Neuregulin-1 therapy improved cardiac function and reduced ANPmRNA expression in post myocardial infarction rats with cardiac dysfunction

Objective To observe the influence of neuregulin-1 on the cardiac function of post-myocardial infarction rats.Methods Left ventricular MI was created in Sprague-Dawley rats by ligation of the left anterior descending coronary.Six months after the operation,rats were evaluated with echocardiology methods.36 rats that had an infarct area and a EF around 60%were randomized into 3 groups:MI group(n=12)were injected a blank vehicle fluid intravenously for 5 days,after which they continued to be raised on standard food and water for 30 days.MI+NRG group(n=12),received NRG-110μg·kg-^(1) intravenously for 5 days,after which they continued to be raised on standard food and water for 30 days.MI+Capt group(n=12)received captopril orally(dissolved in their drinking water 2g/L)for 30days,after which tap water substituted the solution for 5 days.Final echocardiographic and hemodynamic measurements were made at the end of 1 month of therapy.Total RNA was extracted from frozen left ventricular tissues,and was reverse transcribed into firststrand PCR was performed with primers for BNP、ANP.Results Rats treated with neuregulin had a smaller LVDs(P=0.014),a betterLVEF(P=0.004),and a tendency towards less lung perfusion than untreated rats.Neuregulin decreased the expression of ANP mRNA in the ventricle(P=0.025).Conclusion Neuregulin markedly improved the cardiac function of rats that survived myocardial infarction,and decreased the expression of ANP mRNA in the ventricle.

Effectiveness and safety of Shexiang Baoxin Pill(MUSKARDIA)in patients with stable coronary artery disease and concomitant diabetes mellitus:a subgroup analysis of a randomized clinical trial

Background:Preliminary studies have indicated that Shexiang Baoxin Pill(MUSKARDIA)has a coronary artery dilation effect and increases the coronary blood flow,relieving the symptoms of angina.This study aimed to evaluate the benefit of MUSKARDIA on patients with stable coronary artery disease(CAD)and diabetes mellitus(DM).Methods:This was a subgroup analysis of a multicenter,randomized,placebo-controlled phase IV trial.CAD patients with a medical history of DM or baseline fasting blood glucose(FBG)≥7.0 mmol/L were grouped according to the treatment(standard therapy plus MUSKARDIA or placebo).The primary outcome was major adverse cardiovascular events(MACEs),which was the composite outcome of cardiovascular death,non-fatal myocardial infarction,and non-fatal stroke.The secondary outcome was the composite outcome of all-cause death,non-fatal myocardial infarction,non-fatal stroke,hospitalization for unstable angina or heart failure,and coronary angioplasty.Results:MACEs occurred in 2.6%(9/340)and 4.8%(18/376)of patients in the MUSKARDIA and placebo groups,respectively(P=0.192).Secondary composite outcome was significantly less frequent with MUSKARDIA than with placebo(15.3%[52/340]vs.22.6%[85/376],P=0.017).Risk of MACEs(hazard ratio[HR]=0.69,95%confidence interval[CI]:0.31-1.57)was comparable between two groups.In patients with uncontrolled DM(≥4 measurements of FBG≥7 mmol/L in five times of follow-up),the risk of secondary outcome was significantly lower with MUSKARDIA(5/83,6.0%)than with placebo(15/91,16.5%)(HR=0.35,95%CI:0.13-0.95).Conclusion:As an add-on to standard therapy,MUSKARDIA shows a trend of reduced MACEs in patients with stable CAD and DM.Furthermore,MUSKARDIA may reduce the frequency of all-cause death,hospitalization,and coronary angioplasty in this population,especially in those with uncontrolled DM.Trial Registration:ChiCTR.org.cn,ChiCTR-TRC-12003513.