1.Clinical observation of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in patients with acute heart failure.
Ming YE ; Xin WANG ; Yue SUN ; Ji HUANG ; Yu Jie ZENG ; Hai GAO
Chinese Journal of Internal Medicine 2023;62(4):422-426
Objective: To observe the clinical effect of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in acute left heart failure patients 7 days after onset as well as the effects of plasma MDA and ET-1. Methods: In total, 240 hospitalized patients with acute left heart failure from October 2017 to May 2021 were selected from the Department of Emergency and Critical Care Center of Beijing Anzhen Hospital, Capital Medical University and the Department of Cardiology of the Jilin Provincial People's Hospital. They were randomly divided into routine treatment group and combined treatment group, with 120 cases in each group. The routine treatment group was treated with vasodilation, diuresis, cardiotonic and recombinant human brain natriuretic peptide. The combined treatment group was treated with Qiliqiangxin capsules based on the routine treatment group. One week later, the changes in clinical efficacy, ejection fraction, left ventricular commoid diameter, and plasma BNP, MDA, and ET-1 were compared between the two groups before and after treatment. SPSS 11.5 statistical software was used. The measurement data was expressed in x¯±s, the independent sample t-test was used for comparison between groups, and the paired t-test was used for comparison before and after treatment within groups. Counting data was expressed as case (%), and the rank sum test was used for inter-group comparison. Result: In terms of clinical efficacy, the total effective rate of the combined treatment group was significantly higher than that of the conventional treatment group, and the difference was statistically significant (P<0.05). Compared with the routine treatment group, the left ventricular ejection fraction in the combined treatment group was significantly increased (P<0.05). The levels of plasma BNP, MDA and ET-1 were significantly decreased (P<0.05). Conclusion: Qiliqiangxin capsule combined with rhBNP treatment can effectively improve the clinical symptoms of acute heart failure, as well as reduce the lipid peroxidation product MDA content and endothetin ET-1 level in blood. The clinical application value of the Qiliqiangxin capsule needs to be further confirmed by further trials.
Humans
;
Heart Failure/physiopathology*
;
Natriuretic Peptide, Brain/therapeutic use*
;
Stroke Volume/physiology*
;
Ventricular Function, Left/physiology*
;
Cardiotonic Agents/therapeutic use*
;
Drugs, Chinese Herbal/therapeutic use*
;
Recombinant Proteins/therapeutic use*
;
Cardiovascular Agents/therapeutic use*
;
Drug Therapy, Combination
2.Dose-dependent Cardiac Dysfunction and Structural Damage in Rats after Shortwave Radiation.
Jing ZHANG ; Chao YU ; Bin Wei YAO ; Hui WANG ; Li ZHAO ; Xin Ping XU ; Ji DONG ; Hao Yu WANG ; Yan Hui HAO ; Rui Yun PENG
Biomedical and Environmental Sciences 2020;33(8):603-613
Objective:
To detect the effects of shortwave radiation on dose-dependent cardiac structure and function in rats after radiation and to elucidate the mechanism of shortwave radiation induced cardiac injury to identify sensitive indicators and prophylactic treatment.
Methods:
One hundred Wistar rats were either exposed to 27 MHz continuous shortwave at a power density of 5, 10, and 30 mW/cm for 6 min or undergone sham exposure for the control (the rats had to be placed in the exposure system with the same schedules as the exposed animals, but with an inactive antenna). The Ca , glutamic oxaloacetic transaminase (AST), creatine kinase (CK) and lactate dehydrogenase (LDH) content in the peripheral serum of the rats were detected by an automatic blood biochemical analyser. The electrocardiogram (ECG) of standard lead II was recorded by a multi-channel physiological recording and analysis system. The cardiac structure of rats was observed by light and electron microscopy.
Results:
The results showed that the 5, 10, and 30 mW/cm shortwave radiation caused a significant increased in the levels of Ca , AST, CK, and LDH in the peripheral serum of rats. The cardiac structure was damaged by radiation and showed a disordered arrangement of myocardial fibres, the cavitation and swelling of myocardial mitochondria. These injuries were most significant 7 d after radiation and were not restored until 28 d after radiation.
Conclusion
Shortwave radiation of 5, 10, and 30 mW/cm can damage rat cardiac function, including damage to the tissue structure and ultrastructure, especially at the level of the myocardial fibres and mitochondria. Shortwave radiation at 5, 10, and 30 mW/cm induced damage to rat heart function and structure with a dose-effect relationship, i.e., the greater the radiation dose was, the more significant the damage was.
Animals
;
Dose-Response Relationship, Radiation
;
Heart
;
radiation effects
;
Heart Diseases
;
ethnology
;
pathology
;
physiopathology
;
Male
;
Myocardium
;
pathology
;
Radio Waves
;
adverse effects
;
Random Allocation
;
Rats
;
Rats, Wistar
3.Early Warning of Acute Altitude Sickness by Physiological Variables and Noninvasive Cardiovascular Indicators.
Zong Bin LI ; Chun Wei LIU ; Jun GUO ; Ya Jun SHI ; Yang LI ; Jin Li WANG ; Jing WANG ; Yun Dai CHEN
Chinese Medical Sciences Journal 2020;35(1):13-19
Objective To examine if the variations at sea level would be able to predict subsequent susceptibility to acute altitude sickness in subjects upon a rapid ascent to high altitude. Methods One hundred and six Han nationality male individuals were recruited to this research. Dynamic electrocardiogram, treadmill exercise test, echocardiography, routine blood examination and biochemical analysis were performed when subjects at sea level and entering the plateau respectively. Then multiple regression analysis was performed to construct a multiple linear regression equation using the Lake Louise Score as dependent variable to predict the risk factors at sea level related to acute mountain sickness (AMS). Results Approximately 49.05% of the individuals developed AMS. The tricuspid annular plane systolic excursion (22.0±2.66 vs. 23.2±3.19 mm, t=1.998, P=0.048) was significantly lower in the AMS group at sea level, while count of eosinophil [(0.264±0.393)×109/L vs. (0.126±0.084)×109/L, t=-2.040, P=0.045], percentage of differences exceeding 50 ms between adjacent normal number of intervals (PNN50, 9.66%±5.40% vs. 6.98%±5.66%, t=-2.229, P=0.028) and heart rate variability triangle index (57.1±16.1 vs. 50.6±12.7, t=-2.271, P=0.025) were significantly higher. After acute exposure to high altitude, C-reactive protein (0.098±0.103 vs. 0.062±0.045 g/L, t=-2.132, P=0.037), aspartate aminotransferase (19.7±6.72 vs. 17.3±3.95 U/L, t=-2.231, P=0.028) and creatinine (85.1±12.9 vs. 77.7±11.2 mmol/L, t=-3.162, P=0.002) were significantly higher in the AMS group, while alkaline phosphatase (71.7±18.2 vs. 80.6±20.2 U/L, t=2.389, P=0.019), standard deviation of normal-to-normal RR intervals (126.5±35.9 vs. 143.3±36.4 ms, t=2.320, P=0.022), ejection time (276.9±50.8 vs. 313.8±48.9 ms, t=3.641, P=0.001) and heart rate variability triangle index (37.1±12.9 vs. 41.9±11.1, t=2.020, P=0.047) were significantly lower. Using the Lake Louise Score as the dependent variable, prediction equation were established to estimate AMS: Lake Louise Score=3.783+0.281×eosinophil-0.219×alkaline phosphatase+0.032×PNN50. Conclusions We elucidated the differences of physiological variables as well as noninvasive cardiovascular indicators for subjects after high altitude exposure compared with those at sea level. We also created an acute high altitude reaction early warning equation based on the physiological variables and noninvasive cardiovascular indicators at sea level.
Acute Disease
;
Adolescent
;
Adult
;
Alkaline Phosphatase/blood*
;
Altitude
;
Altitude Sickness/physiopathology*
;
Aspartate Aminotransferases/blood*
;
Blood Pressure/physiology*
;
C-Reactive Protein/analysis*
;
Creatinine/blood*
;
Electrocardiography/methods*
;
Exercise Test/methods*
;
Heart Rate/physiology*
;
Humans
;
Leukocyte Count
;
Male
;
Risk Factors
;
Young Adult
4.An increase in heart rate variability can be an index for end point of resuscitation in trauma patients.
Ali FOROUTAN ; Shahram PAYDAR ; Seyyed Taghi HEYDARI ; Leila MOHAMMADI ; Farnaz RAHBAR
Chinese Journal of Traumatology 2019;22(3):134-137
PURPOSE:
The measurement of heart rate variability (HRV) is a non-invasive method to analyze the balance of the autonomic nervous system. The aim of this study was to compare the changes of HRV and base deficit (BD) during the treatment of trauma patients.
METHODS:
Forty-three trauma patients with a low injury severity scores (ISS < 24) and negative base excess on admission were included in this study. Based on the BD changes, patients were divided into three groups: 'end pointed' group (n = 13), patients' BDs instantly cleared after primary hydration; 'needs further resuscitation' group (n = 21), patients' BDs did not reach the end point and thus required further hydration or packed red blood cells transfusion; and 'hydration minimal change' group (n = 9), patients' BDs lower than 2.5 mmol/L at the onset of admission and thereafter had minimal change (near normal range). The changes in HRV during fluid resuscitation were detected and compared to BD changes in their arterial blood gases. All data were analysed using the SPSS software Version 15.0. Repeated measures ANOVA was used to determine the changes in HRV, heart rate, blood pressure, and BD among groups.
RESULTS:
A significant reverse correlation was found between the BD ratio and the HRV ratio (r = -0.562; p = 0.01). The HRV of patients with aggravated BDs after fluid resuscitation was decreased. There was an increase in HRV at the time of BD clearance. A decrease in HRV after primary crystalloid hydration bore a significant connection with the need for an ICU (p = 0.021) and transfusion of packed red blood cells (p < 0.001).
CONCLUSION
Increase in HRV may be a new non-invasive index for the end point of resuscitation in trauma patients.
Adolescent
;
Adult
;
Aged
;
Autonomic Nervous System
;
physiopathology
;
Crystalloid Solutions
;
administration & dosage
;
Fluid Therapy
;
Heart Rate
;
Humans
;
Injury Severity Score
;
Middle Aged
;
Resuscitation
;
methods
;
Wounds and Injuries
;
diagnosis
;
physiopathology
;
Young Adult
5.Serum levels of homocysteine and circulating antioxidants associated with heart rate variability in patients with unstable angina pectoris.
Yong-Cheng WANG ; Du-Fang MA ; Ping JIANG ; Jin-Long YANG ; Yi-Mei ZHANG ; Xiao LI
Chinese Medical Journal 2019;132(1):96-99
Aged
;
Angina, Unstable
;
blood
;
physiopathology
;
Antioxidants
;
metabolism
;
Female
;
Heart Rate
;
physiology
;
Homocysteine
;
blood
;
Humans
;
Male
;
Middle Aged
6.Prediction of recurrence of paroxysmal atrial fibrillation based on RR interval.
Journal of Biomedical Engineering 2019;36(4):521-530
Atrial fibrillation (AF) is one of the most common arrhythmias, which does great harm to patients. Effective methods were urgently required to prevent the recurrence of AF. Four methods were used to analyze RR sequence in this paper, and differences between Pre-AF (preceding an episode of AF) and Normal period (far away from episodes of AF) were analyzed to find discriminative criterion. These methods are: power spectral analysis, approximate entropy (ApEn) and sample entropy (SpEn) analysis, recurrence analysis and time series symbolization. The RR sequence data used in this research were downloaded from the Paroxysmal Atrial Fibrillation Prediction Database. Supporting vector machine (SVM) classification was used to evaluate the methods by calculating sensitivity, specificity and accuracy rate. The results showed that the comprehensive utilization of recurrence analysis parameters reached the highest accuracy rate (95%); power spectrum analysis took second place (90%); while the results of entropy analyses and time sequence symbolization were not satisfactory, whose accuracy were both only 70%. In conclusion, the recurrence analysis and power spectrum could be adopted to evaluate the atrial chaotic state effectively, thus having certain reference value for prediction of AF recurrence.
Atrial Fibrillation
;
diagnosis
;
Entropy
;
Heart Atria
;
physiopathology
;
Humans
;
Recurrence
;
Sensitivity and Specificity
;
Support Vector Machine
7.Research progress on miR-21 in heart diseases.
Journal of Zhejiang University. Medical sciences 2019;48(2):214-218
Pathological processes such as myocardial apoptosis, cardiac hypertrophy, myocardial fibrosis, and cardiac electrical remodeling are involved in the development and progression of most cardiac diseases. MicroRNA-21 (miR-21) has been found to play an important role in heart diseases as a novel type of endogenous regulators, which can inhibit cardiomyocyte apoptosis, improve hypertension and cardiac hypertrophy, promote myocardial fibrosis and atrial electrical remodeling. In this review, we summarize the research progress on the function of miR-21 in heart diseases and its mechanism, and discuss its potential application in diagnosis and treatment of heart diseases.
Cardiomegaly
;
genetics
;
physiopathology
;
Heart Diseases
;
genetics
;
physiopathology
;
Humans
;
MicroRNAs
;
genetics
;
metabolism
;
Myocardium
;
pathology
8.The effects of salidroside on the apoptosis pathway of myocardial cells in acute exhausted rats.
Tao QIE ; Peng XU ; Bing-Xin ZHANG ; Xue-Bin CAO
Chinese Journal of Applied Physiology 2019;35(4):376-380
OBJECTIVE:
To investigate whether salidroside (Sal) plays a part in protecting myocardial cell through reducing the myocardial ischemia and the apoptosis pathway of both death receptors and mitochondria in acute exhausted rats.
METHODS:
Male SD rats were randomly divided into 4 groups (n=6): control group(Con), acute exhaustive swimming group (EE), low-dose and high-dose Sal pre-treatment exhaustive swimming group (SLE, SHE). Rats were treated with Sal solution (15 or 30 mg/(kg·d)) or 0.9%NaCl (3 ml/(kg·d)) by intraperitoneal injection for 15 d, respectively. The Con group did not carry out swimming training. The next day after the end of intraperitoneal administration, the rats in EE, SLE and SHE group were forced to swim until they were exhausted followed the standard of Thomas. After the end of exhaustive exercise, the rats were anesthetized and the blood samples and hearts were collected immediately. The myocardial ischemia and hypoxia area and myocardial apoptosis index (AI) were also observed. Serum ischemia modified albumin (IMA), cardiac troponin I (cTnI), brain natriuretic peptide(BNP) and myocardial cell Bcl-2-associated X protein (Bax), B-cell lymphoma-2 (Bcl-2) were determined. The expressions of myocardial TNF receptor superfamily member 6 (Fas), cytochrome C (Cyto-c), aspartate proteolytic enzyme-3(Caspase-3), aspartate proteolytic enzyme-8(Caspase-8), and aspartate proteolytic enzyme-9(Caspase-9) were detected.
RESULTS:
Compared with the Con group, the myocardial ischemia and hypoxia area in EE group was increased significantly. The serum levels of IMA, cTnI and BNP, AI and Bax levels and cardiac Fas, Cyto-C, Caspase-3, Caspase-8 and Caspase-9 protein expressions of EE group were also increased significantly (P<0.01), while the protein expression of Bcl-2 in cardiac tissues was decreased significantly (P<0.01). Compared with the EE group, the myocardial ischemia and hypoxia area, serum levels of IMA, cTnI and BNP, AI and Bax levels, and the protein expressions of cardiac Fas, Cyto-C, Caspase-3, Caspase-8 and Caspase-9 in Sal group were all decreased significantly(P<0.01). while the protein expression of cardiac Bcl-2 in Sal group were increased significantly (P<0.01).
CONCLUSION
Sal plays a role in protecting myocardial cell through reducing the myocardial ischemia and inhibiting myocardial cell apoptosis in exhaustive exercise rats. The mechanism of reducing myocardial cell apoptosis may be related to inhibiting the expressions of Fas, Cyto-C, Caspase-3, Caspase-8, Caspase-9 and increasing the expression of Bcl-2.
Animals
;
Apoptosis
;
Biomarkers
;
blood
;
Fatigue
;
physiopathology
;
Female
;
Glucosides
;
pharmacology
;
Heart
;
drug effects
;
Male
;
Myocardial Ischemia
;
drug therapy
;
Myocardium
;
cytology
;
Phenols
;
pharmacology
;
Physical Conditioning, Animal
;
Rats
;
Rats, Sprague-Dawley
9.Effects of simulated high-altitude hypobaric hypoxia on cardiac structure and function in rats.
Zhen Long FENG ; Tong ZHAO ; Xiang CHENG ; Ling Ling ZHU ; Yong Qi ZHAO ; Bing SHI
Chinese Journal of Applied Physiology 2019;35(2):173-177
OBJECTIVE:
To investigate the effects of simulated hypobaric hypoxia environment at 7 000 m above sea level on cardiac structure and function in rats.
METHODS:
A total of 96 male SD rats were randomly divided into high-altitude hypobaric hypoxia group (hypoxia group) and normobaric normoxia group (control group). Rats of hypoxia group were placed in a large cabin simulated 7 000 m high-altitude hypobaric hypoxia environment. Operating time 23 h / d, the control circadian ratio of approximately 12 h:12 h. The rats in control group were bred under normobaric normoxia. The hypoxic group was divided into 3 d, 7 d, 14 d, 28 d groups according to hypoxic time, 12 rats in each group. Changes of structure and function of heart due to hypoxia were evaluated by echocardiography and electrocardiogram. Myocardial pathological changes were analyzed by hematoxylin-eosin staining(HE).
RESULTS:
Compared with the control group at the same time point ①With prolonged exposure to hypobaric hypoxia, the growth ratio of body mass in rats is slower. Arterial oxygen saturation was significantly lower in both 14 d and 28 d (P<0.05). ② Left ventricular end-diastolic anterior wall thickness (LVAWD) and left ventricular end-diastolic posterior wall thickness (LVPWD) of rats in 28 d were increased significantly (P<0.05). Left ventricular end-diastolic diameter (LVIDD) and left ventricular internal dimension systole (LVIDS) of rats in 28 d were decreased significantly (P<0.05, P<0.01). Left ventricular ejection fraction (EF), fractional shortening of left ventricle (FS), pulmonary vein (PV) peak velocity and PV peak gradient of rats in 7 d were decreased significantly (P<0.05, P<0.01). ③The QRS and QT interval period were significantly prolonged in 14 d and 28 d (P<0.05, P<0.01). The ST was significantly lower in 3 d and 7 d (P<0.05, P<0.01). The amplitude of R wave gradually shifted downward in 7 d, 14 d, 28 d (P<0.05, P<0.01). ④The red blood cell (RBC), hemoglobin (HGB), red blood cell distribution width (RDW) in hypoxic group were increased significantly (P<0.01). The platelet count (PLT) count was decreased significantly in 14 d and 28 d (P<0.01). The serum creatinine (CR) was increased significantly in 14 d and 28 d (P<0.05). ⑤Pathological changes such as myocardial edema, sarcolemma condensate, focal degeneration and necrosis with inflammatory cell infiltration could be found at early stage of hypoxia. Myocardial compensatory repair such as myocardial fibroblasts proliferation was significant at end stage of hypoxia.
CONCLUSION
Left ventricular systolic functions of rats were decreased significantly after exposure to high altitude hypoxia hypobaric. The left ventricular systolic functions would recovery compensatory after one week exposed to high altitude hypoxia hypobaric.
Altitude
;
Animals
;
Heart
;
physiopathology
;
Hypoxia
;
Male
;
Rats
;
Rats, Sprague-Dawley
10.Effect of Shexiang Tongxin Dropping Pills () on the Immediate Blood Flow of Patients with Coronary Slow Flow.
Sheng-Huang WANG ; Lin CHU ; Zhao XU ; Hong-Lin ZHOU ; Jiang-Fei CHEN ; Huang-Fu NING
Chinese journal of integrative medicine 2019;25(5):360-365
OBJECTIVE:
To observe the immediate effect and safety of Shexiang Tongxin dropping pills (, STDP) on patients with coronary slow flow (CSF), and furthermore, to explore new evidence for the use of Chinese medicine in treating ischemic chest pain.
METHODS:
Coronary angiography (CAG) with corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) was applied (collected at 30 frames/s). The treatment group included 22 CSF patients, while the control group included 22 individuals with normal coronary flow. CSF patients were given 4 STDP through sublingual administration, and CAG was performed 5 min after the medication. The immediate blood flow frame count, blood pressure, and heart rate of patients before and after the use of STDP were compared. The liver and kidney functions of patients were examined before and after treatments.
RESULTS:
There was a significant difference in CTFC between groups (P<0.05). The average CTFC values of the vessels with slow blood flow in CSF patients were, respectively, 49.98 ± 10.01 and 40.42 ± 11.33 before and after the treatment with STDP, a 19.13% improvement. The CTFC values (frame/s) measured before and after treatment at the left anterior descending coronary artery, left circumflex artery, and right coronary artery were, respectively, 48.00 ± 13.32 and 41.80 ± 15.38, 59.00 ± 4.69 and 50.00 ± 9.04, and 51.90 ± 8.40 and 40.09 ± 10.46, giving 12.92%, 15.25%, and 22.76% improvements, respectively. The CTFC values of vessels with slow flow before treatment were significantly decreased after treatment (P<0.05). There were no apparent changes in the heart rate, blood pressure, or liver or kidney function of CSF patients after treatment with STDP (all P>0.05).
CONCLUSIONS
The immediate effect of STDP in treating CSF patients was apparent. This medication could significantly improve coronary flow without affecting blood pressure or heart rate. Our findings support the potential of Chinese medicine to treat ischemic chest pain.
Blood Pressure
;
drug effects
;
Coronary Circulation
;
drug effects
;
physiology
;
Drugs, Chinese Herbal
;
pharmacology
;
therapeutic use
;
Female
;
Heart Rate
;
drug effects
;
Humans
;
Kidney
;
drug effects
;
physiopathology
;
Liver
;
drug effects
;
physiopathology
;
Male
;
Middle Aged
;
No-Reflow Phenomenon
;
drug therapy
;
physiopathology

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