OBJECTIVETo investigate clinical implications of expression of CD40L in monocytes and changes in serum soluble CD40L in patients with acute coronary syndromes (ACS).

METHODSSixteen control and 56 patients, including 24 with stable angina (SA), 20 with unstable angina (UA) and 12 with acute myocardial infarction (AMI) enrolled in this study. Expression of CD40L in monocytes was analyzed by flow cytometry and sCD40L levels were measured by ELISA.

RESULTSExpression of CD40L in monocytes and serum levels of sCD40L in UA and AMI patients were higher than in SA patients and controls. In patients with AMI, sCD40L levels showed no significant increase when compared to patients with UA, while AMI patients had a peak level of sCD40L at 24 hours after AMI. PTCA induced a marked rise in sCD40L levels in all patients, while CD40L expression in monocytes showed no difference between patients with PTCA, before and after.

CONCLUSIONEnhanced level of serum sCD40L may be a reliable prognostic indicator for ACS and may represent a marker of coronary disease activity.

Angina Pectoris ; blood ; pathology ; CD40 Ligand ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Monocytes ; metabolism ; Myocardial Infarction ; blood ; pathology

OBJECTIVETo investigate the effect of coronary microemboliation (CME) on coronary microvascular injury and myocardial endothelin-1 (ET-1) level.

METHODSCME was induced in 10 miniswines by selective infusion of microspheres (45 microm) into left anterior descending artery (LAD). The ET-1 level in coronary sinus was measured with radioimmunoassay. The microvascular integrity indicator CFR was measured by Doppler flow wire in LAD at baseline and after infusion of microspheres.

RESULTCompared to the baseline, CFR decreased significantly with different doses of microspheres. ET-1 level increased significantly with doses of 5 x 10(4) and peaked with 10 x 10(4), and progressively decreased from doses of 12 x 10(4) to 15 x 10(4) microspheres. There was negative correlation between ET-1 and CFR (r=-0.31, P=0.02).

CONCLUSIONThe extent of microvascular injury is not linearly related to the extent of microembolization, but it is closely associated with myocardial ET-1 level.

Animals ; Coronary Vessels ; pathology ; Disease Models, Animal ; Embolism ; Endothelin-1 ; blood ; Female ; Male ; Myocardial Infarction ; blood ; pathology ; Swine ; Swine, Miniature

OBJECTIVEIn this study, we try to find the better protocol of limb ischemia postconditioning by observing different protective effects of limb ischemic postconditioning (different strength and time windows in rabbits).

METHODS42 healthy New Zealand rabbits were randomly divided into 7 groups (n = 6): Sham; Control (CON); Skeletal muscle postconditioning (SP); 6 min-delayed skeletal muscle postconditioning (6M-DSP); 1 min-delayed skeletal muscle postconditioning (1M-DSP); Strengthen skeletal muscle postconditioning (SSP); Weakened skeletal muscle postconditioning (WSP). Acute ischemia/reperfusion (I/R) model was induced by 45 minutes occlusion on left circumflex coronary artery (LCX) and 2 hours reperfusion in all anesthetized open-chest rabbits except the Sham. Limb ischemia was induced by external iliac arteries occlusion and reperfusion through artery clamps. The extent of myocardial infarction was assessed by triphenyltetrazolium (TTC) staining. Blood serum creatine kinase (CK) activity and lactate dehydrogenase (LDH) activity were measured at baseline,the end of ischemia, after 1 hour and 2 hours of reperfusion respectively.

RESULTSCompared with the CON, the weight ratio and area ratio of myocardial infarction size were significantly decreased by 49.97% and 43.78% in SP, by 42.32% and 42.68% in 1M-DSP, by 48.36% and 48.86% in SSP (P < 0.05). But there was no significant difference between SP and 1M-DSP and SSP (P > 0.05). Otherwise, compared with the CON, myocardial infarct size was not significantly reduced in 6M-DSP or WSP (P > 0.05). The change of CK was similar to the trend of myocardial infarct size.

CONCLUSIONThe limb ischemia strength of 5 mini/1 minR x 1 cycle could significantly reduce the myocardial ischemia/ reperfusion injury in rabbits, if it was achieved before myocardial reperfusion.

Animals ; Extremities ; blood supply ; Ischemic Postconditioning ; methods ; Male ; Muscle, Skeletal ; blood supply ; Myocardial Infarction ; pathology ; Myocardial Reperfusion Injury ; pathology ; prevention & control ; Myocardium ; metabolism ; Rabbits

The effect of limb ischemic preconditioning (LIP) on ischemia-reperfused myocardium was examined in the urethane-anesthetized rats to determine whether LIP produces cardioprotection and to observe the roles of adenosine and neural reflex in this effect. The area at risk (AR) and infarct area (IA) were determined using Evans blue and nitro-blue tetrazolium staining respectively. Infarct size (IS) was defined as 100xIA/AR (%). The results obtained are as follows: (1) During 30 min myocardial ischemia and subsequent 120 min reperfusion, the myocardial infarct size occupied 51.48+/-0.82% of the area at risk. (2) LIP significantly reduced the myocardial infarct size to 35.14+/-0.88% (p<0.01 ), indicating the cardioprotective effect of such an intervention. (3) Femoral nerve section (FNS) completely abolished the cardioprotection afforded by LIP. (4) Intrafemoral artery injection of adenosine (10 nmol/kg) produced a similar effect to that of LIP, reducing the myocardial infarct size to 37.28+/-1.68%, while intrafemoral vein injection of the same dose of adenosine showed no effect. (5) Pretreatment with a selective adenosine A(1) receptor antagonist 8-cyclopentyl-1,diproylxanthine (DPCPX ) (32 nmol/kg) partially abolished the cardioprotection of LIP on myocardium. Taken together, it is concluded that LIP reduces infarct size following myocardial ischemia-reperfusion, and that the locally released adenosine and thereby the activated relevant neural pathway play an important role in the cardioprotection provided by LIP.
Adenosine ; metabolism ; Animals ; Extremities ; blood supply ; Ischemic Preconditioning ; Male ; Myocardial Infarction ; pathology ; prevention & control ; Myocardial Reperfusion Injury ; pathology ; prevention & control ; Rats ; Rats, Sprague-Dawley

To explore the protective effects of right coronary artery ischemic preconditioning and post-conditioning on myocardial ischemia reperfusion injury in rabbit heart.
 Methods: A total of 30 rabbits were randomly divided into 4 groups: a control group (n=7), an ischemia reperfusion group (IR group, n=8), an ischemic preconditioning group (IPC group, n=8) and an ischemic post-conditioning group (IPO group, n=7). Venous blood samples were taken at pre-operation, 1 and 6 h post-operation, and the concentration of serum creatine kinase isoenzyme (CK-MB) and cardiac troponin-T (cTn-T) were measured. The infarct area of cardiac muscle was calculated.
 Results: Compared with the IR group, the levels of CK-MB and cTn-T at 1 and 6 h post-operation in the IPC group and the IPO group were reduced (all P<0.05). Compared with the IR group, the infarct size in the IPC group and the IPO group was significantly decreased, with significant difference (both P<0.05) .
 Conclusion: Right coronary artery ischemic preconditioning and post-conditioning exert significant protective effects on the myocardial ischemia reperfusion injury in New Zealand rabbits.
Animals ; Coronary Vessels ; Creatine Kinase, MB Form ; blood ; Heart ; Ischemia ; Ischemic Postconditioning ; Ischemic Preconditioning ; Ischemic Preconditioning, Myocardial ; Myocardial Infarction ; etiology ; pathology ; physiopathology ; prevention & control ; Myocardial Ischemia ; complications ; therapy ; Myocardial Reperfusion Injury ; prevention & control ; Myocardium ; Rabbits ; Troponin T ; blood

BACKGROUND: The mortality of cardiovascular disease is constantly rising, and novel biomarkers help us predict residual risk. This study aimed to evaluate the predictive value of serum homocysteine (HCY) levels on prognosis in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: The 419 consecutive patients with STEMI, treated at one medical center, from March 2010 to December 2015 were retrospectively investigated. Peripheral blood samples were obtained within 24 h of admission and HCY concentrations were measured using an enzymatic cycling assay. The patients were divided into high HCY level (H-HCY) and low HCY level (L-HCY) groups. Short- and long-term outcomes were compared, as were age-based subgroups (patients aged 60 years and younger vs. those older than 60 years). Statistical analyses were mainly conducted by Student t-test, Chi-squared test, logistic regression, and Cox proportional-hazards regression. RESULTS: The H-HCY group had more males (84.6% vs. 75.4%, P = 0.018), and a lower prevalence of diabetes (20.2% vs. 35.5%, P < 0.001), compared with the L-HCY group. During hospitalization, there were seven mortalities in the L-HCY group and 10 in the H-HCY group (3.3% vs. 4.8%, P = 0.440). During the median follow-up period of 35.8 (26.9-46.1) months, 33 (16.2%) patients in the L-HCY group and 48 (24.2%) in the H-HCY group experienced major adverse cardiovascular and cerebrovascular events (MACCE) (P = 0.120). History of hypertension (hazard ratio [HR]: 1.881, 95% confidence interval [CI]: 1.178-3.005, P = 0.008) and higher Killip class (HR: 1.923, 95% CI: 1.419-2.607, P < 0.001), but not HCY levels (HR: 1.007, 95% CI: 0.987-1.027, P = 0.507), were significantly associated with long-term outcomes. However, the subgroup analysis indicated that in older patients, HCY levels were significantly associated with long-term outcomes (HR: 1.036, 95% CI: 1.011-1.062, P = 0.005). CONCLUSION Serum HCY levels did not independently predict in-hospital or long-term outcomes in patients with STEMI; however, among elderly patients with STEMI, this study revealed a risk profile for late outcomes that incorporated HCY level.
Aged ; Chi-Square Distribution ; Coronary Angiography ; Female ; Homocysteine ; blood ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; blood ; Proportional Hazards Models ; Retrospective Studies ; ST Elevation Myocardial Infarction ; blood ; pathology

Pericarditis and myocarditis are characterised by electrocardiographic changes and elevated cardiac enzymes, respectively, and patients with perimyocarditis often complain of chest discomfort. These findings are nonspecific and often lead to diagnostic difficulties, as ST-elevation myocardial infarction commonly presents in a similar fashion. Clinical differentiation between perimyocarditis and myocardial infarction are especially important because adverse side effects can occur if reperfusion therapy is administered for a patient with acute pericarditis or if a diagnosis of acute myocardial infarction is missed. We herein describe a case of perimyocarditis with ST elevation and raised cardiac markers, which led to two emergency coronary angiographies that were subsequently found to be normal. We include the three serial electrocardiographies (ECGs) performed to show the characteristic features of perimyocarditis and further discuss the importance of identifying typical and atypical ECG features of pericarditis.
Acute Disease ; Aged ; Biopsy ; Blood Pressure ; Coronary Angiography ; Electrocardiography ; Female ; Humans ; Myocardial Infarction ; pathology ; Myocarditis ; diagnosis ; physiopathology

OBJECTIVEHuman umbilical cord blood contains abundant immature stem/progenitor cells, which may contribute to the repair of infarcted myocardium. Present study aimed to explore the feasibility and effects of human umbilical cord blood mononuclear cells (HUCBC) transplantation for the treatment of myocardial infarction.

METHODSForty-five male Wistar rats were randomly divided into three groups: (1) Myocardial infarction (MI plus vehicle, n = 15), (2) MI plus cell transplantation (HUCBC were implanted into the peri-infarct area immediately after MI, n = 15), (3) Normal control group (n = 15). After echocardiography and hemodynamic measurements, the rats were sacrificed for histological and immunochemical examinations one month post MI.

RESULTSThe transplanted HUCBC survived and participated the repair process in host heart. Significantly improved left ventricular function was evidenced by echocardiography in cell transplantation group compared to the MI control group. Left ventricular end-diastolic pressure was significantly reduced LVEDP (21.08 +/- 8.10) vs (30.82 +/- 9.59) mm Hg, P < 0.05], +dp/dt(max) [(4.29 +/- 1.27) vs (3.24 +/- 0.75) mm Hg/ms, P < 0.05] and -dp/dt(max) increased [(3.71 +/- 0.79) vs (3.00 +/- 0.49) mm Hg/ms, P < 0.05] in cell transplantation rats compared with MI control rats. vWF immunostaining examination showed significantly increased microvessels within the boundary of infarcted myocardium in cell transplantation group compared to the MI control group (P < 0.01).

CONCLUSIONSHUCBC transplantation may improve cardiac function in MI rats by promoting microvessel formation.

Animals ; Cord Blood Stem Cell Transplantation ; Humans ; Male ; Myocardial Infarction ; pathology ; surgery ; Random Allocation ; Rats ; Rats, Wistar

OBJECTIVETo observe the effects of SSTG on infarction size and tumor necrosis factor-alpha (TNF-alpha), intercellular adhesion molecular-1 (ICAM-1) levels in serum during reperfusion injury of acute myocardial ischemia.

METHODAnterior descending branch of coronary artery was ligated and released to create myocardial ischemia-reperfusion injury. The size and weight of infarction area and the contents of TNF-alpha, IGAM-1 in serum were assayed by N-BT staining and ELISA respectively.

RESULTThe size and weight of infarct area and the contents of TNF-alpha, ICAM-1 in serum were significantly increased compared with the normal group and were obviously decreased after being treated with SSIG.

CONCLUSIONIschemia-reperfusion stimulated the secretion of TNF-alpha and ICAM-1, which play an important role in ischemia-reperfusion injury. SSTG might protect myocardium from ischemia-reperfusion injury by suppressing over-secretion of TNF-alpha and ICAM-1 and reducing the size and weight of infarction area.

Animals ; Drug Combinations ; Drugs, Chinese Herbal ; pharmacology ; Intercellular Adhesion Molecule-1 ; blood ; Myocardial Infarction ; blood ; pathology ; Myocardial Reperfusion Injury ; blood ; pathology ; Myocardium ; pathology ; Panax ; chemistry ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley ; Salvia miltiorrhiza ; chemistry ; Tumor Necrosis Factor-alpha ; metabolism

AIMTo investigate a possible role for the transcription factor nuclear factor kappa-B (NF-kappaB) in preconditioning of the heart to ischemia by remote, early protection.

METHODS48 Wistar rats were randomly divided into three experimental groups. In group I/R, the rats underwent 30 min occlusion of the left anterior descending coronary artery, and 120 min reperfusion. In group PL, the rats underwent four cycles of 5 min occlusion and reperfusion of both hind limbs using a tourniquet before the experiment was continued as in Group I/R. In Group P(L-D), we administered NF-kappaB specific inhibitor, ProDTC 125 mg/kg peritoneally, 15 min before IPG. Infarct size as a percentage of the area at risk was determined by triphenyltetrazolium chloride staining. And another 8 rats in each group were killed and myocardium were stored in liquid nitrogen for the measurement of NF-kappaB mRNA.

RESULTSThe myocardial infarct size (IS) was decreased significantly in Group PL compared with group I/R, and the IS/AAR was 34.5% +/- 7.6% and 58.5% +/- 8.5%, respectively ( P < 0.05). The IS/AAR was 54.4% +/- 8.9% in group P(L-D), and there was no significant difference compared with group I/R (P > 0.05). The NF-kappaBmRNA was weaker in P(L) group than that in I/R Group,but is stronger than that in P(L-D) group (P < 0.05). There was almost no expression of NF-kappaB mRNA in P(L-D) group.

CONCLUSIONNoninvasive limb IPC is effective in protecting the myocardium from ischemia reperfusion injury. NF-kappaB plays an important role in the mechanism of this acute remote preconditioning.

Animals ; Extremities ; blood supply ; Ischemic Preconditioning, Myocardial ; methods ; Male ; Myocardial Infarction ; pathology ; Myocardium ; metabolism ; NF-kappa B ; metabolism ; Rats ; Rats, Wistar