LIU Danyong , XIA Zhengyuan , HAN Ronghui , CHEN Hao , LIU Xin , TANG Jing
Abstract:Myocardial infarction is one of the leading causes of death in patients with coronary heart disease worldwide. In the early stage of acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, drugs and other treatment means can restore the blood supply of ischemic myocardial tissue, save the dying myocardium and reduce the mortality rate of patients. However, after the interruption of myocardial blood supply and the restoration of blood supply within a certain period of time, the original ischemic myocardium may suffer more serious damage than that of ischemia. This phenomenon is called myocardial ischemia-reperfusion injury (MIRI), and its mechanism has not been fully elucidated. In this paper, the research progress of MIRI mechanism in recent years is reviewed, and the pathophysiological mechanism of MIRI is expounded, which will help to develop new therapeutic interventions and provide help for clinical treatment of myocardial infarction.
Abstract:血红素蛋白在生物体系中执行重要的生物功能。在乏氧状态下,一系列血红素蛋白,如血红蛋白(Hb)、肌红蛋白(Mb)、细胞色素C(CytC)、神经红蛋白(Ngb)和胞红蛋白(Cgb)等,表现出不同的亚硝酸盐还原酶(NIR)活性,催化NO-2还原成NO,这与生物体在常氧状态下由L-精氨酸氧化产生NO的通路形成互补。研究表明:蛋白质构象、血红素的配位状态、分子内二硫键以及氢键网络等,可以调控其NIR催化活性,同时受生物体内微环境的影响,如NO-2浓度和pH等。文章对不同血红素蛋白的NIR催化活性进行了分析比较,探讨了其生物学意义,特别是NO-3-NO-2-NO通路在调节心血管系统内稳态平衡中的重要作用。
SI Shengyong , LI Zhijing , MIU Sisi , LIU Li
2020, 28(12):1026-1033, 1059. CSTR:
Abstract:Aim To investigate the effect of long non-coding RNA MIR155 host gene (lncRNA MIR155HG) on proliferation, migration, differentiation and collagen synthesis of myocardial fibroblasts and its molecular mechanism. Methods Mouse myocardial infarction model was constructed. Myocardial fibroblasts were isolated and divided into silent control group, silent MIR155HG group, silent MIR155HG and inhibitor control group, silent MIR155HG and interference miR-133a-3p group, silent MIR155HG and over-expressed Furin group. The expression levels of MIR155HG, miR-133a-3p and Furin were detected by quantitative real-time PCR. Methyl thiazolyl tetrazolium colorimetry was used to detect cell viability. Cell migration was detected by Transwell experiment. Western blot was used to detect the expressions of cyclin D1, cyclin-dependent kinase inhibitor 1A (P21), vascular endothelial growth factor (VEGF), collagen type 1 (Col-1) and α-smooth muscle actin (α-SMA). Targeting relationships between MIR155HG and miR-133a-3p, between miR-133a-3p and Furin were detected by luciferase report experiment. Results In the heart tissue of myocardial infarction model mice, MIR155HG and Furin were highly expressed, and miR-133a-3p was lowly expressed (P<0.05). After inhibiting MIR155HG expression, the cell viability, migration cell number and cyclin D1, VEGF, Col-1, α-SMA expression levels of myocardial fibroblasts were significantly decreased, while P21 expression level was significantly increased (P<0.05). MIR155HG targetedly regulated miR-133a-3p, and miR-133a-3p targetedly regulated Furin. Inhibition of miR-133a-3p expression and overexpression of Furin reversed the inhibition effect of inhibiting MIR155HG expression on proliferation, migration, differentiation and collagen synthesis related proteins of myocardial fibroblasts. Conclusion Inhibition of MIR155HG expression can inhibit the proliferation, migration, differentiation and collagen synthesis of myocardial fibroblasts, which may be related to the regulation of miR-133a-3p/Furin axis.
BING Yanping , SONG Xuan , JIANG Nan , SONG Lijie
Abstract:Aim To investigate the effect and mechanism of lncRNA NEAT1 on hypoxia/reoxygenation induced oxidative stress injury and apoptosis of cardiomyocytes by regulating miR-206. Methods H9c2 cardiomyocytes were cultured in vitro to construct cardiomyocyte hypoxia/reoxygenation model. Real-time quantitative PCR (RT-qPCR) was used to detect the expression of lncRNA NEAT1 and miR-206 after hypoxia/reoxygenation induction. LncRNA NEAT1 small interference RNA (si-lncRNA NEAT1) and miR-206 mimics (miR-206 mimics) were transfected into H9c2 cell, respectively. After hypoxia/reoxygenation induction, the kit was used to detect the content of malondialdehyde (MDA) and reactive oxygen species (ROS) in the cell and the content of lactate dehydrogenase (LDH) in the cell supernatant, MTT assay was used to detect cell activity, flow cytometry was used to detect cell apoptosis, and Western blot was used to detect the expression of cleaved Caspase-3 and cleaved Caspase-9 proteins. The luciferase reporter assay and RT-qPCR were used to verify the targeted binding relationship between lncRNA NEAT1 and miR-206. Results After the induction of hypoxia/reoxygenation, the expression of lncRNA NEAT1 in H9c2 cell was significantly increased, while the expression of miR-206 was significantly decreased (P<0.05). After transfection with si-lncRNA NEAT1 or miR-206 mimics, the survival rate of H9c2 cell was significantly increased, MDA, ROS contents and LDH activity were significantly reduced, and the expression of cleaved Caspase-3 and cleaved Caspase-9 proteins were significantly reduced, and the apoptosis rate was significantly reduced (P<0.05). lncRNA NEAT1 targets miR-206 and negatively regulates miR-206 expression. Inhibition of miR-206 partially reversed the effects of silencing lncRNA NEAT1 on oxidative damage and apoptosis of cardiomyocytes induced by hypoxia/reoxygenation (P<0.05). Conclusion Silencing lncRNA NEAT1 could reduce hypoxia/reoxygenation-induced oxidative stress injury and apoptosis of cardiomyocytes by up-regulating miR-206, and then exert myocardial protection.
LI Ping , HUI Pinjing , JIN Lin , WANG Yingchun , NIU Peiyu , FENG Lan
Abstract:Aim To investigate the method and value of anti-intercellular adhesion molecule-1 (ICAM-1) nano targeted ultrasound bubbles in detecting early inflammation of atherosclerosis (As) and ultrasound molecular imaging. Methods Anti-ICAM-1 nano targeted ultrasound bubbles were prepared by biotin-avidin method. 20 experimental rabbits were randomly divided into 4 groups:control group, 2-week modeling group, 4-week modeling group and 6-week modeling group, with 5 rabbits in each group. The control group was not treated with any treatment. The As models were established by surgical balloon injury and high-fat cholesterol diet in 2-week modeling group, 4-week modeling group and 6-week modeling group. Contrast-enhanced ultrasound was performed in each group to obtain the contrast parameters such as peak intensity (PI), time to peak (PPT), area under curve (AUC) in region of interest. At the end of the experiment, pathological examination was performed on the target abdominal aorta. Results Preparation of nano targeted ultrasound bubbles:the binding rate of ICAM-1 antibody to nano ultrasound bubbles was 72.6%. Contrast enhanced ultrasound:in the control group, the contrast agent of vascular cavity and vessel wall basically disappeared at the same time; 2 min after the injection of contrast agent in each modeling group, the contrast agent in the vascular cavity faded, and the local vascular wall was still developed and enhanced. The analysis of targeted contrast-enhanced ultrasound curve at the thickest part of abdominal aorta showed that PPT of the four groups had no significant difference with the extension of modeling time (P>0.05); PI and AUC of the four groups gradually increased with the extension of modeling time (P<0.05).HE staining:the vascular wall endothelial cell of the control group were arranged completely; the vascular smooth muscle of the model group proliferated obviously; the lipid plaques were formed in 2-week modeling group and 6-week modeling group, and more significantly in the 6-week modeling group. Immunohistochemical staining:the mean integral optical density (IODM) value of ICAM-1 positive staining in abdominal aorta of four groups increased gradually with the extension of modeling time (P<0.05). Correlation analysis:the angiographic parameters PI, AUC were positively correlated with the IODM value of ICAM-1 positive staining in abdominal aorta (r=0.835, P<0.05; r=0.868, P<0.05). Conclusion Anti-ICAM-1 nano targeted ultrasound bubbles can identify the early inflammation of As at the molecular level, and provide more objective and quantifiable contrast-enhanced ultrasound parameters for early detection of As vascular inflammatory lesions.
ZHAO Ning , CHEN Zaiyan , WANG Zhe , XU Qiang , ZHOU Yinpin , XU Zhonglin , SONG Yaoming , JIN Jun , HUANG Lan , ZHAO Xiaohui
Abstract:Aim To evaluate the effects of high-dose (>300 mL) iodixanol on renal function of diabetic patients within 72 hours after percutaneous coronary intervention (PCI) . Methods From October 2015 to December 7,7 patients who received high-dose (>300 mL) iodixanol during PCI in four centers were selected. Finally, 204 cases were enrolled in this study. The incidence of contrast-induced acute kidney injury (CI-AKI) was evaluated. ResultsThe incidence of CI-AKI was 3.9% (8/204). In patients administered 300~500 mL and >500 mL iodixanol, the incidence of CI-AKI was 4.3% (7/161) and 2.3% (1/43), respectively. In the subgroup with pre-PCI estimated glomerular filtration rate (eGFR)<60 mL/(min·1.73 m2), the incidence of CI-AKI was 6.9%(2/29). Multivariate Logistic regression analysis showed independent risk factors for CI-AKI were chronic renal failure, anemia, emergency PCI, and high Mehran score, but not contrast volume. Conclusion The administration of high-dose (>300 mL) iodixanol in patients with diabetes undergoing PCI does not result in high incidences of post-PCI CI-AKI.
WAN Jindong , RAN Fei , XIA Siwei , YANG Lun , CHEN Shichao , WANG Dan , LIU Sen , YANG Yi , ZHOU Peng , WANG Peijian
Abstract:Aim To explore association between high density lipoprotein (HDL) particle size and silent myocardial ischemia (SMI) in young patients with coronary heart disease (CHD). Methods Blood samples were obtained on admission in 469 consecutive patients with CHD. Patients were divided into SMI group (n=194) and non-SMI group (n=275). General data of the patients were collected, and serum total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDLC), high density lipoprotein-cholesterol (HDLC), apolipoprotein A1(ApoA1) and related biochemical indexes were examined. Quantitative indicator of HDL particle size was measured by HDLC/ApoA1, and other lipid parameters (TC/HDLC, non-HDLC, TG/HDLC, LDLC/HDLC) were assessed. Logistic regression analysis was performed to define the independent predictors of SMI. Results Levels of TC, uric acid, LDLC, LDLC/HDLC, TC/HDLC, non-HDL were significantly lower in patients with SMI than those in patients with non-SMI (P<0.05). Levels of HDLC, ApoA1, HDLC/ApoA1 were significantly higher in patients with SMI than those in patients with non-SMI (P<0.05). Results of correlation analysis showed HDL particle size (HDLC/ApoA1) was negatively correlated with Gensini scores (r=-0.405,P<0.05). Logistic regression analysis showed that HDL particle size (HDLC/ApoA1) was independent predictor of SMI in young patients with CHD. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off point of HDL particle size (HDLC/ApoA1) in predicting SMI was 0.36, sensitivity was 92.1% and specificity was 75.5%. Conclusion HDL particle size (HDLC/ApoA1) have certain predictive value for SMI in young patients with CHD.
CHENG Hongji , HUANG Yuli , HUANG Weijun , LI Meijun , TONG Huiyu , SHEN Changzao , CHEN Rui , TAN Kuan , HU Yunzhao
Abstract:Aim To investigate the predictive factors of long-term death in patients with acute heart failure (AHF). Methods From June 2012 to December 6,2 consecutive patients with AHF were enrolled in Shunde Hospital of Southern Medical University. The patients were divided into survival group (n=323) and death group (n=189) according to whether they died within one year after discharge. The baseline data of patients were recorded. Patients were followed-up during the median foullow-up of 20.2 months, and all-cause death events were recorded. Cox proportional hazard regression model was used to analyze the risk factors of death. Results All-cause mortality within one year was 36.9%. Univariate Cox regression analysis showed that AHF history (HR 1.1,5%CI 1.02~1.95, P<0.05), increased heart rate (HR 1.1,5%CI 1.00~1.02, P<0.05), elevated brain natriuretic peptide (HR 1.8,5%CI 1.05~3.01, P<0.05), low albumin (HR 0.4,5%CI 0.92~0.97, P<0.001), low serum sodium (HR 0.7,5%CI 0.94~1.00, P<0.05) were independent predictors of long-term death in patients with AHF. Multivariate Cox regression analysis showed that AHF history (HR 1.1,5%CI 1.06~1.88, P=0.018), increased heart rate (HR 1.1,5%CI 1.00~1.01, P=0.024), low albumin (HR 0.6,5%CI 0.94~0.99, P=0.003), low serum sodium (HR 0.7,5%CI 0.94~0.99, P=0.010) were risk factors for long-term death in patients with AHF. ConclusionAHF history, increased heart rate, low albumin and low serum sodium were predictors of long-term death in patients with AHF.
Abstract:目的 探讨急性心肌梗死患者经皮冠状动脉介入治疗(PCI)术后近期主要不良心血管事件(MACE)的危险因素及血小板功能参数对其的预测作用。方法 回顾性分析行PCI手术的184例急性心肌梗死患者的临床病历资料,均于术前、术后3天及术后14天行血小板功能检测。根据术后6月内MACE发生情况将所有患者分为发生MACE组与未发生MACE组,对比两组术后血小板功能相关指标水平,并采用Logistic回归分析法分析PCI术后血小板功能(术后3天与基线变化量用Δ表示,术后14天与基线的变化量用Δ′表示)对急性心肌梗死PCI术后发生MACE的影响,另使用受试者工作特征(ROC)曲线评估血小板功能对患者PCI术后近期MACE发生的预测价值。结果 术后3天及14天的血小板α颗粒膜糖蛋白(CD62P)、血小板膜糖蛋白GpⅡb/Ⅲa复合物(PAC-1)、血小板最大聚集率及平均血小板体积(MPV)/血小板计数(P)均低于术前,术后14天均低于术后3天,差异均有统计学意义(P<0.05);经Logistic回归分析发现,老年、多个部位梗死、病变支数≥2支、左心室射血分数(LVEF)<50%、高血压、糖尿病、高脂血症、PCI术后慢/无复流、PCI术后CD62P、术后PAC-1、术后血小板最大聚集率、术后MPV/P比值均是急性心肌梗死PCI术后近期MACE发生的危险因素(P<0.05);经ROC分析,ΔCD62P、ΔPAC-1、Δ血小板最大聚集率、ΔMPV/P单项及联合预测近期MACE发生的AUC分别为0.731、0.737、0.759、0.751、0.871;(ΔCD62P)′、(ΔPAC-1)′、(Δ血小板最大聚集率)′、(ΔMPV/P)′单项及联合预测近期MACE发生的AUC分别为0.756、0.763、0.774、0.749、0.865。结论 急性心肌梗死PCI术后血小板功能活性增强以及合并高血压、糖尿病、高脂血症以及PCI术后慢/无复流等均可增加术后近期MACE的发生风险,且术后血小板功能参数对术后近期发生MACE具有一定的预测价值。
QIAO Chong , CHAI Zhiyong , SHEN Wenyu , LIU Lin
Abstract:Aim To investigate the therapeutic effect of Danshen Chuanxiongqin injection combined with metoprolol in the treatment of acute coronary syndrome (ACS) and its improvement effect on blood lipid and cardiac function.Methods 124 patients with ACS admitted to Nanyang Central Hospital were selected from January 2016 to January 2019, and according to the random number table method, the patients were divided into two groups:monotherapy group and combined group, 62 cases in each group. The monotherapy group was treated with metoprolol, while the combined group was treated with Danshen Chuanxiongqin injection and metoprolol. The levels of blood lipids were measured by enzyme colorimetry, including low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC), triglyceride (TG) and total cholesterol (TC). Echocardiography was used to detect cardiac function indexes:left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF). The level of plasma cardiac troponin I (cTnI) was detected by chemiluminescence. Results The total effective rate of combined group and monotherapy group was 98.39% and 87.10%, respectively, and the difference between the two groups was statistically significant (χ2=5.871, P=0.015). After treatment, the levels of LDLC, TG and TC in the two groups were significantly lower than those before treatment, and HDLC was significantly higher than that before treatment (P<0.05); the levels of LDLC, TG and TC in the combined group were lower than those in the monotherapy group, and HDLC was higher than that in the monotherapy group (P<0.05). After treatment, LVESV and LVEDV in the two groups were significantly smaller than those before treatment, LVEF was significantly higher than that before treatment, cTnI was significantly lower than that before treatment (P<0.05); LVESV and LVEDV in the combined group were much smaller than those in the monotherapy group, LVEF was much higher than that in the monotherapy group, cTnI was much lower than that in the monotherapy group (P<0.05). Conclusion Danshen Chuanxiongqin injection combined with metoprolol has a satisfactory therapeutic effect on ACS patients, which is beneficial to the improvement of blood lipid level and cardiac function, and is worthy of clinical application.
XU Qiming , HU Yunding , SU Hongying , LIU Junhua , LIU Kaidong
Abstract:目的 分析射频消融治疗三尖瓣环游离壁起源室性心律失常的疗效及安全性。方法 对2016年1月—2019年1月佛山市禅城区中心医院收治的100例三尖瓣环游离壁起源的室性早搏(VPB)/室性心动过速(VT)患者的临床资料进行回顾性分析,患者平均年龄为(45.28±7.61)岁,男性占比61%,均为非器质性心脏病患者。于三维标测系统指导下应用压力监测导管行激动标测,采用导管消融治疗。根据导管贴靠方式不同,分为“大弯法”导管贴靠组(36例)和“小弯法”导管贴靠组(64例)。分析导管消融治疗效果及患者体表心电图特征。结果体表心电图QRS波群特征:均呈左束支传导阻滞,V1及V2导联呈rS型,Ⅰ、V5及V6导联呈R型,aVL导联呈R型或rsr型,aVR导联呈QS型或rS型。三尖瓣环游离壁VPB/VT分布于前侧壁26例(26.0%)、后侧壁41例(41.0%)、侧壁33例(33.0%)。“大弯法”与“小弯法”导管贴靠消融治疗均可实现即刻消融成功。两组手术时间、建模时间、X线曝光时间、放电时间及放电次数比较差异无统计学意义(P>0.05);两组随访期间均未出现传导阻滞等并发症,临床较为安全。结论 应用“大弯法”及“小弯法”导管贴靠方式消融治疗三尖瓣环游离壁起源的VPB/VT安全有效,且患者体表心电图特征明显。
ZHANG Ying , SI Yanhong , ZHANG Jingjun , QIN Shucun
Abstract:The occurrence and development of cardiovascular disease are closely related with intestinal cholesterol metabolism, so cardiovascular events can be efficiently reduced by regulating intestinal cholesterol metabolism balance. Natural medicines can regulate cholesterol metabolism level by regulating cholesterol absorption and transport in intestinal tract. So all natural medicines which suppressed cardiovascular disease by regulating cholesterol metabolism were summarized in recent years in order to provide reference for the prevention and treatment for cardiovascular disease induced by dyslipidemia.
SI Yanhong , SHAO Bo , ZHAO Min , LI Ying , ZHANG Xianzhe , ZHANG Ying , QIN Shucun
Abstract:高密度脂蛋白(HDL)作为体内保护心血管系统的重要物质,可通过多种途径拮抗动脉粥样硬化(As)进展。然而,在病理状态下,氧化、糖化、甲基化修饰及微小核糖核酸(miRNA)修饰可引起HDL组分出现结构改变和功能障碍。本文重点综述了HDL功能组分及其修饰与As关系研究进展,此方面研究对于探寻As诊断和治疗潜在靶点具有重要意义。
Abstract:前蛋白转化酶枯草溶菌素9是一种全新的低密度脂蛋白调节靶向物,主要通过调节肝脏低密度脂蛋白受体的表达和分泌活性来发挥作用。PCSK9可通过调节脂质代谢、参与炎症反应、介导细胞凋亡、促进血栓形成等参与动脉粥样硬化的发生与发展,现已成为治疗血脂异常和动脉粥样硬化性心血管疾病前景良好的靶点。
LI Lixia , WANG Hao , ZHANG Shouyan
Abstract:The global incidence rate of diabetes is increasing gradually, and cardiovascular disease is one of its major complications. Interleukin-15 is a cytokine with multiple biological activities, which plays an important role in reducing inflammation, antioxidant stress, regulating lipid metabolism and improving insulin resistance. It can also significantly reduce the inflammatory reaction of vascular endothelial cell, inhibit the formation of atherosclerotic plaque, stabilize plaque, improve myocardial cell energy metabolism, reduce myocardial cell injury and apoptosis, and inhibit myocardial remodeling. This article reviews the research progress of interleukin-15 in diabetes mellitus complicated with cardiovascular disease, in order to provide reference for the prevention and treatment of diabetic cardiovascular disease.
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