1.Cholesteryl ester transfer protein levels and gene deficiency in Chinese patients with cardio-cerebrovascular diseases.
Yiyi ZHUANG ; Junjun WANG ; Hongjuan QIANG ; Yong LI ; Xiaochuan LIU ; Luyan LI ; Guanghui CHEN
Chinese Medical Journal 2002;115(3):371-374
OBJECTIVETo detect cholesteryl ester transfer protein (CETP) levels, frequencies of CETP D442G and I 14A mutations and characteristics of abnormal lipids in patients with cardio-cerebro vascular diseases.
METHODSNinety-four myocardial infarction (MI) patients, 110 stroke patients and 335 healthy controls were selected. The CETP concentration was determined using ELISA. The CETP activity was measured using a substrate of (14)C-radiolabeled discoidal bilayer particles. The CETP gene mutations were detected by PCR-RFLP.
RESULTSThe CETP concentrations in the MI and stroke group, were higher than those in the controls. The gene mutation frequencies of D442G in the MI, stroke and control group were 3.5%, 3.6% and 5%, respectively, and the frequencies of I 14A were 1.05%, 0.91% and 1%, respectively. One case of D442G homozygote was detected in the healthy group. The frequency of two CETP gene mutations showed no significant difference among the patients and controls. The CETP concentration and activity in subjects with CETP mutations were one-third of those in the control group. The level of HDL-C, apo-A1 increased in the mutation subjects, while the TG level decreased.
CONCLUSIONSThe CETP level increased significantly in patients with cardio-cerebrovascular diseases. The carriers of CETP deficiency had CETP and lipid abnormalities.
Carrier Proteins ; blood ; genetics ; Cholesterol Ester Transfer Proteins ; Glycoproteins ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Mutation ; Myocardial Infarction ; blood ; genetics ; Stroke ; blood ; genetics
2.Association study of the angiotensin-converting enzyme (ACE) gene G2350A dimorphism with myocardial infarction.
M Perwaiz IQBAL ; Saeed MAHMOOD ; Naseema MEHBOOBALI ; Mohammad ISHAQ ; Tasnim FATIMA ; Saddiqa PARVEEN ; Philippe FROSSARD
Experimental & Molecular Medicine 2004;36(2):110-115
The angiotensin converting enzyme (ACE) is a strong candidate gene for myocardial infarction (MI). Insertion-deletion dimorphism in intron 16 of this gene has been inconclusively found to be associated with it. Several new polymorphisms in the ACE gene have been identified and among these, a dimorphism in exon 17, ACE G2350A, has a significant effect on plasma ACE concentrations. To assess the value of genotyping the ACE G2350A dimorphism in a genetically homogeneous population, we carried out a case-control study of dimorphism G2350A for a putative association with MI among Pakistani nationals. We investigated a sample population of 370 Pakistanis, comprising 163 controls, and 207 patients with clinical diagnosis of acute MI (AMI). ACE G2350A alleles were visualized by assays based on polymerase chain reaction and restriction endonuclease analysis. Frequencies of G alleles were 0.68 among controls and 0.72 among AMI patients. The ACE G2350A dimorphism showed no significant association with MI (c2=0.90, 2 df, P=0.64), plasma levels of homocysteine (P=0.52) or with serum levels of folate (P=0.299). The results indicate that ACE G2350A polymorphism is not associated with risk of myocardial infarction in the Pakistani population investigated here.
Adult
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Aged
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Exons/*genetics
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Female
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Genetic Predisposition to Disease
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Genetics, Population
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Genotype
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Humans
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Male
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Middle Aged
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*Mutation
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Myocardial Infarction/blood/*genetics
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Peptidyl-Dipeptidase A/blood/*genetics
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*Polymorphism, Genetic
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Predictive Value of Tests
3.Association of the Pro1770Leu polymorphism in CYP5A1 gene with myocardial infarction in Uigur population of Xinjiang.
Bao-zhu WANG ; Yi-tong MA ; Zhen-yan FU ; Xiang XIE ; Bang-dang CHEN ; Xue-lian ZHANG ; Fen LIU ; Zi-xiang YU
Chinese Journal of Medical Genetics 2010;27(5):535-539
OBJECTIVETo investigate the association between the polymorphism of the thromboxane synthase gene and Uigur patients with myocardial infarction (MI) in Xinjiang.
METHODSThree hundred and fifteen patients with MI and 218 healthy control subjects were detected by polymerase chain reaction and restriction fragment length polymorphism. The serum thromboxane B2 (TXB2) in all subjects was detected with radioimmunoassay kit.
RESULTSThe genotype distributions of the MI group and control group were in Hardy-Weinberg equilibrium (Chi-square=0.375,0.029, P>0.05). The frequencies of CC and TC were 0.933 and 0.067 in MI group while they were 0.977 and 0.023 in controls. There was significant difference in frequencies of the TC genotype and T allele but no difference in frequencies of CC genotype between controls and MI cases. There was significant difference in serum TXB2 level between the MI and control group (P<0.05), and between individuals of the TC and CC genotypes (P<0.05). The serum TXB2 level in the MI cases with TC genotype was increased compared with that of other genotypes (P<0.05).
CONCLUSIONThe TC genotype and T allele of thromboxane synthase gene might be risk factors of MI in Uigur population in Xinjiang, which might result from the increased serum TXB2 level.
Adult ; Asian Continental Ancestry Group ; ethnology ; genetics ; Base Sequence ; Case-Control Studies ; China ; Female ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation, Missense ; Myocardial Infarction ; blood ; enzymology ; ethnology ; genetics ; Polymorphism, Genetic ; Thromboxane B2 ; blood ; Thromboxane-A Synthase ; genetics
4.Association of Rs10487667 genetic polymorphism of thromboxane synthase with myocardial infarction in Uigur population of Xinjiang.
Bao-zhu WANG ; Yi-tong MA ; Zhen-yan FU ; Xiang XIE ; Xue-lian ZHANG ; Bang-dang CHEN ; Fen LIU ; Zi-xiang YU
Chinese Journal of Preventive Medicine 2010;44(11):1032-1036
OBJECTIVETo investigate the association between the polymorphism of thromboxane synthase gene (CYP5A1) and myocardial infarction (MI) of Uigur nationality patients in Xinjiang.
METHODSRs10487667 site polymorphism in CYP5A1 gene of 318 patients with MI (MI group) and 232 healthy control subjects (control group) were analyzed by polymerase chain reaction and restriction fragment length polymorphism. The serum thromboxane B(2)(TXB(2)) concentration was also detected in all subjects. The relationship of multiple factors and myocardial infarction was evaluated comprehensively by non-condition logistic regression analysis.
RESULTSThe frequencies of CYP5A1 gene Rs10487667 site polymorphism in MI group and control group were: GG type 0.204 (65/318) and 0.155 (36/232), GT type 0.553 (176/318) and 0.466 (106/232), TT type 0.242 (77/318) and 0.379 (88/232), respectively. There was significant difference in frequencies of GG genotype (χ(2) = 12.193, P = 0.002) between two groups and G allele frequency in MI group (0.481 (306/636)) was significant higher than control group (0.388 (180/464)) (χ(2) = 9.449, P = 0.021), but no difference in frequencies of GT and TT genotypes (χ(2) = 0.699, P > 0.05)between controls and MI cases. There was significant difference in serum TXB(2) level between MI ((184.3 ± 34.7) pg/ml) and control ((124.3 ± 28.1) pg/ml) groups (t = 5.503, P = 0.034). In the case and control group, the serum TXB(2) level of the person with GT + GG genotype ((164.21 ± 22.56) and (134.26 ± 19.83) pg/ml)) was significant higher than those of TT genotypes ((113.67 ± 54.23) and (98.54 ± 13.11) pg/ml) (t values were 5.433 and 5.108, respectively, both P values < 0.05). Logistic regression analysis showed that the T allele of the CYP5A1 gene was one independent risk factor of MI (OR = 1.673, 95%CI: 1.020 - 2.156) after adjustment of risk factors.
CONCLUSIONRs10487667 polymorphism in CYP5A1 gene might be a risk factor of MI in Uigur population in Xinjiang, which maybe related with the significant high serum TXB(2) level.
Alleles ; Case-Control Studies ; China ; epidemiology ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; epidemiology ; genetics ; Polymorphism, Genetic ; Thromboxane B2 ; blood ; Thromboxane-A Synthase ; genetics
5.Effect of folium panax quinquefolium saponins on apoptosis of cardiac muscle cells and apoptosis-related gene expression in rats with acute myocardial infarction.
Hui-jun YIN ; Ying ZHANG ; Yue-rong JIANG
Chinese Journal of Integrated Traditional and Western Medicine 2005;25(3):232-235
OBJECTIVETo observe the effect of Folium Panax quinquefolium saponins (PQS) on apoptosis of cardiac muscle cells (CMCs) and apoptosis-related gene expression in rats with acute myocardial infarction (AMI).
METHODSFifty Wistar rats were randomly divided into 5 groups, 40 rats underwent coronary ligation of left anterior descending branch to establish AMI rats model, while to the other 10 rats in the sham-operation group, thoracotomy without coronary ligation was carried out. The AMI model rats in treated groups were treated with high-dosage PQS, low-dosage PQS, captopril respectively for 7 days, and those in the control group were treated with normal saline instead. Then, the apoptotic CMCs were labeled by TUNEL and the expression of Bcl-2 and Fas in cardiac muscle cells were determined by immunohistochemical methods.
RESULTSThe apoptotic index of CMCs in the model rats (46.48%) was significantly higher than that in the sham-operation group ( 1.03%, P<0.01 ). CMCs apoptosis rate in the low-dosage PQS group, the large-dosage group and the captopril group was 23.53 %, 17.58 % and 25.17 %, respectively, all were significantly lower than that in the sham-operation group (P<0.01). The expression of Bcl-2 gene was up-regulated and expression of Fas protein was down-regulated in the three treated groups.
CONCLUSIONPQS can inhibit CMCs apoptosis in AMI rats, downregulate Fas protein expression and up-regulate Bcl-2 protein expression, and has antagonistic effect in myocardial ischemic injury.
Animals ; Apoptosis ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Male ; Myocardial Infarction ; blood ; genetics ; pathology ; Myocytes, Cardiac ; pathology ; Panax ; Plant Leaves ; chemistry ; Proteins ; genetics ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Wistar ; Saponins ; pharmacology
6.Construction of VEGF recombinant plasmid pcDNA/V and its expression in model rats with acute myocardial ischemia.
Ya-Mei WANG ; Bing LIU ; Li-Cui SUN ; Yu-Dong YAN ; Yang SI ; Ya-Hui QI
Chinese Journal of Biotechnology 2006;22(2):220-225
The cDNA encoding human Vascular Endothelial Growth Factor 165 (VEGF165) was amplified using RT-PCR from human tonsil tissue and cloned into eukaryotic expression vector pcDNA3.1 (+). The recombinant plasmid pcDNA/V was transferred into 293 cells mediated by liposome and the cells stably expressing VEGF were selected under the pressure of G418. ELISA and Western blotting demonstrated that the eukaryotic expression vector pcDNA/V was successfully constructed and its corresponding protein could be expressed efficiently in vitro. Chick Charioallantoic Membrane (CAM) bioassay showed that recombinant protein has biological activity of hVEGF. Model rats with acute myocardial ischemia were used to further study the expression of VEGFin vivo. The model rats were divided randomly into three groups: control group, pcDNA3.1 (+) group and pcDNA/V group. 50microL naked plasmid DNA or saline was intramyocardially injected at three sites into the border zone of infarction. The hearts of rats were excised and fixed histologically, then the infarction sizes were studied by immunohistochemical staining and electron microscope after four weeks. Immunohistochemical staining for VEGF appeared to be negative in control and pcDNA3.1 (+) groups. In pcDNA/V group, myocardial cells in infarction border zone showed positive staining for VEGF in cytoplasm. Ultrastructural anaylsis showed that there were visible hyperplasia of vascular endothilium in pcDNA/V group. The control and pcDNA3.1 (+) groups showed less capillary hyperplasia. In this study, VEGF165 gene was successfully cloned and its protein expressed in vitro and in vivo was of bioactivity, which provides a basis for the further study of biological functions of human VEGF.
Animals
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Cell Line
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Chickens
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Chorioallantoic Membrane
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blood supply
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Disease Models, Animal
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Genetic Therapy
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Humans
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Male
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Myocardial Infarction
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metabolism
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pathology
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therapy
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Random Allocation
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Rats
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Rats, Sprague-Dawley
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Recombinant Proteins
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biosynthesis
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genetics
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therapeutic use
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Transfection
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Vascular Endothelial Growth Factor A
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biosynthesis
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genetics
7.Association of polymorphism of the prostacyclin synthase gene with myocardial infarction in Uigur population of Xinjiang.
Xiang XIE ; Yitong MA ; Zhenyan FU ; Yining YANG ; Yinghong WANG ; Bangdang CHEN ; Fen LIU
Chinese Journal of Medical Genetics 2008;25(6):708-711
OBJECTIVETo investigate the association between the polymorphism of the prostacyclin synthase gene and Uigur patients with myocardial infarction in Xinjiang.
METHODSThree hundred and ten patients with myocardial infarction (MI) and 306 healthy control subjects were detected by polymerase chain reaction and restriction fragment length polymorphism. The serum 6-keto-PGF(1alpha ) was detected with radioimmunoassay kit in all subjects.
RESULTSThe genotype distributions of the control group and MI group were in the Hardy-Weinberg equilibrium(chi (2)= 0.442, 1.867, P> 0.05). The frequencies of CC, CA and AA were 0.70, 0.26 and 0.03 in the MI group and 0.62, 0.32 and 0.06 in the controls. There was significant difference in frequencies of CC genotype and C allele but no difference in frequencies of CA and AA genotypes between the controls and the MI cases. There was significant difference in serum 6-keto-PGF(1alpha ) level between the MI group and control group (P< 0.05), as well as among the three genotypes (P< 0.05). In the cases with CC genotype the serum 6-keto-PGF(1alpha ) level was lower than that of others (P< 0.05).
CONCLUSIONThe CC genotype and C allele of the prostacyclin synthase gene might be a risk factor of MI in Uigur population in Xinjiang, which may lead to the decreased serum 6-keto-PGF(1alpha ) level.
6-Ketoprostaglandin F1 alpha ; blood ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Case-Control Studies ; Cytochrome P-450 Enzyme System ; genetics ; Ethnic Groups ; genetics ; Exons ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Intramolecular Oxidoreductases ; genetics ; Logistic Models ; Male ; Middle Aged ; Myocardial Infarction ; blood ; genetics ; Polymorphism, Genetic
8.Effects of transplanted myoblasts transfected with human growth hormone gene on improvement of ventricular function of rats.
Shu-ling RONG ; Yong-xin LU ; Yu-hua LIAO ; Xiao-lin WANG ; Yong-jin WANG ; Chao CHANG ; Yu-qin WANG ; Qi-yun LIU ; Yan-zhang GAO ; Shao-hua MI
Chinese Medical Journal 2008;121(4):347-354
BACKGROUNDCell transplantation for myocardial repair is limited by early cell death. Gene therapy with human growth hormone (hGH) has been shown to promote angiogenesis and attenuate apoptosis in the experimental animal. This study was conducted to explore the effects of myoblast-based hGH gene therapy on heart function restoration and angiogenesis after myocardial infarction, and to compare the differences between myoblast-based hGH gene therapy and myoblast therapy.
METHODSMyoblasts were isolated from several SD rats, cultured, purified, and transfected with plasmid pLghGHSN and pLgGFPSN. Radioimmunoassay (RIA) was used to detect the expression of hGH in these myoblasts. SD rats underwent the ligation of the left anterior descending coronary artery so as to establish a heart ischemia model. Thirty surviving rats that underwent ligation were randomly divided into 3 equal groups 2 weeks after left coronary artery occlusion: pLghGHSN group received myoblast infected with hGH gene transplantation; pLgGFPSN group received myoblast infected with GFP gene transplantation; control group: received cultured medium only. Four weeks after the injection the surviving rat underwent evaluation of cardiac function by echocardiography. The rats were killed and ventricular samples were undergone immunohistochemistry with hematoxylin-eosin and factor VIII. Cryosection was analyzed by fluorescence microscopy to examine the expression of green fluorescent protein. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to examine the mRNA expression of vascular endothelial growth factor (VEGF), bax and Bcl-2. hGH expression in myocardium was examined by Western blot.
RESULTSMyoblast can be successfully isolated, cultured and transfected. The expression of hGH in transfected myoblast was demonstrated with RIA. Four weeks after therapy, the cardiac function was improved significantly in pLghGHSN group and pLgGFPSN group. Fractional shortening (FS) and ejection fraction (EF) in pLghGHSN group were elevated significantly compared with pLgGFPSN group and control group after therapy (FS: 36.9+/-5.3 vs 29.5+/-3.5, 21.8+/-2.9; EF: 56.9+/-4.3 vs 47.1+/-3.6, 38.4+/-4.8, P<0.05). Left ventricular end-diastolic dimension (LVEDD) and heart infracted size in pLghGHSN group were decreased significantly compared with pLgGFPSN group and control group after therapy (LVEDD: 5.9+/-0.3 vs 6.8+/-0.2, 8.6+/-0.3; heart infracted size: (34.5+/-4.2)% vs (40.0+/-3.9)%, (46.1+/-3.8)%, P<0.05); Green fluorescence was detected in cryosection of pLgGFPSN group. The capillary density of the pLgGFPSN group was significantly greater than those of the pLghGHSN group and control group (P<0.05). The mRNA expression of VEGF and Bcl-2/bax in pLghGHSN group was higher than in pLgGFPSN group or control group (P<0.05). The expression of hGH gene in myocardium tissue can be detected by Western blot assay in pLghGHSN group.
CONCLUSIONSTransplantation of heart cells transfected with hGH induced greater angiogenesis and effect of antiapoptosis than transplantation of cells transfected with GFP. Combined GH gene transfer and cell transplantation provided an effective strategy for improving postinfarction ventricular function.
Animals ; Blotting, Western ; Cells, Cultured ; Echocardiography ; Genetic Therapy ; Human Growth Hormone ; blood ; genetics ; Immunohistochemistry ; Myoblasts, Skeletal ; transplantation ; Myocardial Infarction ; physiopathology ; therapy ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Transfection ; Ventricular Function
9.Microvessel angiogenesis: a possible cardioprotective mechanism of external counterpulsation for canine myocardial infarction.
Gui-fu WU ; Zhi-min DU ; Cheng-hen HU ; Zhen-sheng ZHENG ; Cheng-yang ZHAN ; Hong MA ; Dian-qiu FANG ; John C K HUI ; William E LAWSON
Chinese Medical Journal 2005;118(14):1182-1189
BACKGROUNDEnhanced external counterpulsation (EECP) has been demonstrated to be effective in the treatment of patients with coronary artery disease (CAD). It has been proposed that the beneficial effects of EECP observed in clinical studies may be due to the formation of new blood vessels (angiogenesis) and collateral development. However, there is a relative paucity of basic studies to support the proposed mechanisms.
METHODSTwelve Beagle dogs were anesthetized with 3% sodium pentobarbital, 1 mg/kg intraperitoneal injection and mechanically ventilated for the development of myocardial infarction. After coronary occlusion, all animals were randomly assigned to either EECP or control. EECP was given one hour per day, 5 days a week, for a total of 28 to 30 hours treatment over a 6-week course. Immunohistochemical studies of alpha-actin and von Willebrand factor (vWF) were used to detect newly developed microvessels. Systemic and local vascular endothelial growth factor (VEGF) were identified by enzyme linked immunosorbent assay (ELISA) and reverse-transcriptional polymerase chain reaction (RT-PCR) analysis.
RESULTSThere was a significant increase in the density of microvessels per mm(2) in the infarcted regions of EECP group compared to control group (vWF, 15.2 +/- 6.3 versus 4.9 +/- 2.1, P < 0.05; alpha-actin, 11.8 +/- 5.3 versus 3.4 +/- 1.2, P < 0.05), along with significant increase of positive vWF and alpha-actin stained area. Both immunohistochemical staining and RT-PCR analysis documented a significant increase in VEGF expression. These factors associated with angiogenesis corresponded to improved myocardial perfusion by 99mTc-sestamibi single-photon emission computed tomography.
CONCLUSIONMicrovessel angiogenesis may be a mechanism of action for the improved myocardial perfusion after EECP therapy.
Animals ; Counterpulsation ; Dogs ; Hemodynamics ; Immunohistochemistry ; Male ; Microcirculation ; Myocardial Infarction ; physiopathology ; therapy ; Neovascularization, Physiologic ; RNA, Messenger ; analysis ; Reverse Transcriptase Polymerase Chain Reaction ; Vascular Endothelial Growth Factor A ; blood ; genetics ; Ventricular Function, Left
10.Transplanted human umbilical cord blood mononuclear cells improve left ventricular function through angiogenesis in myocardial infarction.
Cheng-heng HU ; Gui-fu WU ; Xiao-qing WANG ; Yan-hua YANG ; Zhi-min DU ; Xiao-hong HE ; Peng XIANG
Chinese Medical Journal 2006;119(18):1499-1506
BACKGROUNDHuman umbilical cord blood contains an abundance of immature stem/progenitor cells, which may participate in the repair of hearts that have been damaged by myocardial infarction (MI). This study aimed to evaluate the effects of human umbilical cord blood mononuclear cells (hUCBC) transplantation on cardiac function and left ventricular remodeling in rat model of MI.
METHODSForty-five male Wistar rats were randomized into three groups: MI or control group (n = 15), MI plus cell transplantation (n = 15), and sham group (n = 15). Acute myocardial infarction (AMI) was established by ligating the left anterior descending artery, thereafter, hUCBC were implanted into the marginal area of infarcted myocardium. In MI/control group, DMEM was injected instead of hUCBC following the same protocol. Left ventricular function assessment was carried out by echocardiography and invasive hemodynamic measurements one month post MI. All rats were sacrificed for histological and immunochemical examinations.
RESULTSThe transplanted hUCBC survived and engaged in the process of myocardial repair in the host heart. Echocardiography demonstrated that left ventricular function improved significantly in the rats that underwent cell transplantation. Hemodynamic studies found a significantly decreased left ventricular end-diastolic pressure (LVEDP) [(21.08 +/- 8.10) mmHg vs (30.82 +/- 9.59) mmHg, P < 0.05], increase in +dp/dt(max) [(4.29 +/- 1.27) mmHg/ms vs (3.24 +/- 0.75) mmHg/ms, P < 0.05), and increase in -dp/dt(max) [(3.71 +/- 0.79) mmHg/ms vs (3.00 +/- 0.49) mmHg/ms, P < 0.05] among MI group with hUCBC transplantation when compared with MI/control group. Masson's trichrome staining revealed that the collagen density in the left ventricle was significantly lower in rats of transplantation group than that in the MI control groups [(6.33 +/- 2.69)% vs (11.10 +/- 3.75)%, P < 0.01]. Based on immunostaining of alpha-actin, the numbers of microvessels were significantly (P < 0.01) increased at the boundary of infarction site. Similarly higher mRNA expression of vascular endothelial growth factor (VEGF) 164 and VEGF188 were found at 7- and 28-day post cell transplantation in MI group with hUCBC transplantation when compared with MI/control group.
CONCLUSIONSTransplanted hUCBC can survive in host myocardium without immunorejection, significantly improve left ventricular remodeling after AMI and promote a higher level of angiogenesis in the infarct zones. All these factors beneficially affect cardiac repair in the setting of MI. Therefore human umbilical cord blood may be potential source for cell-based therapy for AMI.
Actins ; analysis ; Animals ; Antigens, CD34 ; analysis ; Collagen ; metabolism ; Cord Blood Stem Cell Transplantation ; Electrocardiography ; Gene Expression ; Humans ; Immunohistochemistry ; Leukocytes, Mononuclear ; chemistry ; cytology ; transplantation ; Male ; Myocardial Infarction ; physiopathology ; surgery ; Myocardium ; chemistry ; metabolism ; pathology ; Neovascularization, Physiologic ; physiology ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Transplantation, Heterologous ; Vascular Endothelial Growth Factor A ; genetics ; Ventricular Function, Left ; physiology