动态心电图监测冠心病患者心肌缺血改变及昼夜变化规律对老年保健的价值

冠心病的发病率逐年增高,西方国家冠心病的死亡率一直高居首位。面对世界各国人口老化,而冠心病又是老年人之常见病,因此预防急性心肌梗塞和猝死发生的老年保健工作显得格外重要。对129例冠心病患者分析24小时动态心电图监测,其中有无痛性心肌缺血(SMI)和伴心绞痛的心肌缺血(PMI)。观察两组心肌缺血改变(MIs)发生频率、持续时间、缺血程度及与心律失常之间发生的关系。

沙库巴曲缬沙坦钠对慢性射血分数降低缺血性心肌病病人心功能的影响

目的探讨沙库巴曲缬沙坦钠(诺欣妥)对慢性射血分数降低缺血性心肌病病人心脏功能、药物安全性及预后的影响。方法选取2017年8月—2019年8月于山西医科大学第一医院住院治疗的纽约心脏病协会(NYHA)心功能Ⅲ级的慢性射血分数减低缺血性心肌病病人160例,采用随机数字表法分为对照组和治疗组,每组80例。两组病人基础心力衰竭治疗基本相似,对照组给予血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)药物治疗,治疗组给予诺欣妥药物治疗。观察两组药物干预前后超声心动图指标[包括左室射血分数(LVEF)、左室收缩末期直径(LVESD)、左室舒张末期直径(LVEDD)],血N末端脑钠肽前体(NT-proBNP)、6 min步行试验(6MWT)距离;对比两组病人在药物干预期间的不良反应发生率(如低血压、高钾血症、咳嗽、血管性水肿、肝肾功能异常),随访12个月病人心源性死亡率、再住院率和室性心动过速/心室颤动发生率。结果两组临床基线资料、出院时研究指标比较差异均无统计学意义(P>0.05);治疗后,治疗组LVEF、6MWT距离提高,LVEDD、LVESD、血NT-proBNP水平降低,且明显优于对照组(P<0.05);两组在药物干预期间不良反应发生率比较差异无统计学意义(P>0.05);治疗组12个月期间死亡率、再住院率、室性心动过速/心室颤动发生率分别为2.5%、32.5%、5.0%,明显低于对照的11.3%、51.2%、16.3%(P<0.05)。结论诺欣妥能提高慢性射血分数降低缺血性心肌病病人的心脏功能,安全性良好,可降低心源性死亡率、再住院率和室性心动过速/心室颤动的发生率,逆转心室重构,改善病人预后。

沙库巴曲缬沙坦钠片治疗慢性射血分数降低缺血性心肌病的疗效分析

目的:分析沙库巴曲缬沙坦钠片治疗慢性射血分数降低缺血性心肌病的疗效。方法:选取2019年2月~2020年2月收治的慢性射血分数降低缺血性心肌病患者78例作为研究对象,按入院号分为对照组和试验组,各39例。两组患者均接受基础治疗,对照组采用缬沙坦治疗,试验组采用沙库巴曲缬沙坦钠片治疗。对比两组患者临床疗效、心功能[左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、左心室射血分数(LVEF)]变化、死亡率、不良心血管事件发生率。结果:试验组总有效率为92.31%,高于对照组的74.36%(P<0.05)。治疗3个月及1年后试验组LVEDd、LVESd低于对照组,LVEF高于对照组(P<0.05)。试验组不良心血管事件发生率为15.38%,低于对照组的35.89%(P<0.05)。两组死亡率对比无明显差异(P>0.05)。结论:采用沙库巴曲缬沙坦钠片治疗慢性射血分数降低缺血性心肌病患者能明显提高疗效,改善患者心功能。

沙库巴曲缬沙坦钠治疗慢性射血分数降低缺血性心肌病患者对其心脏功能及预后的影响

目的评估慢性射血分数降低缺血性心肌病患者采用沙库巴曲缬沙坦钠治疗对其心脏功能、药物安全性及预后的影响。方法选取牡丹江心血管病医院2017年5月~2020年5月收治的60例慢性射血分数降低缺血性心肌病患者为研究对象,使用随机数表法分为对照组与研究组,每组30例,分别给予常规治疗和常规治疗联合沙库巴曲缬沙坦钠治疗,将两组患者治疗成效进行比较。结果研究组患者收缩压(SBP)、舒张压(DBP)、左室舒张末期内经(LVEDD)、左室收缩末期内径(LVESD)均低于对照组,研究组左室射血分数(LVEF)、6分钟步行试验距离(6MWT)均高于对照组,差异有统计学意义(P<0.05)。研究组患者用药期间不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论沙库巴曲缬沙坦钠治疗慢性射血分数降低缺血性心肌病效果显著,值得在临床使用。

镍纹蛋白样β对脂多糖诱导心肌细胞损伤的抑制作用及其机制

目的探讨镍纹蛋白样β(Metrnβ)对脂多糖(LPS)诱导心肌细胞损伤的抑制作用及其可能的机制。方法取对数生长期的H9c2心肌细胞,将其分为LPS组、Metrnβ组、Metrnβ+LPS组及对照组。LPS组、Metrnβ组、Metrnβ+LPS组分别给予1 mg/L LPS、200 ng/mL Metrnβ、1 mg/L LPS+200 ng/mL Metrnβ,对照组给予等体积PBS,作用12 h。采用MTT法检测细胞增殖情况,ELISA法检测乳酸脱氢酶(LDH)、炎症反应相关因子[肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1、IL-6]、氧化反应相关因子[活性氧(ROS)、丙二醛(MDA)、谷胱甘肽(GSH)]及抗铁死亡蛋白谷胱甘肽过氧化物酶4(Gpx4)表达,Western blotting法检测炎症信号分子Toll样受体4(TLR4)、Gpx4蛋白相对表达量,总铁比色法检测细胞游离铁(Fe^(2+))含量。结果与Metrnβ组、对照组比较,LPS组及Metrnβ+LPS组细胞LDH、TNF-α、IL-1β、IL-6、ROS、MDA表达均升高,细胞增殖率及GSH、Gpx4表达均降低,且LPS组变化更明显(P均<0.05)。与Metrnβ组、对照组比较,LPS组及Metrnβ+LPS组细胞Fe^(2+)含量升高、Gpx4蛋白相对表达量降低,且LPS组变化更明显(P均<0.05)。与Metrnβ组、对照组及Metrnβ+LPS组比较,LPS组TLR4蛋白相对表达量升高(P均<0.05)。结论Metrnβ可以减轻LPS引起的心肌细胞损伤,其机制可能与减轻细胞氧化应激反应、炎症反应及铁死亡有关。

Effect of shenfu injection on gastrointestinal microcirculation in rabbits after myocardial ischemia-reperfusion injury

AIM： To investigate the effect of shenfu injection on gastrointestinal microcirculation after myocardial ischemic-reperfusion （IR） injury in rabbits and probe into the mechanism. METHODS： Forty healthy flap-eared white rabbits were randomly divided into 4 groups： IR injury control group （group Ⅰ ）, shenfu injection 5 mL/kg per h group （group Ⅱ）, shenfu injection 10 mL/kg per h group （group Ⅲ） and shenfu injection 20 mL/kg per h group （group Ⅳ）. The four groups were treated with Lactated Ringer＇s solution, shenfu injection 5, 10, and 20 mL/ kg per h were infused intravenously 30 min before experiment respectively. The values of hemodynamics [mean arterial pressure （MAP）, heart rate （HR）, gastric intramucosal partial pressure of carbon dioxide （PCO2）, blood gas analysis and pH] were measured and compared with those before myocardial ischemia, 60 min after myocardial ischemia and 60, 90, and 180 rain after reperfusion. RESULTS： The MAP, HR and gastric intramucosal pH were （70.50 ± 4.50） kPa, （165 ± 14） beats per rain, 7.032 ± 0.024 in group Ⅰ 60 min after myocardial ischemia, which were significantly decreased compared with those before myocardial ischemia （88.50 ± 9.75 kPa, 217 ± 18 beats per rain, 7.112 ± 0.035, P 〈 0.05）. The MAP, HR and gastric intramucosal pH were significantly decreased in group Ⅰ 60, 90, and 180 min after reperfusion （61.50 ± 5.25 kPa, 133 ± 31 beats per rain, 6.997 ± 0.025） compared with those before reperfusion respectively （P 〈 0.05）, whereas the values were insignificantly different in groups Ⅱ, Ⅲ or Ⅳ after reperfusion, compared with those before reperfusion, and there were no significant differences between groups Ⅱ, Ⅲ, and Ⅳ after reperfusion. CONCLUSION： Pre-infusion of shenfu injection has a protective effect on gastrointestinal microcirculation after myocardial IR injury in rabbits, in a dose independent manner.

Optimal time for mesenchymal stem cell transplantation in rats with myocardial infarction

Background:Bone marrow mesenchymal stem cell (MSC) transplantation is a promising strategy in the treatment of myocardial infarction (MI). However, the time for transplanting cells remains controversial. The aim of this study was to find an optimal time point for cell transplantation. Methods: MSCs were isolated and cultured from Sprague-Dawley (SD) rats. MI model was set up in SD rats by permanent ligation of left anterior descending coronary artery. MSCs were directly injected into the infarct border zone at 1 h, 1 week and 2 weeks after MI, respectively. Sham-operated and MI control groups received equal volume of phosphate buffered saline (PBS). At 4 weeks after MI, cardiac function was assessed by echocardiography; vessel density was analyzed on hematoxylin-eosin stained slides by light microscopy; the apoptosis of cardiomyocytes was evaluated by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay; the expressions of proteins were analyzed by Western blot. Results: MSC transplantation improved cardiac function, reduced the apoptosis of cardiomyocytes and increased vessel density. These benefits were more obvious in 1-week group than in 1-h and 2-week groups. There are more obvious in-creases in the ratio of bcl-2/bax and the expression of vascular endothelial growth factor (VEGF) and more obvious decreases in the expression of cleaved-caspase-3 in 1-week group than those in other two groups. Conclusion: MSC transplantation was beneficial for the recovery of cardiac function. MSC transplantation at 1 week post-MI exerted the best effects on increases of cardiac function, anti-apoptosis and angiogenesis.

Ultrastructure and histochemistry of rat myocardial capillary endothelial cells in response to diabetes and hypertension

Insufficient growth and rarefaction of capillaries, followed by endothelial dysfunction may represent one of the most critical mechanisms involved in heart damage. In this study we examined histochemical and ultrastructural changes in myocardial capillary endothelium in two models of heart failure streptozotocin-induced diabetes mellitus （STZ） and NO-deficient hypertension in male Wistar rats. Diabetes was induced by a single i.v. dose of STZ （45 mg/kg） and chronic 9-week stage was analysed. To induce NO-deficient hypertension, animals were treated with inhibitor of NO synthase Lnitroarginine methylester （L-NAME） （40 mg/kg） for 4 weeks. Left ventricular tissue was processed for enzyme catalytic histochemistry of capillary alkaline phosphatase （A1Ph）, dipeptidyl peptidase IV （DPP IV）, and endothelial NO synthase/NADPH-diaphorase （NOS） and for ultrastructural analysis. In diabetic and hypertensive rats, lower/absent A1Ph and DPP IV activities were found in focal micro-areas. NOS activity was significantly reduced and persisted only locally. Quantitative evaluation demonstrated reduction of reaction product intensity of A1Ph, DPP and NOS by 49.50%,74.36%, 20.05% in diabetic and 62.93%, 82.71%, 37.65% in hypertensive rats. Subcellular alterations of endothelial cells were found in heart of both groups suggesting injury of capillary function as well as compensatory processes. Endothelial injury was more significant in diabetic animals, in contrast the adaptation was more evident in hypertensive ones. Concluding： both STZ-induced diabetes- and NO-deficient hypertension-related cardiomyopathy were accompanied by similar features of structural remodelling of cardiac capillary network manifested as angiogenesis and angiopathy. The latter was however, predominant and may accelerate disappearance of capillary endothelium contributing to myocardial dysfunction.

Pre-and postoperative systemic hemodynamic evaluation in patients subjected to esophagogastric devascularization plus splenectomy and distal splenorenal shunt:A comparative study in schistomomal portal hypertension

AIM: To investigate the systemic hemodynamic effects of two surgical procedures largely employed for treatment of schistosomal portal hypertension. METHODS: Thirty-six patients undergoing elective surgical treatment of portal hypertension due to hepatosplenic mansonic schistosomiasis were prospectively evaluated. All patients were subjected to preoperative pulmonary artery catheterization; 17 were submitted to esophagogastric devascularization and splenectomy (EGDS) and 19 to distal splenorenal shunt (DSRS). The systemic hemodynamic assessment was repeated 4 d after the surgical procedure. RESULTS: Preoperative evaluation revealed (mean ± SD) an increased cardiac index (4.78 ± 1.13 L/min per m2),associated with a reduction in systemic vascular resistance index (1457 ± 380.7 dynes.s/cm5.m2). The mean pulmonary artery pressure (18 ± 5.1 mmHg) as well as the right atrial pressure (7.9 ± 2.5 mmHg) were increased,while the pulmonary vascular resistance index (133 ± 62 dynes.s/cm5.m2) was decreased. Four days after EGDS,a significant reduction in cardiac index (3.80 ± 0.4 L/min per m2,P < 0.001) and increase in systemic vascular resistance index (1901.4 ± 330.2 dynes.s/cm5. m2,P < 0.001) toward normal levels were observed. There was also a significant reduction in pulmonary artery pressure (12.65 ± 4.7 mmHg,P < 0.001) and no significant changes in the pulmonary vascular resistance index (141.6 ± 102.9 dynes.s/cm5.m2). Four days after DSRS,a non-significant increase in cardiac index (5.2 ± 0.76 L/min per m2) and systemic vascular resistance index (1389 ± 311 dynes.s/cm5.m2) was observed. There was also a non-significant increase in pulmonary artery pressure (19.84 ± 5.2 mmHg),right cardiac work index (1.38 ± 0.4 kg.m/m2) and right ventricular systolic work index (16.3 ± 6.3 g.m/m2),without significant changes in the pulmonary vascular resistance index (139.7 ± 67.8 dynes.s/cm5.m2). CONCLUSION: The hyperdynamic circulatory state observed in mansonic schistosomiasis was corrected by EGDS,but was maintained in patients who underwent DSRS. Similarly,the elevated mean pulmonary artery pressure was corrected after EGDS and maintained after DSRS. EGDS seems to be the most physiologic surgery for patients with schistosomal portal hypertension.

Pharmacologic treatment of depression in patients with myocardial infarction

Depression is a common medical problem and is more prevalent among patients with coronary artery disease. Whether early detection and treatment of depression will enhance cardiovascular outcome is uncertain. Obviously, the safety and efficacy of the anti-depression drugs is an important link. This article reviews the patho-physiologic and behavioural links between depression and cardiovascular disease progression, the treatment of depression, and the potential benefits of anti-depressants in patients with coronary disease.

The history, hotspots, and trends of electrocardiogram

The electrocardiogram （ECG） has broad applications in clinical diagnosis and prognosis of cardiovascular disease. Many researchers have contributed to its progressive development. To commemorate those pioneers, and to better study and promote the use of ECG, we reviewed and present here a systematic introduction about the history, hotspots, and trends of ECG. In the historical part, information including the invention, improvement, and extensive applications of ECG, such as in long QT syndrome （LQTS）, angina, and myocardial infarction （MI）, are chronologi- cally presented. New technologies and applications from the 1990s are also introduced. In the second part, we use the bibliometric analysis me- thod to analyze the hotspots in the field of ECG-related research. By using total citations and year-specific total citations as our main criteria, four key hotspots in ECG-related research were identified from 11 articles, including atrial fibrillation, LQTS, angina and MI, and heart rate variability. Recent studies in those four areas are also reported. In the final part, we discuss the future trends concerning ECG-related research. The authors believe that improvement of the ECG instrumentation, big data mining for ECG, and the accuracy of diagnosis and application will be areas of continuous concern.

Culprit vessel only versus ＂one-week＂ staged percutaneous coronary intervention for multivessel disease in patients presenting with ST-segment elevation myocardial infarction

Objective To explore the impact of a ＂one-week＂ staged muhivessel percutaneous coronary intervention （PCI） versus culprit-only PCI on deaths and major adverse cardiac events （MACE）. Methods We retrospectively analyzed 447 patients with multivessel disease who experienced a ST-segment elevation myocardial infarction （STEMI） within 12 h before undergoing PCI between July 26, 2008 and Septem- ber 25, 201 l. After completion of PCI in the infarct artery, 201 patients still in the hospital agreed to undergo PCI in non-infarct arteries with more than 70% stenosis for a ＂one-week＂ staged multivessel PCI. A total of 246 patients only received intervention for the culprit vessel. Follow-up ended on September 9, 2014. This study examined the differences in deaths from any cause （i.e., cardiac and noncardiac） and MACE between the two treatment groups. Results Compared to a culprit-only PCI treatment approach, the ＂one-week＂ staged multivessel PCI was strongly associated with greater benefits for 55-month all cause death [41 （16.7%） vs. 13 （6.5%）, P = 0.004] and MACE [82 （33.3%） vs. 40 （19.9%）, P = 0.002] rates. In addition, there were significant differences in the number of myocardial infarctions [43 （17.5%） vs. 20 （10.0%）, P = 0.023], coronary-artery bypass grafting [CABG; 20 （8.1%） vs. 6 （3.0%）, P = 0.021], and PCI [31 （12.6%） vs. 12 （6.0%）, P - 0.018]. Patients undergoing culprit-only PCI compared to ＂one-week＂ PCI had the same number of stent thrombosis events [7 （2.8%） vs. 3 （1.5%）, P - 0.522]. Conclusions Compared to a culprit-only PCI treatment approach, ＂one-week＂ staged multi-vessel PCI was a safe and effective selection for STEMI and multi-vessel PCL

Stenting versus non-stenting treatment of intermediate stenosis culprit lesion in acute ST-segment elevation myocardial infarction： a multicenter random- ized clinical trial

Background The benefit/risk ratio of stenting in acute ST-segment elevation myocardial infarction （STEMI） patients with single vessel intermediate stenosis culprit lesions merits further study, therefore the subject of the present study. Methods and results It was a pro- spective, multicenter, randomized controlled trial. Between April 2012 and July 2015, 399 acute STEMI patients with single vessel disease and intermediate （40%-70%） stenosis of the culprit lesion before or after aspiration thrombectomy and/or intracoronary tirofiban （15 pg/kg） were enrolled and were randomly assigned （h 1） to stenting group （n = 201） and non-stenting group （n = 198）. In stenting group, patients received pharmacologic therapy plus standard percutaneous coronary intervention （PCI） with stent implantation. In non-stenting group, pa- tients received pharmacologic therapy and PCI （thrombectomy）, but without dilatation or stenting. Primary endpoint was 12-month rate of major adverse cardiac and eerebrovascular events （MACCE）, a composite of cardiac death, non-fatal myocardial infarction （M1）, repeat re- vascularization and stroke. Secondary endpoints were 12-month rates of all cause death, ischemia driven admission and bleeding complica- tion. Median follow-up time was 12.4 ~ 3.1 months. At 12 months, MACCE occurred in 8.0% of the patients in stenting group, as compared with 15.2% in the non-stenting group （adjusted HR： 0.42, 95% Ch 0.19-0.89, P = 0.02）. The stenting group had lower non-fatal MI rate than non-stenting group, （1.5% vs. 5.5%, P = 0.03）. The two groups shared similar cardiac death, repeat revascularization, stroke, all cause death, ischemia driven readmission and bleeding rates at 12 months. Conclusions Stent implantation had better efficacy and safety in reducing MACCE risks among acute STEMI patients with single vessel intermediate stenosis culprit lesions.

Acute coronary syndrome in the older adults

Coronary heart disease remains the leading cause of death in the developed world. Advanced age is the single strongest risk factor for coronary artery disease （CAD） and independent predictor for poor outcomes following an acute coronary syndrome （ACS）. ACS refers to a spectrum of conditions compatible with acute myocardial ischemia and/or infarction due to various degrees of reduction in co- ronary blood flow as a result of plaque rupture/erosion and thrombosis formation or supply and demand mismatch.

Sarcopenia is associated with Framingham risk score in the Korean population： Korean National Health and Nutrition Examination Survey （KNHANES） 2010-2011

Background Sarcopenia is a risk factor for metabolic disorders and cardiovascular disease, but the association between sarcopenia and cardiovascular risk factors according to age and obesity status in the general population remains unknown. We thus investigated these associations in the Korean population. Methods We included 8,958 and 8,518 subjects from the fifth Korean National Health and Nutrition Examination Survey （KNHANES） （from 2010 and 2011, respectively）. The study was restricted to participants 〉 20 years old who had completed the health examination survey, including whole body dual-energy X-ray absorptiometry scans. After exclusion, 7,366 subjects （3,188 men, 4,178 women） were included in our final analysis. Age was categorized according to three age groups （20-39, 40-59, mad 〉 60 years）, and subjects were catego- rized according to their sarcopenic and obesity status. Cardiovascular risk was assessed with Framingham risk score （FRS）. Results The sarco- penic obese group had a higher FRS than the non-sarcopenic obese group, which had a higher FRS than the non-sarcopenic non-obese group. Age-wise, the 20-39 year-old group showed a non-significant association between sarcopenia and FRS. In the 40-59 year-old group, regardless of obesity status, sarcopenic subjects had a higher FRS than non-sarcopenic subjects. In the 〉 60 year-old group, sarcopenic subjects had a higher FRS than non-sarcopenic subjects for the non-obese group. Conclusions Sarcopenia was associated with cardiovascular disease and may be an early predictor of its susceptibility in both elderly and middle-aged subjects. Thus, management of sarcopenia is necessary to prevent cardiovascu- lar disease.

Angiogenesis effects of adenovirus-mediated gene transfer of VEGF-B on chronic ischemic myocardium

Objective: To study the angiogenesis effects of adenovirus-mediated gene transfer of VEGF-B on chronic ischemic myocardium. Methods: Domestic pigs underwent thoracotomy and placement of an ameroid constrictor on the circumflex coronary artery. Four weeks later, Ad. VEGF-B, Ad. LacZ or PBS were administrated directly into the myocardium at 10 sites in the circumflex distribution (109 PFU or 100 μl) according to groups. Echocardiography and ex vivo coronary angiography were performed. The injection sites around myocardium were harvested and subjected to histological analysis and immunochemical staining. Results: E-chocardiography assessment 4 weeks after vector administration demonstrated significant improvement of regional wall systolic function. Collateral vessel development assessed by angiography was also significantly greater in Ad. VEGF-B animals than that in control animals. Vascular density analysis revealed a mean of 43±5 neovessels per high-power field in Ad. VEGF-B group versus 19±4 and 17±6 in Ad. LacZ and PBS group. Conclusion: Direct intramyocardial administration of Ad. VEGF-B can induce focal angiogenesis and result in improvement in regional myocardial function, which may be useful in patients with ischemic heart disease who are not eligible for conventional therapies.

Anabolic steroid-induced cardiomyopathy underlying acute liver failure in a young bodybuilder

Heart failure may lead to subclinical circulatory disturbances and remain an unrecognized cause of ischemic liver injury. We present the case of a previously healthy 40-year-old bodybuilder, referred to our Intensive-Care Unit of Hepatology for treatment of severe acute liver failure, with the suspicion of toxic hepatitis associated with anabolic steroid abuse. Despite the absence of symptoms and signs of congestive heart failure at admission, an anabolic steroid-induced dilated cardiomyopathy with a large thrombus in both ventricles was found to be the underlying cause of the liver injury. Treatment for the initially unrecognized heart failure rapidly restored liver function to normal. To our knowledge, this is the f irst reported case of severe acute liver failure due to an unrecognized anabolic steroid-induced cardiomyopathy. Awareness of this unique presentation will allow for prompt treatment of this potentially fatal cause of liver failure.

Recombinant adeno-associated virus serotype 9 with p65 ribozyme protects H9c2 cells from oxidative stress through inhibiting NF-κB signaling pathway

Background Oxidative stress is a major mechanism underlying the pathogenesis of cardiovascular disease. It can trigger inflammatory cascades which are primarily mediated via nuclear factor-κB （NF-κB）. The NF-κB transcription factor family includes several subunits （p50, p52, p65, c-Rel, and Rel B） that respond to myocardial ischemia. It has been proved that persistent myocyte NF-κB p65 activation in heart failure exacerbates cardiac remodeling. Mechods A recombinant adeno-associated virus serotype 9 carrying enhanced green fluorescent protein and anti-NF-κB p65 ribozyme （AAV9-R65-CMV-eGFP） was constructed. The cells were assessed by MTT assay, Annexin V–propidium iodide dual staining to study apoptosis. The expression of P65 and P50 were assessed by Western blot to investigate the under-lying molecular mechanisms. Results After stimulation with H2O2 for 6 h, H9c2 cells viability decreased significantly, a large fraction of cells underwent apoptosis. We observed a rescue of H9c2 cells from H2O2-induced apoptosis in pretreatment with AAV9-R65-CMV-eGFP. Moreover, AAV9-R65-CMV-eGFP decreased H2O2-induced P65 expression. Conclusions AAV9-R65-CMV-eGFP protects H9c2 cells from oxidative stress induced apoptosis through down-regulation of P65 expression. These observations indicate that AAV9-R65-CMV-eGFP has the potential to exert cardioprotective effects against oxidative stress, which might be of great importance to clinical efficacy for cardiovascular disease.

EFFECTS OF EPCs OR b-FGF INTRAMYOCARDIAL INFUSION ON CARDIAC FUNCTION AND NEOVASCULARIZATION FOR DILATED CARDIOMYOPATHY RATS

Objective To compare the different effects of endothelia progenitor cells （ EPCs ） or basic fibroblast growth factor （b-FGF） intromyocardial infusion on cardiac function and neovascularization for dilated cardiomyopathy（ DCM） rats. Methods Fifty adult female rats received inguinal subcutaneous injections of isoproterenol （ISO, 250 mg/kg） for induction of DCM. Four weeks later, the model rats were randomly divided into EPCs group, b-FGF group and control group. The 2×106 EPCs （ resolved in 100 μL PBS） , 100 μL b-FGF （ lO0 μg/mL ） and 100 μL PBS were evenly transplanted into the myocardium of EPCs group, b-FGF group and control group, respectively. Three months later, echocardiographic examination and regional myocardial blood flow （RMBF） measurement were performed. EPCs were traced by fluorescence in situ hybridization （FISH）. The protein and mRNA expression of b-FGF in each group was measured by ELISA assay and reverse transcription-polymerase chain reaction （ RT-PCR ） . Results Three months after transplantation, sry positive cells were detected only in EPCs group. The cardiac function as well as RMBF was significantly improved in EPCs group compared with b-FGF group or control group. There was higher capillary density in EPCs group. The protein and mRNA expression of b-FGF was stronger than b-FGF group and control group. Conclusion Transplantation of EPCs can improve cardiac function, induce neovascularization and increase RMBF for DCM rats. The treatment with EPCs has better effect than administration of b-FGF alone.

Pathology of diabetic myocardiac microangiopathy

Objective To investigate the cause of high cardiovascular lethality in patients with diabetics mellitus. Methods Sections from autopsied coronary arteries and myocardium of dead patients with non-insulin-dependent diabetics mellitus and 12 dead control subjects were used for histomorphometric studies. Results The coronary atherosclerotic lesion in diabetics patients was not different in severity fi＇om those in controls. Nor was there difference in number ofmyofibers or diameters of myoeardic fibers and capillaries.But the capillary density and the ratio of capillary number to myocardic fiber number in diabetics group were significeantly reduced compared with control group（P〈0.0 l）,and the capillary basement membrane in the former was significantly thicker than in the latter（P〈0.01）.Conclision The decrease in number of capillaries and the thickening of basement membrane enhance myocardiac vulnerability to further ischemia and hypoxia,which may undelie high lethality of myocardiopathy in diabetic patients.