and increased glutathione/glutathione disulfide ratio, ROS(0. 35 ±0.08)A/μg protein vs (0.24 ±0.03) A/μg protein] . GSH/GSSG 2.1 ±0.2 vs 2.6 ±0.4, P ＜0. 05. Conclusion MT overexpression improved cardiac function and ablated oxidative stress in LPS treated mice.

Objective To investigate the difference of blood sampling methods from heparin maintained arterial catheter for blood gas analysis and activated partial thromboplastin time (APTT).Methods Conventional and modified arterial catheter blood sampling methods were applied at the same period of time to 30 cases with arterial pressure measurement.3-5 ml blood containing heparin was disposed in conventional method.No blood was disposed for the modified method.The samples were used for blood gas analysis and APTT.The operation time of the sampling by two methods were compared.Results No significant difference was seen for the blood gas analysis and APTT from the blood samples collected by two different methods (P ＞ 0.05).The operation time of modified method was significantly shorter than that of the conventional method [(187.87 ±15.05)s vs (275.73 ±14.75)s,t =22.84;P＜0.01].Conclusions Arterial catheter blood sampling from heparin maintained blood by the modified method gives accurate clinical laboratory results,in this case,the blood gas analysis and the APTT.No blood is wasted and the operation time for the nurses is reduced.The modified method could be an alternative to the conventional blood collection method.