Shexiang Tongxin Dropping Pill Promotes Angiogenesis through VEGF/eNOS Signaling Pathway on Diabetic Coronary Microcirculation Dysfunction

Objective:To study the effect of Shexiang Tongxin Dropping Pill(STDP)on angiogenesis in diabetic cardiomyopathy mice with coronary microcirculation dysfunction(CMD).Methods:According to a random number table,6 of 36 SPF male C57BL/6 mice were randomly selected as the control group,and the remaining 30 mice were injected with streptozotocin intraperitoneally to replicate the type 1 diabetes model.Mice successfully copied the diabetes model were randomly divided into the model group,STDP low-dose group[15 mg/(kg·d)],medium-dose group[30 mg/(kg·d)],high-dose group[60 mg/(kg·d)],and nicorandil group[15 mg/(kg·d)],6 in each group.The drug was given by continuous gavage for 12 weeks.The cardiac function of mice in each group was detected at the end of the experiment,and coronary flow reserve(CFR)was detected by chest Doppler technique.Pathological changes of myocardium were observed by hematoxylin-eosin staining,collagen fiber deposition was detected by masson staining,the number of myocardial capillaries was detected by platelet endothelial cell adhesion molecule-1 staining,and the degree of myocardial hypertrophy was detected by wheat germ agglutinin staining.The expression of the vascular endothlial growth factor(VEGF)/endothelial nitric oxide synthase(eNOS)signaling pathway-related proteins in myocardial tissue was detected by Western blot.Results:Compared with the model group,medium-and high-dose STDP significantly increased the left ventricular ejection fraction and left ventricular fraction shortening(P<0.01),obviously repaired the disordered cardiac muscle structure,reduced myocardial fibrosis,reduced myocardial cell area,increased capillary density,and increased CFR level(all P<0.01).Western blot showed that high-dose STDP could significantly increase the expression of VEGF and promote the phosphorylation of vascular endothelial growth factor receptor 2,phosphoinositide 3-kinase,protein kinase B,and eNOS(P<0.05 or P<0.01).Conclusion:STDP has a definite therapeutic effect on diabetic CMD,and its mechanism may be related to promoting angiogenesis through the VEGF/eNOS signaling pathway.

Effect of Danhong Injection(丹红注射液)on Improving Coronary Microcirculation Injury after Percutaneous Coronary Intervention

Objective:To explore the effectiveness of Danhong Injection(丹红注射液)on improving microcirculatory injury after percutaneous coronary intervention(PCI)in patients with coronary heart disease(CHD).Methods:A randomized controlled trial was conducted and 90 patients were enrolled.A random sequence was generated using statistical analysis software.Patients with microcirculatory injuries after PCI were randomly divided into 3 groups for treatment(30 subjects in each group):Danhong Injection group:after PCI,Danghong Injections were given with intravenous administration with 40 mL twice a day for a week;statins intensive group:after PCI,atorvastatin calcium tablets were given oral medication with 80 mg once,and then atorvastatin 40 mg daily for 1 week;the control group:after PCI,atorvastatin calcium tablets were given oral medication with 10–20 mg daily for 1 week.The index of microcirculation resistance(IMR)was used to assess microcirculatory injury during PCI.The IMR of the target vessel was reexamined after 1 week of drug treatment.Results:After one week's drug treatment,IMR was significantly decreased in both statins intensive group and Danhong Injection group compared with the control group(P<0.01),but no difference was found between statins intensive group and Danhong injection group(14.03±2.54 vs.16.03±5.72 U,P=0.080).Conclusions:The efficacy of Danhong Injection is non-inferior to statin.Early use of Danhong Injection after PCI can effectively improve coronary microcirculation injury after PCI.

Usefulness of coronary flow reserve measured by transthoracic coronary Doppler ultrasound in the elderly

The left anterior descending （LAD） coronary artery is the main vessel of human coronary circulation, and life-threa- tening consequences are seen when flow in this area is im- paired, Noninvasive measurement of coronary flow re- serve （CFR）, defined as the ratio of maximal to baseline coronary blood flow, has been repeatedly shown to be a feasible technique by ultrasound transthoracic Doppler （TTD） both in the LAD and, with some limitations, in the posterior descending （PD） coronary artery.