Background Chronic heart failure (CHF) is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate (cQTd) and heart f...Background Chronic heart failure (CHF) is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate (cQTd) and heart function in patients with CHF. Methods From January 2013 to December 2015, we continuously enrolled 240 patients categorized as New York Heart Association functional class (NYHA) III-IV with a left ventricular ejection fraction (LVEF) 〈 40%. Based on the etiology, the patients were divided into a dilated cardiomyopathy (DCM) group (n = 120) and an ischemic cardiomyopathy (ICM) group (n = 120). Then, based on the cQTd width, the ICM group was divided into two subgroups: a QS group (cQTd ≤60 ms, n = 70) and a QL group (cQTd 〉 60 ms, n = 50). All patients were examined by echocardiography and 12-lead electrocardiography (ECG) at 1, 3, 6, and 12 months after enrollment. Results After one year of optimized medical treatment, patients in both groups showed significant improvement in LVEF and NYHA classification from baseline. However, the cQTd in the ICM group, especially the QL, was significantly shorter than that in the DCM group at each time point. In addition, the cQTd was negatively correlated with LVEF and 6-min walking test and positively correlated with NYHA class in the ICM group. Conclusions The present findings clearly demonstrate that cQTd is a meaningful parameter for assessing heart function in the follow-up of ICM patients.展开更多
Objective To investigate the effect of acute myocardium ischemic on heart function of pregnancy rat. Methods 13 female SD rats and 6 early pregnancy rats were divided into normal group, unpregnant group with acute myo...Objective To investigate the effect of acute myocardium ischemic on heart function of pregnancy rat. Methods 13 female SD rats and 6 early pregnancy rats were divided into normal group, unpregnant group with acute myocardial infarction and early pregnant group with acute myocardial infarction. The anterior branch of the left coronary artery was ligated. 3 weeks later, Image 1.31 software was used to measure areas of myocardial infarction, and to evaluate hemodynamics of heart with powerLAB4.12, and cardiac tissues were stained with Massion. Results Compared with unpregnant group with acute myocardial infarction , the early pregnant group with acute myocardial infarction had less myocardial infarction area (28.86% vs. 36.8%),and had a higher left ventricle end systolic pressure, ±dp/dt _ max , and lower left ventricle end diastolic pressure. Massion stain showed the amount of collagen of the lesion was less in the early pregnant group with acute myocardial infarction than that in unpregnant group. Conclusion The early pregnant group with acute myocardial infarction had better heart contractive and diastolic function .展开更多
Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical p...Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical perception of symptoms may be adapted or compromised, regular evaluation from medical interviews often fails to determine functional classification. This study aimed to assess the correlation between New York Heart Association Functional Class (NYHA-FC) and the distance walked in the 6MWT. Methods: We conducted a cross-sectional observational study that included patients with HF with reduced ejection fraction followed up at an outpatient service of a teaching hospital, from August 2018 to April 2019. Patients in NYHA-FC I, II, or III were included. We compared NYHA-FC subjectively obtained during the consultation with the 6MWT performed after medical consultation, and the correlation between these two parameters was assessed. Results: The study included 70 patients with HF, 41 (58.6%) of whom were female. The mean age was 61.2 ± 12.7 years. The most prevalent etiologies were dilated idiopathic cardiomyopathy (35.7%) followed by ischemic cardiomyopathy (25.7%). The mean ejection fraction was 34.1% ± 9.8%. The average distance walked in the 6MWT by NYHA-FC I patients was 437.8 ± 95.8 meters, NYHA-FC II 360.1 ± 96.4, and NYHA-FC III 248.4 ± 98.3. Functional class measured by the 6MWT was different than that estimated by NYHA-FC in 34 patients (48.6%), 23 (32.9%) for a higher functional class and 11 (15.7%) for a lower one (p = 0.07). Pearson’s correlation coefficient between NYHA-FC and the 6MWT was -0.55. Conclusion: There was a moderate correlation between the subjective NYHA-FC and the 6MWT. The 6MWT revealed a different classification from NYHA-FC in almost half of the patients. Among those who presented discrepancies between methods, 6MWT reclassification towards a higher functional class was more common.展开更多
Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This st...Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.展开更多
Objective: To study the effect of Shengmai injection (生脉注射液, SMI) on vascular endothelial and heart functions in coronary heart disease patients complicated with diabetes mellitus (CHD-DM). Methods: One hun...Objective: To study the effect of Shengmai injection (生脉注射液, SMI) on vascular endothelial and heart functions in coronary heart disease patients complicated with diabetes mellitus (CHD-DM). Methods: One hundred and twenty patients with CHD-DM, their diagnosis confirmed by coronary arteriography, were equally randomized into a control group treated with conventional treatment and a treated group treated with conventional treatment plus SMI. The changes in blood levels of nitric oxide (NO), endothelin-1 (ET-1) and angiotensin Ⅱ (Ang Ⅱ), as well as endothelium-dependent vascular dilating function and heart function in the patients were observed before treatment and after the 3-week treatment. Results: After being treated with SMI for 3 weeks, in the treated group, blood level of NO was raised significantly from 69.8±33.1 μmol/L to 120.1±50.8μmol/L, and ET-1 was lowered from 70.1±32.1 ng/L to 46.2±21.3 ng/L, respectively (P〈0.01); that of Ang Ⅱ was lowered from 81.3±24.3 ng/L to 50.2±27.3 ng/L (P〈0.01); brachial arterial post-congestion blood flow increasing rate was raised from 389.4±26.3% to 459.3±27.8% (P〈0.01); and the improvement in heart function as seen through the ejection fraction (EF) was increased from 44±5% to 68±6% (P〈0.01), all the changes being more significant than those in the control group (all P〈0.01). Conclusion: SMI can improve not only the endothelial function in CHD-DM patients, but also heart contraction significantly.展开更多
Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Assoc...Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Association functional class. There is no consensus on the optimal surgical technique for this condition, including on whether to perform the procedure on a beating or an arrested heart and whether to perform valve repair or replacement. Methods: We analyzed four case series between 2015 and 2022 in which patients with secondary tricuspid regurgitation (TR) underwent valve repair on a beating heart and right atrial plication for a dilated right atrium. The TRI-SCORE was calculated for each patient. Results: All patients experienced a favorable postoperative course with significant improvements in heart failure symptoms. TR was markedly reduced;however, in one patient with concomitant mitral regurgitation (MR) and a high TRI-SCORE, MR worsened postoperatively. This patient later died from unknown causes due to multiple comorbidities in the late phase. Conclusions: Tricuspid valve repair on a beating heart was effective for improving the cardiac function, and the TRI-SCORE proved useful as a preoperative risk assessment tool. The underlying mechanism by which TR exacerbates MR requires further investigation.展开更多
Objective:To investigate the correlations among persistent viral infection,heart function and Chinese medicine(CM) difined-syndromes in patients with dilated cardiomyopathy(DCM).Methods:Fifty patients with DCM i...Objective:To investigate the correlations among persistent viral infection,heart function and Chinese medicine(CM) difined-syndromes in patients with dilated cardiomyopathy(DCM).Methods:Fifty patients with DCM in the First Affiliated Hospital of Zhejiang Chinese Medical University from October 2009 to December 2011 were selected as the research subjects,and 30 healthy people were simultaneously selected as the normal control group to detect persistent viral infections after admission.The CM syndrome type and grade of heart function were then evaluated.The expression level of Coxsackie adenovirus receptor(CAR) was detected using the flow cytometry(FCM) technique,coxsackie virus RNA(CVB-RNA) using reverse transcription polymerase chain reaction(RTPCR),and the plasma brain natriuretic peptide(BNP) level with a Triage meter plus diagnosis instrument.Finally,the parameters such as left ventricular end diastolic diameter(LVEDd) and left ventricular ejection fraction(LVEF) were measured by ultrasonic cardiogram.Person correlation analysis was used for measured data,Spearman correlation analysis for rating data,and the Chi-square test for numerical data.Results:CVB-RNA was positive in 22 patients(44%) with DCM,while only 6 cases(20%) were CVB-RNA-positive in the normal control group,with a significant difference between the two groups(P〈0.01).The expression level of CAR was significantly elevated in the DCM group compared with the normal control group(P〈0.01).In CVB-RNA-positive patients(22 cases),the expression level of CAR was significantly higher than in CVB-RNA-negative patients(28 cases;P〈0.01).In the DCM patients,there was a positive correlation between the CAR expression and the BNP level(r=0.34,P〈0.05),while no significant difference was found between the CAR expression and the LVEF and LVEDd(r=-0.32,0.30,P〉0.05).There was no clear correlation between virus infection and the CM syndrome types in DCM patients(r=-0.22,P〉0.05).According to the sequence of syndrome types:phlegm → qi deficiency → blood stasis → hydroretention with asthenic yang(from low to high),a positive correlation was existed between the BNP levels and CM syndrome types(r=0.139,P〈0.05).Conclusion:The expression of CAR on the surface of white cells could be used to detect persistent viral infection.The expression level of CAR and heart function in DCM patients were highly correlated.The expression level of BNP may serve as an objective index for differentiating CM syndromes for patients with DCM.展开更多
Magnesium(Mg) is crucial for the function of G proteins which play important roles in mediating the inotropic effects of β adrenergic agonists in the heart and are alteredin heart failure.This study was performed to ...Magnesium(Mg) is crucial for the function of G proteins which play important roles in mediating the inotropic effects of β adrenergic agonists in the heart and are alteredin heart failure.This study was performed to determine whether or not dietary Mg deficiency alters functional activity and levels of the two major ventricular G proteins, Gia and Gsa in the heart after myocardial infarction(MI).Six week old rats were fed a Mg adequate or deficient diet for 6 weeks.At the end of week 3,MI was induced by coronary artery ligation.A sham operation was performed as control.After surgery,surviving animals were maintained on their assigned diets for another 3 weeks.Then,cardiac function was measured.Severe hypomagnesemia and increased plasma catecholamine level were observed in all animals fed the Mg deficient diet.A significant reduction of ruyocardial Mg concentration accompanied by elevated plasma and myocardial calcium concentrations was observed in MI animals with existing Mg deficiency vs.animals fed the Mg adequate diet.Cardiac function was impaired in MI rats and further reduced in MI rats with existing Mg deficiency. Gia level was not altered by either Mg deficiency or MI alone,but was dramatically elevated in animals with combined Mg deficiency and MI (9. 9±0.7 arbitrary unit.mg-1 protein) as compared to MI alone (5.8±0. 6,P<0.05 )and Mg deficiency alone(6.1± 0.8,P<0.05 ). Gsa level did not differ between groups.Bacal,GppNHp-and forskolin-but not fluoride-, stimulated adenylyl cyclase activity was signifcantly reduced in MI animals with existing Mg deficiency indicating increased functional activity of Gia.The findings suggest that dietary Mg deficiency increases the expression and functional ac tivity of Gia in the heart after MI, while levels and function of Gsa are not compromised during dietary Mg deficiency either with or without MI.展开更多
Changes in the functional activity and levels of Gsa and Gia in heart failure have been studied predominantly in the end-stage failing heart.The objective of this study was to determine if levels and function of Gsa a...Changes in the functional activity and levels of Gsa and Gia in heart failure have been studied predominantly in the end-stage failing heart.The objective of this study was to determine if levels and function of Gsa and Gia2 in rat hearts change over time following acute myocar(lial infarction (MI) and if so,whether the changes in G proteins are associated with changes in heart function.As compared with sham-operated controls, Giα2, level of MI rats did not change at day l,increased by 64% at day 3 (P<0.01) and 55% at day 9 (P< 0.05)accompanied by reduced adenylyl cyclase activity,and returned to control by day 21. By contrast,Gsa level did not change at any time. Cardiac function in MI animals was markedly impaired at days 1,3 and 9 as evidenced by substantial elevation in LVEDP and reduction in +and -dp/dtmax,and partially restored at day 21. The increased Gia2level in MI rats at days 3 and 9 correlated positively to LVEDP(P< 0.05), and negatively to +and -dp/dtmax (p < 0. 01).The results show a three phase dynamic pattern in Gia2 level following acute MI:a lag phase, an increased expression phase associated with marked impairment of heart function,and a late phase in which the expression retums to control level accompanied by partially restored cardlac function.The results suggest that ② in G protein-mediated pathways,cardiac myocytes respond to MI Via regulating the gene expression of the inhibitory pathway, and ② up-regulation of Gia2 levels is related to the severity of impairment in cardiac function.展开更多
Heart function and plasma atrial natriuretic peptide (ANP).plasma renin actiity(PRA) andangiotensionⅡ(Ang Ⅱ) were examined with echocardiography and radioimmunoassay in patients with dilated cardiomyopathy(DCM),
Isoptin SR was used in 65 essential hypertensive patients.240mg Isoptin SR(German Knoll Pharmaceutical company) Per day was used in group A(35 cases)for 6 weeks,and in guoup B(30 cases)for 24 weeks,BP in group a and B...Isoptin SR was used in 65 essential hypertensive patients.240mg Isoptin SR(German Knoll Pharmaceutical company) Per day was used in group A(35 cases)for 6 weeks,and in guoup B(30 cases)for 24 weeks,BP in group a and B decreased obviously in the first and second week after treament.展开更多
Objective:To explore the value and feasibility of real-time three-dimensional echocardiography(RT-3DE)in evaluating left ventricular function in patients with different degrees of heart failure.Methods:The 60 heart fa...Objective:To explore the value and feasibility of real-time three-dimensional echocardiography(RT-3DE)in evaluating left ventricular function in patients with different degrees of heart failure.Methods:The 60 heart failure patients in the case group were divided into three subgroups according to the New York Heart Association(NYHA)classification:12 cases of cardiac function gradeⅡ,35 cases of cardiac function gradeⅢ,13 cases of cardiac function grade IV,and the other 30 cases of healthy subjects as control group.Compare the left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),and left ventricular 16,12,and 6 segments reaching the minimum systolic volume time standard deviation standardized value(Tmsv SD%),left ventricular 16,12 and 6 segments reaching the minimum systolic volume time standardized values of the maximum difference(Tmsv DIF%),analysis of the correlation between the above left ventricular function-related parameters and cardiac function grading.Results:(1)There were statistically significant differences in LVEDV and LVESV between each group(p<0.001).There was no statistically significant difference in LVEF between the cardiac function gradeⅡgroup and the control group,and between the grade IV group and the gradeⅢgroup(p=0.094 and 0.246).(2)compared with the control group,all parameters related to RT-3DE evaluation of left ventricular synchronization were prolonged in the case group,and the difference was statistically significant(p<0.001).The differences of Tmsv 16-SD%and Tmsv 16-DIF%in each subgroup of the case group were statistically significant(p<0.001).(3)LVEF was negatively correlated with NYHA classification of cardiac function(rs=-0.779,p<0.001),and LVEDV,LVESV,Tmsv 16-SD%,Tmsv 12-SD%,Tmsv 6-SD%,Tmsv 16-DIF%,Tmsv 12-DIF%,Tmsv 6-DIF%were positively correlated with NYHA function classification,showing strong correlation(rs=0.710,0.785,0.885,0.675,0.605,0.885,0.695,0.622,p<0.001),among them,Tmsv 16-SD%and Tmsv 16-Dif%have the highest correlation.Conclusion:RT-3DE can comprehensively evaluate the impairment of cardiac function.The measured parameters of left ventricular function are strongly correlated with cardiac function classification,which has impo-rtant application value for clinical judgment of the severity of heartfailure.展开更多
High ce rvical spinal co rd injuries induce permanent neuromotor and autonomic deficits.These injuries impact both central respiratory and cardiovascular functions through modulation of the sympathetic nervous system....High ce rvical spinal co rd injuries induce permanent neuromotor and autonomic deficits.These injuries impact both central respiratory and cardiovascular functions through modulation of the sympathetic nervous system.So far,cardiovascular studies have focused on models of complete contusion or transection at the lower cervical and thoracic levels and diaphragm activity evaluations using invasive methods.The present study aimed to evaluate the impact of C2 hemisection on different parameters representing vital functions(i.e.,respiratory function,cardiovascular,and renal filtration parameters)at the moment of injury and 7 days post-injury in rats.No ventilatory parameters evaluated by plethys mography were impacted during quiet breathing after 7 days post-injury,whereas permanent diaphragm hemiplegia was observed by ultrasound and confirmed by diaphragmatic electromyography in anesthetized rats.Interestingly,the mean arterial pressure was reduced immediately after C2 hemisection,with complete compensation at 7 days post-injury.Renal filtration was unaffected at 7 days post-injury;however,remnant systolic dysfunction chara cterized by a reduced left ventricular ejection fraction persisted at 7 days post-injury.Taken together,these results demonstrated that following C2 hemisection,diaphragm activity and systolic function are impa cted up to 7 days post-injury,whereas the respiratory and cardiovascular systems display vast ada ptation to maintain ventilatory parameters and blood pressure homeostasis,with the latter likely sustained by the remaining descending sympathetic inputs spared by the initial injury.A better broad characterization of the physiopathology of high cervical spinal cord injuries covering a longer time period post-injury could be beneficial for understanding evaluations of putative therapeutics to further increase cardiorespiratory recovery.展开更多
Aim: To investigate the relationship between androgen level and the indexes indicating endothelial function in male patients with coronary heart disease (CHD). Methods: We registered the following data for 106 50-...Aim: To investigate the relationship between androgen level and the indexes indicating endothelial function in male patients with coronary heart disease (CHD). Methods: We registered the following data for 106 50-70-year-old men: age, weight, blood lipid, including total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride, whether a smoker, sugar levels, blood pressure, free testosterone (FT), vascular cell adhesion molecule- 1 (VCAM- 1) and the intima-media thickness (IMT) of common carotid artery, common carotid diameter, maximum velocity in systolic phase, minimum velocity in diastolic phase and resistent index. Among the 106 men, 51 were patients with CHD. The relationships between FT level, VCAM-1 concentration and IMT were examined, respectively, using a stepwise linear regression technique among all the 106 men. Results: There was no statistical difference in terms of age, blood pressure, whether a smoker, sugar levels, HDL-C, minimum velocity in diastolic phase, resistent index between male CHD patients and controls; whereas results for weight, total cholesterol, low density lipoprotein cholesterol, triglyceride, VCAM- 1 and IMT of male CHD patients were higher than those of controls; FT level and maximum velocity in systolic phase were lower. It was found that among all the objects, FT level was inversely correlated with IMT and VCAM-1 concentration. Condusion: FT level was inversely correlated with VCAM-I concentration and IMT which are indicators of endothelial function. (Asian JAndro12008 Mar; 10: 214-218)展开更多
MicroRNAs (miRNAs) play important roles in maintaining normal heart function. Abnormal expression of miR-331 has been observed in the hearts of patients with atrial fibrillation and Marfan syndrome. However, whether m...MicroRNAs (miRNAs) play important roles in maintaining normal heart function. Abnormal expression of miR-331 has been observed in the hearts of patients with atrial fibrillation and Marfan syndrome. However, whether miR-331 regulates cardiac function under physiological and pathological conditions still remains unknown. In the present study, we investigated the function and underlying mechanisms of miR-331 in a pressure overload-induced heart failure model and miR-331 transgenic rat model. First, we found that the expression of miR-331-3p exhibited a 1.7-fold increase in hypertrophy compared with that in the sham group (P<0.01), yet the expression of miR-331-5p remained unchanged. Furthermore, overexpression of miR-331 in cardiomyocytes and defective excitation-contraction (E-C) coupling efficiency were observed. Luciferase assays showed that miR-331-3p suppressed JPH2 expression by binding to the coding region of JPH2 mRNA. Finally, in the miR-331 transgenic rat model, JPH2 expression was suppressed at both the mRNA and protein levels in vivo, which resulted in impairment of both the E-C coupling efficiency of cardiomyocytes and systolic function of the heart. This finding mechanistically linked miR-331 to JPH2 downregulation and suggested an important role for the abnormal expression of miR-331 leading to the dysfunction of E-C coupling in heart failure.展开更多
Objective: This study investigated the effects of cardiac rehabilitation exercise protocols on physical function (PF) in patients with chronic heart failure (CHF). Study Design and Setting: This randomized controlled ...Objective: This study investigated the effects of cardiac rehabilitation exercise protocols on physical function (PF) in patients with chronic heart failure (CHF). Study Design and Setting: This randomized controlled trial recruited 70 patients who are in stage II CHF with ejection fraction (≤40%) from a Nigerian university teaching hospital. They were randomly assigned into Exercise Group (EG: n = 35) or Control Group (CG: n = 35). Physical function, activity of daily living (ADL), distance walked in six minutes and grip strength were assessed using a validated ADL questionnaire, six minute walk test and a hand dynamometer respectively. In addition to medication, EG underwent aerobic and upper extremity resistance exercises thrice weekly for eight weeks while CG used medications only. Data were analyzed using descriptive and inferential statistics. Alpha level was at p p > 0.05). Significant improvements were noticed at fourth week among participants’ ADL (30.0% ± 6.0%), 6MWD (321.7 ± 26.3 m) and VO<sub>2</sub> max (8.9 ± 0.4 mL/kg/min) variables within the exercise EG but no significant changes were observed in the CG (p > 0.05). Participants in EG demonstrated more significant improvements in ADL (15.0% ± 5.0%), 6MWD (406.0 ± 29.7 m) and VO<sub>2</sub> max (10.3 ± 0.5 mL/kg/min) (p p > 0.05). Conclusions: Cardiac rehabilitation exercise protocols involving self-paced walking, sit-to-stand and upper extremity dynamic strength training improved activity of daily living, walking and functional capacity in patients with stable chronic heart failure.展开更多
Subjective: To observe the effect of electroacupuncture (EA) of acupoints of the Heart Meridian and Lung Meridian on ischemic cardiac systolic ability for analyzing the relative specific relationship between the Heart...Subjective: To observe the effect of electroacupuncture (EA) of acupoints of the Heart Meridian and Lung Meridian on ischemic cardiac systolic ability for analyzing the relative specific relationship between the Heart Meridian and the heart. Methods: Acute myocardial ischemia (AMI) was produced by intravenous infusion of pituitrin (40 u + 5% glucose injection 500 ml, 60 drips/min) in the rabbit. Left intraventricular pressure (LVP), maximal rising velocity of LVP (dp/dt max), isovolumetric pressure (IP) and end-diastolic pressure (EDP) of the left cardiac ventricle were used as the indexes. Three points of Heart Meridian [HM, from 'Shenmen' (HT 7) to 'Lingdao' (HT 4)] and the three points of Lung Meridian [LM, from 'Taiyuan' (LU 9) to 'Lieque' (LU 7)] were punctured with filiform needles and stimulated with hand-manipulation and electrically with ZY2-1 EA Therapeutic Apparatus. 30 rabbits anesthetized with urethane (1 g/kg) were randomly and evenly divided into control group, HM group and LM group. Result-s: The effects of EA of HM points were evidently superior to those of EA of LM points in promoting the recovery of both AMI-induced decrease of LVP and dp/dtmax, and AMI-induced increase of IP and EDP. Conclusion: Acupoints of Heart Meridian has a relatively specific connection with the heart in comparison with those of Lung Meridian; and the Heart Meridian is a functional whole.展开更多
基金Acknowledgments This study was supported by the National Natural Science Foundation of China (No. 8130 1276) and the Heilongjiang Provincial Department of Education (No. 12541544). The authors declare that there are no competing interests.
文摘Background Chronic heart failure (CHF) is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate (cQTd) and heart function in patients with CHF. Methods From January 2013 to December 2015, we continuously enrolled 240 patients categorized as New York Heart Association functional class (NYHA) III-IV with a left ventricular ejection fraction (LVEF) 〈 40%. Based on the etiology, the patients were divided into a dilated cardiomyopathy (DCM) group (n = 120) and an ischemic cardiomyopathy (ICM) group (n = 120). Then, based on the cQTd width, the ICM group was divided into two subgroups: a QS group (cQTd ≤60 ms, n = 70) and a QL group (cQTd 〉 60 ms, n = 50). All patients were examined by echocardiography and 12-lead electrocardiography (ECG) at 1, 3, 6, and 12 months after enrollment. Results After one year of optimized medical treatment, patients in both groups showed significant improvement in LVEF and NYHA classification from baseline. However, the cQTd in the ICM group, especially the QL, was significantly shorter than that in the DCM group at each time point. In addition, the cQTd was negatively correlated with LVEF and 6-min walking test and positively correlated with NYHA class in the ICM group. Conclusions The present findings clearly demonstrate that cQTd is a meaningful parameter for assessing heart function in the follow-up of ICM patients.
文摘Objective To investigate the effect of acute myocardium ischemic on heart function of pregnancy rat. Methods 13 female SD rats and 6 early pregnancy rats were divided into normal group, unpregnant group with acute myocardial infarction and early pregnant group with acute myocardial infarction. The anterior branch of the left coronary artery was ligated. 3 weeks later, Image 1.31 software was used to measure areas of myocardial infarction, and to evaluate hemodynamics of heart with powerLAB4.12, and cardiac tissues were stained with Massion. Results Compared with unpregnant group with acute myocardial infarction , the early pregnant group with acute myocardial infarction had less myocardial infarction area (28.86% vs. 36.8%),and had a higher left ventricle end systolic pressure, ±dp/dt _ max , and lower left ventricle end diastolic pressure. Massion stain showed the amount of collagen of the lesion was less in the early pregnant group with acute myocardial infarction than that in unpregnant group. Conclusion The early pregnant group with acute myocardial infarction had better heart contractive and diastolic function .
文摘Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical perception of symptoms may be adapted or compromised, regular evaluation from medical interviews often fails to determine functional classification. This study aimed to assess the correlation between New York Heart Association Functional Class (NYHA-FC) and the distance walked in the 6MWT. Methods: We conducted a cross-sectional observational study that included patients with HF with reduced ejection fraction followed up at an outpatient service of a teaching hospital, from August 2018 to April 2019. Patients in NYHA-FC I, II, or III were included. We compared NYHA-FC subjectively obtained during the consultation with the 6MWT performed after medical consultation, and the correlation between these two parameters was assessed. Results: The study included 70 patients with HF, 41 (58.6%) of whom were female. The mean age was 61.2 ± 12.7 years. The most prevalent etiologies were dilated idiopathic cardiomyopathy (35.7%) followed by ischemic cardiomyopathy (25.7%). The mean ejection fraction was 34.1% ± 9.8%. The average distance walked in the 6MWT by NYHA-FC I patients was 437.8 ± 95.8 meters, NYHA-FC II 360.1 ± 96.4, and NYHA-FC III 248.4 ± 98.3. Functional class measured by the 6MWT was different than that estimated by NYHA-FC in 34 patients (48.6%), 23 (32.9%) for a higher functional class and 11 (15.7%) for a lower one (p = 0.07). Pearson’s correlation coefficient between NYHA-FC and the 6MWT was -0.55. Conclusion: There was a moderate correlation between the subjective NYHA-FC and the 6MWT. The 6MWT revealed a different classification from NYHA-FC in almost half of the patients. Among those who presented discrepancies between methods, 6MWT reclassification towards a higher functional class was more common.
文摘Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.
文摘Objective: To study the effect of Shengmai injection (生脉注射液, SMI) on vascular endothelial and heart functions in coronary heart disease patients complicated with diabetes mellitus (CHD-DM). Methods: One hundred and twenty patients with CHD-DM, their diagnosis confirmed by coronary arteriography, were equally randomized into a control group treated with conventional treatment and a treated group treated with conventional treatment plus SMI. The changes in blood levels of nitric oxide (NO), endothelin-1 (ET-1) and angiotensin Ⅱ (Ang Ⅱ), as well as endothelium-dependent vascular dilating function and heart function in the patients were observed before treatment and after the 3-week treatment. Results: After being treated with SMI for 3 weeks, in the treated group, blood level of NO was raised significantly from 69.8±33.1 μmol/L to 120.1±50.8μmol/L, and ET-1 was lowered from 70.1±32.1 ng/L to 46.2±21.3 ng/L, respectively (P〈0.01); that of Ang Ⅱ was lowered from 81.3±24.3 ng/L to 50.2±27.3 ng/L (P〈0.01); brachial arterial post-congestion blood flow increasing rate was raised from 389.4±26.3% to 459.3±27.8% (P〈0.01); and the improvement in heart function as seen through the ejection fraction (EF) was increased from 44±5% to 68±6% (P〈0.01), all the changes being more significant than those in the control group (all P〈0.01). Conclusion: SMI can improve not only the endothelial function in CHD-DM patients, but also heart contraction significantly.
文摘Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Association functional class. There is no consensus on the optimal surgical technique for this condition, including on whether to perform the procedure on a beating or an arrested heart and whether to perform valve repair or replacement. Methods: We analyzed four case series between 2015 and 2022 in which patients with secondary tricuspid regurgitation (TR) underwent valve repair on a beating heart and right atrial plication for a dilated right atrium. The TRI-SCORE was calculated for each patient. Results: All patients experienced a favorable postoperative course with significant improvements in heart failure symptoms. TR was markedly reduced;however, in one patient with concomitant mitral regurgitation (MR) and a high TRI-SCORE, MR worsened postoperatively. This patient later died from unknown causes due to multiple comorbidities in the late phase. Conclusions: Tricuspid valve repair on a beating heart was effective for improving the cardiac function, and the TRI-SCORE proved useful as a preoperative risk assessment tool. The underlying mechanism by which TR exacerbates MR requires further investigation.
基金Supported by the Chinese Medicine Project of Zhejiang Province,China(No.2007CB144)
文摘Objective:To investigate the correlations among persistent viral infection,heart function and Chinese medicine(CM) difined-syndromes in patients with dilated cardiomyopathy(DCM).Methods:Fifty patients with DCM in the First Affiliated Hospital of Zhejiang Chinese Medical University from October 2009 to December 2011 were selected as the research subjects,and 30 healthy people were simultaneously selected as the normal control group to detect persistent viral infections after admission.The CM syndrome type and grade of heart function were then evaluated.The expression level of Coxsackie adenovirus receptor(CAR) was detected using the flow cytometry(FCM) technique,coxsackie virus RNA(CVB-RNA) using reverse transcription polymerase chain reaction(RTPCR),and the plasma brain natriuretic peptide(BNP) level with a Triage meter plus diagnosis instrument.Finally,the parameters such as left ventricular end diastolic diameter(LVEDd) and left ventricular ejection fraction(LVEF) were measured by ultrasonic cardiogram.Person correlation analysis was used for measured data,Spearman correlation analysis for rating data,and the Chi-square test for numerical data.Results:CVB-RNA was positive in 22 patients(44%) with DCM,while only 6 cases(20%) were CVB-RNA-positive in the normal control group,with a significant difference between the two groups(P〈0.01).The expression level of CAR was significantly elevated in the DCM group compared with the normal control group(P〈0.01).In CVB-RNA-positive patients(22 cases),the expression level of CAR was significantly higher than in CVB-RNA-negative patients(28 cases;P〈0.01).In the DCM patients,there was a positive correlation between the CAR expression and the BNP level(r=0.34,P〈0.05),while no significant difference was found between the CAR expression and the LVEF and LVEDd(r=-0.32,0.30,P〉0.05).There was no clear correlation between virus infection and the CM syndrome types in DCM patients(r=-0.22,P〉0.05).According to the sequence of syndrome types:phlegm → qi deficiency → blood stasis → hydroretention with asthenic yang(from low to high),a positive correlation was existed between the BNP levels and CM syndrome types(r=0.139,P〈0.05).Conclusion:The expression of CAR on the surface of white cells could be used to detect persistent viral infection.The expression level of CAR and heart function in DCM patients were highly correlated.The expression level of BNP may serve as an objective index for differentiating CM syndromes for patients with DCM.
文摘Magnesium(Mg) is crucial for the function of G proteins which play important roles in mediating the inotropic effects of β adrenergic agonists in the heart and are alteredin heart failure.This study was performed to determine whether or not dietary Mg deficiency alters functional activity and levels of the two major ventricular G proteins, Gia and Gsa in the heart after myocardial infarction(MI).Six week old rats were fed a Mg adequate or deficient diet for 6 weeks.At the end of week 3,MI was induced by coronary artery ligation.A sham operation was performed as control.After surgery,surviving animals were maintained on their assigned diets for another 3 weeks.Then,cardiac function was measured.Severe hypomagnesemia and increased plasma catecholamine level were observed in all animals fed the Mg deficient diet.A significant reduction of ruyocardial Mg concentration accompanied by elevated plasma and myocardial calcium concentrations was observed in MI animals with existing Mg deficiency vs.animals fed the Mg adequate diet.Cardiac function was impaired in MI rats and further reduced in MI rats with existing Mg deficiency. Gia level was not altered by either Mg deficiency or MI alone,but was dramatically elevated in animals with combined Mg deficiency and MI (9. 9±0.7 arbitrary unit.mg-1 protein) as compared to MI alone (5.8±0. 6,P<0.05 )and Mg deficiency alone(6.1± 0.8,P<0.05 ). Gsa level did not differ between groups.Bacal,GppNHp-and forskolin-but not fluoride-, stimulated adenylyl cyclase activity was signifcantly reduced in MI animals with existing Mg deficiency indicating increased functional activity of Gia.The findings suggest that dietary Mg deficiency increases the expression and functional ac tivity of Gia in the heart after MI, while levels and function of Gsa are not compromised during dietary Mg deficiency either with or without MI.
文摘Changes in the functional activity and levels of Gsa and Gia in heart failure have been studied predominantly in the end-stage failing heart.The objective of this study was to determine if levels and function of Gsa and Gia2 in rat hearts change over time following acute myocar(lial infarction (MI) and if so,whether the changes in G proteins are associated with changes in heart function.As compared with sham-operated controls, Giα2, level of MI rats did not change at day l,increased by 64% at day 3 (P<0.01) and 55% at day 9 (P< 0.05)accompanied by reduced adenylyl cyclase activity,and returned to control by day 21. By contrast,Gsa level did not change at any time. Cardiac function in MI animals was markedly impaired at days 1,3 and 9 as evidenced by substantial elevation in LVEDP and reduction in +and -dp/dtmax,and partially restored at day 21. The increased Gia2level in MI rats at days 3 and 9 correlated positively to LVEDP(P< 0.05), and negatively to +and -dp/dtmax (p < 0. 01).The results show a three phase dynamic pattern in Gia2 level following acute MI:a lag phase, an increased expression phase associated with marked impairment of heart function,and a late phase in which the expression retums to control level accompanied by partially restored cardlac function.The results suggest that ② in G protein-mediated pathways,cardiac myocytes respond to MI Via regulating the gene expression of the inhibitory pathway, and ② up-regulation of Gia2 levels is related to the severity of impairment in cardiac function.
文摘Heart function and plasma atrial natriuretic peptide (ANP).plasma renin actiity(PRA) andangiotensionⅡ(Ang Ⅱ) were examined with echocardiography and radioimmunoassay in patients with dilated cardiomyopathy(DCM),
文摘Isoptin SR was used in 65 essential hypertensive patients.240mg Isoptin SR(German Knoll Pharmaceutical company) Per day was used in group A(35 cases)for 6 weeks,and in guoup B(30 cases)for 24 weeks,BP in group a and B decreased obviously in the first and second week after treament.
基金Scientific research project of Anhui University of traditional Chinese medicine(No.2018zryb27)2018 key research and development plan project of Anhui Province(No.1804h080248)
文摘Objective:To explore the value and feasibility of real-time three-dimensional echocardiography(RT-3DE)in evaluating left ventricular function in patients with different degrees of heart failure.Methods:The 60 heart failure patients in the case group were divided into three subgroups according to the New York Heart Association(NYHA)classification:12 cases of cardiac function gradeⅡ,35 cases of cardiac function gradeⅢ,13 cases of cardiac function grade IV,and the other 30 cases of healthy subjects as control group.Compare the left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),and left ventricular 16,12,and 6 segments reaching the minimum systolic volume time standard deviation standardized value(Tmsv SD%),left ventricular 16,12 and 6 segments reaching the minimum systolic volume time standardized values of the maximum difference(Tmsv DIF%),analysis of the correlation between the above left ventricular function-related parameters and cardiac function grading.Results:(1)There were statistically significant differences in LVEDV and LVESV between each group(p<0.001).There was no statistically significant difference in LVEF between the cardiac function gradeⅡgroup and the control group,and between the grade IV group and the gradeⅢgroup(p=0.094 and 0.246).(2)compared with the control group,all parameters related to RT-3DE evaluation of left ventricular synchronization were prolonged in the case group,and the difference was statistically significant(p<0.001).The differences of Tmsv 16-SD%and Tmsv 16-DIF%in each subgroup of the case group were statistically significant(p<0.001).(3)LVEF was negatively correlated with NYHA classification of cardiac function(rs=-0.779,p<0.001),and LVEDV,LVESV,Tmsv 16-SD%,Tmsv 12-SD%,Tmsv 6-SD%,Tmsv 16-DIF%,Tmsv 12-DIF%,Tmsv 6-DIF%were positively correlated with NYHA function classification,showing strong correlation(rs=0.710,0.785,0.885,0.675,0.605,0.885,0.695,0.622,p<0.001),among them,Tmsv 16-SD%and Tmsv 16-Dif%have the highest correlation.Conclusion:RT-3DE can comprehensively evaluate the impairment of cardiac function.The measured parameters of left ventricular function are strongly correlated with cardiac function classification,which has impo-rtant application value for clinical judgment of the severity of heartfailure.
基金supported by funding from the Chancellerie des Universites de Paris(Legs Poix)(to SV)Fondation Medisite(to SV)+1 种基金INSERM(to SV,AM,AF)Universite de Versailles Saint-Quentin-en-Yvelines(to SV,AM,AF)。
文摘High ce rvical spinal co rd injuries induce permanent neuromotor and autonomic deficits.These injuries impact both central respiratory and cardiovascular functions through modulation of the sympathetic nervous system.So far,cardiovascular studies have focused on models of complete contusion or transection at the lower cervical and thoracic levels and diaphragm activity evaluations using invasive methods.The present study aimed to evaluate the impact of C2 hemisection on different parameters representing vital functions(i.e.,respiratory function,cardiovascular,and renal filtration parameters)at the moment of injury and 7 days post-injury in rats.No ventilatory parameters evaluated by plethys mography were impacted during quiet breathing after 7 days post-injury,whereas permanent diaphragm hemiplegia was observed by ultrasound and confirmed by diaphragmatic electromyography in anesthetized rats.Interestingly,the mean arterial pressure was reduced immediately after C2 hemisection,with complete compensation at 7 days post-injury.Renal filtration was unaffected at 7 days post-injury;however,remnant systolic dysfunction chara cterized by a reduced left ventricular ejection fraction persisted at 7 days post-injury.Taken together,these results demonstrated that following C2 hemisection,diaphragm activity and systolic function are impa cted up to 7 days post-injury,whereas the respiratory and cardiovascular systems display vast ada ptation to maintain ventilatory parameters and blood pressure homeostasis,with the latter likely sustained by the remaining descending sympathetic inputs spared by the initial injury.A better broad characterization of the physiopathology of high cervical spinal cord injuries covering a longer time period post-injury could be beneficial for understanding evaluations of putative therapeutics to further increase cardiorespiratory recovery.
文摘Aim: To investigate the relationship between androgen level and the indexes indicating endothelial function in male patients with coronary heart disease (CHD). Methods: We registered the following data for 106 50-70-year-old men: age, weight, blood lipid, including total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride, whether a smoker, sugar levels, blood pressure, free testosterone (FT), vascular cell adhesion molecule- 1 (VCAM- 1) and the intima-media thickness (IMT) of common carotid artery, common carotid diameter, maximum velocity in systolic phase, minimum velocity in diastolic phase and resistent index. Among the 106 men, 51 were patients with CHD. The relationships between FT level, VCAM-1 concentration and IMT were examined, respectively, using a stepwise linear regression technique among all the 106 men. Results: There was no statistical difference in terms of age, blood pressure, whether a smoker, sugar levels, HDL-C, minimum velocity in diastolic phase, resistent index between male CHD patients and controls; whereas results for weight, total cholesterol, low density lipoprotein cholesterol, triglyceride, VCAM- 1 and IMT of male CHD patients were higher than those of controls; FT level and maximum velocity in systolic phase were lower. It was found that among all the objects, FT level was inversely correlated with IMT and VCAM-1 concentration. Condusion: FT level was inversely correlated with VCAM-I concentration and IMT which are indicators of endothelial function. (Asian JAndro12008 Mar; 10: 214-218)
基金supported by the National Natural Science Foundation of China (81625001, 91854209, 31630035)the National Key Research & Development Program of China (2018YFC1312700, 2018YFC1312701).
文摘MicroRNAs (miRNAs) play important roles in maintaining normal heart function. Abnormal expression of miR-331 has been observed in the hearts of patients with atrial fibrillation and Marfan syndrome. However, whether miR-331 regulates cardiac function under physiological and pathological conditions still remains unknown. In the present study, we investigated the function and underlying mechanisms of miR-331 in a pressure overload-induced heart failure model and miR-331 transgenic rat model. First, we found that the expression of miR-331-3p exhibited a 1.7-fold increase in hypertrophy compared with that in the sham group (P<0.01), yet the expression of miR-331-5p remained unchanged. Furthermore, overexpression of miR-331 in cardiomyocytes and defective excitation-contraction (E-C) coupling efficiency were observed. Luciferase assays showed that miR-331-3p suppressed JPH2 expression by binding to the coding region of JPH2 mRNA. Finally, in the miR-331 transgenic rat model, JPH2 expression was suppressed at both the mRNA and protein levels in vivo, which resulted in impairment of both the E-C coupling efficiency of cardiomyocytes and systolic function of the heart. This finding mechanistically linked miR-331 to JPH2 downregulation and suggested an important role for the abnormal expression of miR-331 leading to the dysfunction of E-C coupling in heart failure.
文摘Objective: This study investigated the effects of cardiac rehabilitation exercise protocols on physical function (PF) in patients with chronic heart failure (CHF). Study Design and Setting: This randomized controlled trial recruited 70 patients who are in stage II CHF with ejection fraction (≤40%) from a Nigerian university teaching hospital. They were randomly assigned into Exercise Group (EG: n = 35) or Control Group (CG: n = 35). Physical function, activity of daily living (ADL), distance walked in six minutes and grip strength were assessed using a validated ADL questionnaire, six minute walk test and a hand dynamometer respectively. In addition to medication, EG underwent aerobic and upper extremity resistance exercises thrice weekly for eight weeks while CG used medications only. Data were analyzed using descriptive and inferential statistics. Alpha level was at p p > 0.05). Significant improvements were noticed at fourth week among participants’ ADL (30.0% ± 6.0%), 6MWD (321.7 ± 26.3 m) and VO<sub>2</sub> max (8.9 ± 0.4 mL/kg/min) variables within the exercise EG but no significant changes were observed in the CG (p > 0.05). Participants in EG demonstrated more significant improvements in ADL (15.0% ± 5.0%), 6MWD (406.0 ± 29.7 m) and VO<sub>2</sub> max (10.3 ± 0.5 mL/kg/min) (p p > 0.05). Conclusions: Cardiac rehabilitation exercise protocols involving self-paced walking, sit-to-stand and upper extremity dynamic strength training improved activity of daily living, walking and functional capacity in patients with stable chronic heart failure.
基金grants of State Scientific-technological Scale Project
文摘Subjective: To observe the effect of electroacupuncture (EA) of acupoints of the Heart Meridian and Lung Meridian on ischemic cardiac systolic ability for analyzing the relative specific relationship between the Heart Meridian and the heart. Methods: Acute myocardial ischemia (AMI) was produced by intravenous infusion of pituitrin (40 u + 5% glucose injection 500 ml, 60 drips/min) in the rabbit. Left intraventricular pressure (LVP), maximal rising velocity of LVP (dp/dt max), isovolumetric pressure (IP) and end-diastolic pressure (EDP) of the left cardiac ventricle were used as the indexes. Three points of Heart Meridian [HM, from 'Shenmen' (HT 7) to 'Lingdao' (HT 4)] and the three points of Lung Meridian [LM, from 'Taiyuan' (LU 9) to 'Lieque' (LU 7)] were punctured with filiform needles and stimulated with hand-manipulation and electrically with ZY2-1 EA Therapeutic Apparatus. 30 rabbits anesthetized with urethane (1 g/kg) were randomly and evenly divided into control group, HM group and LM group. Result-s: The effects of EA of HM points were evidently superior to those of EA of LM points in promoting the recovery of both AMI-induced decrease of LVP and dp/dtmax, and AMI-induced increase of IP and EDP. Conclusion: Acupoints of Heart Meridian has a relatively specific connection with the heart in comparison with those of Lung Meridian; and the Heart Meridian is a functional whole.