Clinical research progress of ischemic heart failure and prospect of traditional Chinese medicine

As one of the most common types of heart failure, the diagnosis and treatment of Ischemic heart failure are the main focus of clinic. In recent years, the studies on biomarkers have provided supports for clinical diagnosis, prognosis evaluation and stratification. The clinical application of new drugs and the development of non-drug treatment methods have brought more choices conventional treatment. At the same time, under the guidance of Traditional Chinese Medicine syndrome differentiation theory, Traditional Chinese Medicine therapy also plays an increasingly important role and shows its broad prospects .

Effect of diabetes mellitus on long-term outcomes of surgical revascularization in patients with ischemic heart failure:a propensity score-matching study

Background:Diabetes mellitus(DM)is an important risk factor in the long-term outcomes of surgical revascularization.However,few studies have focused on patients with ischemic heart failure(IHF)and DM,and the results are controversial.This study aimed to evaluate the effect of DM on the long-term outcomes of IHF patients undergoing coronary artery bypass grafting(CABG).Methods:In this propensity-matched study,data of IHF patients who underwent CABG in our hospital from January 2007 to December 2017 were analyzed.With a mean 73-month follow-up time,the patients were divided into two groups according to whether they had DM.The primary endpoint was all-cause death,and the secondary endpoint was a composite of all-cause death,stroke,recurrent myocardial infarction,and revascularization.Results:There was no significant difference in all-cause mortality between the two groups(5.8%vs.4.1%,P=0.216).The incidence of main adverse cardiovascular and cerebrovascular events(MACCE)in the secondary endpoint was significantly higher in the DM group than that in the non-DM group(10.4%vs.8.1%,P=0.023).Conclusions:DM can negatively affect the long-term outcomes of IHF patients undergoing CABG by significantly increasing the overall incidence of MACCE,though the long-term survival does not show a significant difference between the DM and non-DM patients.

Qi-Tai-Suan, an oleanolic acid derivative, ameliorates ischemic heart failure via suppression of cardiac apoptosis, inflammation and fibrosis

Although anti-thrombotic therapy has been successful for prevention of deaths from acute myocardial infarction(MI),by far,there are few preventive and therapeutic options for ischemic heart failure(IHF)after MI.Qi-Tai-Suan(QTS)is an oleanolic acid(OA)derivative which once underwent a clinical trial for treating hepatitis.In this study,we investigated the potential cardioprotective effect of QTS on IHF.IHF mouse model was constructed by coronary artery ligation in male C57BL/6J mice,and the protective effects of QTS on IHF were examined by echocardiography measurement,histological and TUNEL analysis,etc.We found that QTS exhibited promising cardioprotective effect on IHF.QTS treatment significantly improved cardiac function of IHF mice and the symptoms of heart failure.Notably,QTS had much better oral bioavailability(F=41.91%)in mice than its parent drug OA,and took effects mainly as its original form.Mechanistically,QTS ameliorated ischemic heart failure likely through suppression of cardiac apoptosis,inflammation and fibrosis.Taken together,QTS holds great promise as a preventive and therapeutic agent for ischemic heart failure and related diseases.

Customized 3D-printed occluders enabling the reproduction of consistent and stable heart failure in swine models

Reproducibility of clinical output is important when investigating therapeutic efficacy in pre-clinical animal studies.Due to its physiological relevance,a swine myocardial infarction(MI)model has been widely used to evaluate the effectiveness of stem cells or tissue-engineered constructs for ischemic heart diseases.Several methods are used to induce MI in the swine model.However,it is difficult,using these approaches,to obtain a similar level of functional outcomes from a group of animals due to interpersonal variation,leading to increased experimental cost.Hence,in order to minimize human intervention,we developed an approach to use a customized occluder that has dimensional similarities with that of the coronary artery of animals in the case of the swine model.We carried out angiography to measure the diameter of the middle left anterior descending artery of each individual animal to fabricate the customized occluder using a 3D-printing system.The fabricated occluder contained a central hole smaller than that of the targeted middle left anterior descending artery to mimic an atherosclerotic coronary artery that has an approximately 20%blocked condition.Interestingly,the 3D-printed occluder can provide continuous blood flow through the central pore,indicating a high survival rate(88%)of up to 28 days post-operation.This method showed the possibility of creating consistent myocardial infarction induction as compared to the conventional representative closed-chest method(50%survival rate),thus highlighting how our method can have a profound effect on accelerating reliable experiments for developing new therapeutic approaches to ischemic heart diseases.