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Regulatory Effects of miRNA-31 on LATS2 and Cardiomyocyte Hypertrophy in Rat's Cardiomyocytein vitro

Junyi ZENG ; Wan ZHANG ; Lu DING ; Yunfeng WEI ; Zeqi ZHENG ; Tong WEN ; Yongnan FU

Chinese Circulation Journal.2017;32(2):177-182. doi:10.3969/j.issn.1000-3614.2017.02.016

Objective: To observe the regulatory effects of miRNA-31 (miR-31) on LATS2 and cardiomyocyte hypertrophy via down-regulating miR-31 expression in rat's cardiomyocytesin vitro. Methods: Rat's cardiomyocytes were isolated and cultured for 10 daysin vitro, according to different intervention methods, the cells were divided into 4 groups:①Blank control group,②AngII intervention group,③Lentivirus with miR-31 inhibitor infection group,④Negative lentivirus infection group. On day-8, gene expressions of MiR-31, LATS2, cardiac hypertrophy ANP and β-MHC were examined by qRT-PCR; on day-10, cell morphology was observed by fluorescence staining. LATS2 protein expression was examined by Western blot analysis. Dual luciferase reporter plasmids were transfected into 293T cells, then luciferase activity was detected to identify the targeting effect of miR-31 on LATS2. Results: Compared with Blank control group, AngII intervention group showed increased gene expressions of miR31, cardiac hypertrophy ANP and β-MHC,P<0.05, enlarged cardiomyocyte surface,P<0.05; while decreased gene and proteinexpressions of LATS2,P<0.05. Compared with AngII intervention group, Lentivirus with miR-31 inhibitor infection group had down-regulated expressions of miR31, cardiac hypertrophy ANP and β-MHC,P<0.05, reduced cardiomyocyte surface, P<0.05; while slightly increased LATS2 gene expression and obviously increased protein expression,P<0.05. Dual luciferase reporter assay presented that relative luciferase activity of TRAF6-3' UTR+miR-146b was significantly decreased than TRAF6-3' UTR+miR-NC,P<0.01 and relative luciferase activity of LATS2-3' UTR+ miR-31 was signiifcantly reduced than LATS2-3' UTR-NC+miR-31,P<0.01. Conclusion: Cardiomyocytes hypertrophy could be reversed at certain degree by down-regulating miR-31; the targeting effect of miR-31 on LATS2 was involved in cardiomyocyte hypertrophyregulation.

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Effect ofin vitro Balloon Dilatation for Treating Aortic Coarctation Infants Younger Than 6 Months

Yong DI ; Kuiliang WANG ; Yueyi REN ; Qian CAO

Chinese Circulation Journal.2017;32(2):174-176. doi:10.3969/j.issn.1000-3614.2017.02.015

Objective: To evaluate the feasibility ofin vitro balloon dilatation for treating aortic coarctation infants younger than 6 months. Methods: A total of 13 aortic coarctation infants treated in our hospital from 2011-01 to 2015-12 were summarized. The patients were at the mean age of 3.4 months (from 20 days to 6 months), with the mean body weight of 4.8 kg (from 3.6 kg to 6.2 kg) including 9 male. Aortic coarctation segments were resected during the operation and the resected segments were expanded by percutaneous transluminal angioplasty (PTA) via (2-4) times diameter balloon dilatation. The diameters of resected aortic segments were recorded before and after expansion; the change of vascular middle smooth muscle layer was observed by HE staining. Results: There were 8 cases with non-restricted ventricular septal defect (VSD) and 3 of them received staging operation, 2 with atrial septal defect (ASD), 3 with bicuspid aortic valve, 3 with patent ductus arteriosus (PDA) and 1 with pericardial effusion. The resected aortic segments presented that 9 patients had diaphragm type narrow and 4 had tube type narrow. After PTA, the diameters of resected aortic segments were slightly increased for the mean of 0.2 mm and no obvious change was observed; HE staining showed that the vascular inner mucosa was shed, while the middle smooth muscle layer was intact. Conclusion: Balloon dilatation had the poor effect for treating aortic coarctation infants younger than 6 months; surgical procedure could be applied for treating the relevant patients.

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Hematoma Aspiration With Manual Compression for Treating the Patients of Iatrogenic Femoral Pseudoaneurysm Under Ultrasound Guidance

Gang CHEN ; Lihui ZHENG ; Lingmin WU ; Shu ZHANG ; Yan YAO

Chinese Circulation Journal.2017;32(2):170-173. doi:10.3969/j.issn.1000-3614.2017.02.014

Objective: To study the safety and efifcacy of hematoma aspiration with manual compression for treating the patients of femoral pseudoaneurysm after cardiac catheterization under ultrasound guidance. Methods: A total of 27 patients suffering from post-catheterization iatrogenic femoral pseudoaneurysm were analyzed including 14 male and 13 female at the mean age of (53.5±11.4) years. The body, neck and blood supply area of pseudoaneurysm were located by ultrasonography; 18 gauge needle was punctured into the center of pseudoaneurysm to aspirate blood, meanwhile the neck and body of pseudoaneurysm were manually compressed to block blood supply for relevant artery under ultrasound guidance. Manual compression was conducted for 15 min followed by bandage compression; the patients were lie on the back and kept lower extremity straight for 12 hours. Ultrasonography was performed at 24 hours and 1 month after the operation in all patients respectively. Results: There were 24/27 (88.9%) patients having successful aspiration with manual compression at ifrst time; 2 (7.4%) having incomplete occlusion at ifrst time and the success was obtained by second time; 1 having incomplete occlusion due to coexisted femoral arteriovenous ifstula, while the body of pseudoaneurysm was obviously decreased. The overall success rate was 96.3% (26/27), no procedural complication occurred. Conclusion Ultrasonography guided hematoma aspiration with manual compression has been safe and effective for treating the patients of iatrogenic femoral pseudoaneurysm.

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Impact of Aspirin or Clopidogrel Resistance on Major Adverse Cardiovascular Events in Elderly Patients With Acute Coronary Syndrome

Meili TIAN ; Huanle LIU

Chinese Circulation Journal.2017;32(2):141-144. doi:10.3969/j.issn.1000-3614.2017.02.007

Objective: To investigate the impact of clopidogrel or aspirin resistance on major adverse cardiovascular events (MACE) in elderly patients with acute coronary syndrome (ACS) and to explore the application value of thromboelastogram (TEG) in antiplatelet therapy. Methods: A total of 177 ACS patients admitted in our hospital from 2012-09 to 2014-12 were enrolled. The patients were at the mean age of (70.4±10.7) years, all of them received TEG and coagulation function test. Based on the reaction of antiplatelet therapy, they were divided into 2 groups: Non-resistance group,n=98 and Resistance group,n=70, which was further divided into 2 subgroups as Maintenance dose subgroup,n=39 and Increased dose subgroup,n=40. The patients were followed-up for 3 months to observe MACE occurrence including cardiovascular death, angina recurrence, ischemic stroke, myocardial infarction, acute thrombosis and hemorrhage. Results: In Resistance group, there were 50/79 (63.3%) patients with aspirin resistance and 29 (36.7%) with clopidogrel resistance. Compared with Non-resistance group, Resistance group showed decreased coagulation time, clot formation time, TEG reducing rate after 30 minutes maximum amplitude (LY30), activated partial thrombin time (APTT), thrombin time (TT) and international normalized ratio (INR), allP<0.05; while increased levels angle, maximum amplitude of TEG, coagulationindex, ifbrinogen and D-dimer, allP<0.05. Compared with Non-resistance group, Resistance group had the higher MACE rate 21.5% vs 7.1%,P<0.05; in addition, Increased dose subgroup had the lower MACE rate than Maintenance dose subgroup 17.5 vs 25.6%,P<0.05. Conclusion: Clopidogrel or aspirin resistance had the higher incidence of MACE in elder ACS patients; TEG was helpful for guiding antiplatelet therapy and reducing MACE incidence.

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Relationship Between Plasma NT-proBNP Level and Coronary Artery Lesions in Acute ST-elevation Myocardial Infarction Patients With Normal Left Ventricular Ejection Fraction

Guanying JIANG ; Yulan ZHAO ; Jing DONG ; Yaping HUANG

Chinese Circulation Journal.2017;32(2):137-140. doi:10.3969/j.issn.1000-3614.2017.02.006

Objective: To study the relationship between plasma NT-ProBNP level and the severity of coronary artery lesions including left anterior descending (LAD) involvement in acute ST-elevation myocardial infarction (STEMI) patients with normal left ventricular ejection fraction (LVEF) while without diastolic heart failure. Methods: A total of 280 qualiifed patients were collected, plasma NT-proBNP level was examined in all patients within 24-hour of admission. The patients were divided into 3 sets of groups. By Gensini score system: Gensini score<30 group, n=94, Gensini score (30-60) group,n=87 and Gensini score>60 group,n=99; by the number of coronary branch lesions: Single branch group,n=78, Double branch group,n=105 and Triple branch group,n=97; by LAD condition: Criminal LAD group,n=146 and Non-criminal LAD group,n=134. Relevant comparison was conducted in all patients. Results: Plasma NT-proBNP level in Gensini score>60 group was higher than the other 2 Gensini groups, it was higher in Gensini score (30-60) group than Gensini score<30 group; the more branches were involved, the higher NT-proBNP were found (1176.70±492.50) pg/ml vs (608.70±331.20) pg/ml vs (336.90±176.70) pg/ml; NT-proBNP was higher in Criminal LAD group than Non-criminal LAD group (1199.40±725.00) pg/ml vs (607.40±244.20) pg/ml, allP<0.05. Pearson correlation analysis showed that NT-proBNP was positively related to Gensini score (r=0.278,P<0.05). Conclusion: Plasma NT-proBNP level was positively related to severity of coronary lesions, it had certain predictivevalue for triple vessel disease and criminal LAD; routine NT-proBNP examination was helpful for risk stratiifcation and clinical treatment in acute STEMI patients.

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Outcome and Influencing Factor Analysis for Graft Vessels in Patients After Coronary Artery Bypass Grafting

Li LI ; Qiang ZHAO ; Luyue GAI ; Tingshu YANG ; Fang ZENG

Chinese Circulation Journal.2017;32(2):128-131. doi:10.3969/j.issn.1000-3614.2017.02.004

Objective: To investigate the outcome and inlfuencing factors of graft vessels including saphenous vein graft (SVG) and left internal mammary artery graft (LIMAG) in patients after coronary artery bypass grafting (CABG). Methods: A total of 92 patients with post-CABG symptom recurrence from 2010 to 2015 were analyzed by angiography and clinical features for their native coronary vessel and graft vessel. There were 83 male and 9 female patients with the mean age of (62.6±10.8) years. The outcomes of graft vessel were assessed; correlation study was conducted between SVG, LIMAG lesions and traditional atherosclerosis risk factors like age, gender, hypertension, hyperlipidemia, diabetic mellitus, smoking, family history of coronary artery disease (CAD) with other clinical factors such as the time of angina recurrence, thetime from coronary angiography (CAG) to CABG, type of SVG (sequential graft or individual graft), the features of native target vessel lesions prior grafting. Results: The average time from CABG to symptom recurrence was (35.10±24.7) months. There were 146 grafts including 52 LIMAG and 94 SVG (60 individual and 34 sequential grafts), the patency rate of LIMAG was higher than SVG (63.5% vs 44.7%),P=0.030. SVG lesion was positively related to symptom recurrence (OR=1.119, 95% CI 1.002-1.249,P=0.046) and trended to female gender (P=0.065), while not related to other clinical factors; LIMGA lesion was not related to any clinical factors. The patency rate of sequential SVG was higher than individual SVG (58.9% vs. 36.7%,P=0.038). The native target vessel lesion (deifned by pre-operative occlusion/stenosis) was similar between individual SVG group (24/14) and no-lesion SVG group (17/5),P=0.388; while the native target vessel lesion in LIMAG group (7/12) was lower than no-lesion LIMAG group (23/10),P=0.04. Conclusion: Post-CABG lesion was not obviously related to traditional risk factors of CAD, post-SVG lesion was positively related to the time of post-CABG angina recurrence. SVG mid-and long-term patency in sequential graft vessel was higher than that in individual graft vessel. Pre-CABG native coronary blood lfow would affect the outcome of individual LIMAG but not SVG.

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Impact of Astragaloside on Ventricular Remodeling and Peroxisome Proliferator Activated Receptor a Expression in Pressure-overload Rats

Bin TANG ; Jinguo ZHANG ; Hongyong TAN ; Xiqing WEI

Chinese Circulation Journal.2017;32(2):183-187. doi:10.3969/j.issn.1000-3614.2017.02.017

Objective: To study the impact of astragaloside on ventricular remodeling and peroxisome proliferator activated receptor a (PPARa) expression in pressure-overload rats and to preliminarily explore its mechanism. Methods: Pressure-overload rat's model was established by abdominal aorta constriction (AAC) in 8-week old SD rats and the result was conifrmed by echocardiography at 6 weeks later. Pressure-overload rats were divided into 4 groups with different intragastric treatment: Model control (normal saline) group, Benazepril hydrochloride [10mg/(kg.d)] group, Low-dose astragaloside [40mg/(kg·d)] group and High-dose astragaloside [80mg/(kg.d)] group; in addition, Sham operation group, the rats received intragastricnormal normal saline.n=20 in each group and all animals were treated for 8 weeks. Rat's cardiac structure and function indexes were assessed by echocardiography, hemodynamic parameter was examined by left ventricular intubation, myocardium and blood levels of free fatty acid (FFA) were determined, morphological changes of myocardial tissue was observed by HE and Masson staining, mRNA and protein expressions of PPARa were measured by qRT-PCR and Western blot analysis. Results: Compared with Sham operation group, Model control group showed increased left ventricular mass index(LVMI), collagen volume fraction (CVF) and FFA level, allP<0.05, while decreased mRNA and protein expressions of PPARa, bothP<0.05. Compared with Model control group, Low-dose and High-dose astragaloside groups presented reduced LVMI, CVF and FFA level, allP<0.05-0.01, while elevated mRNA and protein expressions of PPARa, bothP<0.01. Conclusion:Astragaloside IV mayinhibit myocardial remodeling in pressure-overload rats, which might be via up-regulating mRNA and protein expressions of PPARa, enhance myocardiumFFA utilization, and therefore improve myocardial energy metabolism.

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Effect of Levosimendan in Patients of Dilated Cardiomyopathy With Different Heart Function

Hui ZHANG ; Dandan LI ; Zhenhong FU

Chinese Circulation Journal.2017;32(2):153-155. doi:10.3969/j.issn.1000-3614.2017.02.010

Objective: To study the effect of levosimendan treatment in patients of dilated cardiomyopathy (DCM) with different heart fraction. Methods: A total of 145 DCM patients were enrolled, based on left ventricular ejection fraction (LVEF), the patients were divided into 3 groups: Mild heart failure (HF) group, the patients with LVEF≤45%,n=15, Moderate HF group, LVEF≤40%,n=58 and Severe HF group, LVEF≤30%,n=72. LVEF, left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD) and blood levels of BNP were examined and compared at prior and 7 days after levosimendan treatment respectively. Results: Compared with prior treatment, fater7 days of levosimendan medication, LVEF was elevated at certain degree in all 3 groups, while the statistic improvement was only found in Severe HF group (26.06±3.59) % vs (24.79±2.81) %,P<0.05; LAD and LVEDD had no obvious changes with levosimendan medication in all 3 groups,P>0.05. After levosimendan treatment, blood levels of BNP were decreased in all 3 groups as in Mild HF group (604.80±631.87) pg/ml vs (1252.17±1435.39) pg/ml, Moderate HF group (2369.78±2478.59) pg/ml vs (3206.90±2677.15) pg/ml and Severe HF group (4879.63±5302.42) pg/ml vs (6004.46±5041.59) pg/ml, allP<0.05. The differences of BNP level between prior and after levosimendan treatment, the ratio for BNP reduction were similar among 3 groups, allP>0.05. Conclusion: Levosimendan may, in short term, improve the cardiac function in DCM patients with mild, moderate and severe HF with similar degree; while it could not really change the cardiac structure.

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Correlation Study Between Angiotensin II Type1 Receptor Autoantibodies and the Onset Risk in Patients With Essential Hypertension Combining Acute Coronary Syndrome

Yanxiang SUN ; Jun TAO ; Li FENG ; Yong YUAN ; Xuansheng HUANG ; Liting ZHANG

Chinese Circulation Journal.2017;32(2):149-152. doi:10.3969/j.issn.1000-3614.2017.02.009

Objective: To study the correlation between angiotensin II type1 receptor autoantibodies (AT1-AAs) and the onset risk in patients with essential hypertension (EH) combiningacute coronary syndrome (ACS). Methods: Our research included in 4 groups: EH+ACS group,n=28, ACS group, n=29, EH group,n=26 and Control group,n=23 normal subjects. Serum levels of AT1-AAs were examined by ELISA; high sensitivity C-reactive protein (hs-CRP), blood levels of lipids and glucose were also measured and compared among different groups. The correlations between AT1-AAs and blood lipids, glucose, hs-CRP were studied by multiple linear regression analysis. Results: Compared with Control group, ACS group had similar level of AT1-AAs (0.26±0.09) vs (0.21±0.06),P=0.105; while EH+ACS group and HE group had increased AT1-AAs level as (0.40±0.005) and (0.33±0.10),P=0.001 andP=0.02 respectively; AT1-AAs level was higher in EH+ACS group than HE group,P=0.044. In addition, serum AT1-AAs level was positively related to hs-CRP in EH+ACS group, ACS group and EH group (r=0.589,r=0.503 andr=0.273, allP<0.01). Conclusion: Serum AT1-AAs level was positively related to the onset risk in patients with EH combining ACS; AT1-AAs was also related to hs-CRP at certain degree.

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Expression of Platelet-neutrophil Aggregates in Patients With ST-segment Elevation Myocardial Infarction

Haiqiu DONG ; Mei DONG ; Faxin REN

Chinese Circulation Journal.2017;32(2):145-148. doi:10.3969/j.issn.1000-3614.2017.02.008

Objective: This work studied platelet-neutrophil aggregates (PNA) expression in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: Our research included in 2 groups: STEMI group, n=40 patients admitted in our hospital and Control group, n=30 normal subjects. Blood levels of PNA, platelet-monocyte aggregates (PMA) and platelet-lymphocyte aggregates (PlyA) were measured by lfow cytometry at admission and the results were compared between 2 groups. Results: Compared with Control group, STEMI group had similar blood levels of PlyA and PMA,P=0.245 andP=0.312; while increased blood level of PNA,P<0.05. Correlation analysis showed that platelet-leukocyte aggregates (PLA) level was positively related to CK-MB (r=0.4992,P<0.01) and cTnI (r=0.4365,P<0.01). Conclusion: Blood level of PLA, especially PNA was significantly higher in STEMI patients which suggested that increased PNA might be sued as a new index for AMI diagnosis in clinical practice.

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