The elastic and functional coupling of heart and vessels makes the stroke work （SW） of the heart optimal. Speckle tracking imaging （STI） can evaluate the myocardial strain and function. We studied ventricular-vasc...The elastic and functional coupling of heart and vessels makes the stroke work （SW） of the heart optimal. Speckle tracking imaging （STI） can evaluate the myocardial strain and function. We studied ventricular-vascular coupling in 80 diabetic patients with different systolic function using STI. The patients were divided into two groups according to ejection fraction （EF）： the diabetes mel- litus with normal EF （DMN） group and the diabetes mellitus with abnormal EF （DMA） group. Forty-two volunteers served as control group. The relative wall thickness （RWT）, left ventricular mass index （LVMI）, stroke volume （SV）, SW, rate-pressure product （RPP）, systemic vascular resis- tance index （SVRI）, left ventricular end-systolic elastance （Ees）, effective arterial elasticity （Ea） and ventricular-vascular coupling index （VVI） were measured and calculated by conventional echocardi- ography. The longitudinal strain （LS） at basement （LSBA）, papillary muscle （LSvM） and cardiac apex （LSAv） was assessed with STI. It was found： （A） compared with control group, in DMN and DMA groups, LSBA, LSvM and LSAp decreased, and they were lower in DMA group. （B） VVI, RPP and SVRI increased, and they were higher in DMN group; Ees decreased, and it was lower in DMA group. （C） LSBA, LSpM, and LSAv had negative correlation with VVI. LSAp, RWT, LVMI and SW were independent predictors for VVI. The area under the receiver operating characteristic （ROC） curves was used for identification of DMA and DMN with LSBA, LSpM, and LSAp, and the area under the ROC of LSAp was the largest. This study supports that myocardial LS could reflect the ventricu- lar-vascular coupling. Different segments had an order to “respond to” the state of the coupling, and the cardiac apex might be the earliest.展开更多
Background： Pressure overload-induced myocardial hypertrophy is a key step leading to heart failure. Previous cellular and animal studies demonstrated that deteriorated excitation-contraction coupling occurs as early...Background： Pressure overload-induced myocardial hypertrophy is a key step leading to heart failure. Previous cellular and animal studies demonstrated that deteriorated excitation-contraction coupling occurs as early as the compensated stage of hypertrophy before the global decrease in left ventricular ejection fraction （LVEF）. This study was to evaluate the cardiac electromechanical coupling time in evaluating cardiac systolic function in the early stage of heart failure. Methods： Twenty-six patients with Stage B heart failure （SBHF） and 31 healthy controls （CONs） were enrolled in this study. M-mode echocardiography was performed to measure LVEF. Tissue Doppler imaging （TDI） combined with electrocardiography （ECG） was used to measure cardiac electromechanical coupling time. Results： There was no significant difference in LVEF between SBHF patients and CONs （64.23 ± 8.91% vs. 64.52 ± 5.90%; P= 0.886）. However, all four electromechanical coupling time courses （Qsb： onset of Q wave on ECG to beginning of S wave on TDI, Qst： onset of Q wave on ECG to top of S wave on TDI, Rsb： top of R wave on ECG to beginning orS wave on TDI, and Rst： top of R wave on ECG to top orS wave on TDI） of SBHF patients were significantly longer than those of CONs （Qsb： 119.19 ± 35.68 ms vs. 80.30 ± 14.81 ms, P 〈 0.001 ; Qst： 165.42 ± 60.93 ms vs. 129.04 ± 16.97 ms, P = 0.006; Rsb： 82.43 ± 33.66 ms vs. 48.30 ± 15.18 ms, P 〈 0.001; and Rst： 122.37 ± 36.66 ins vs. 93.25 ± 16.72 ms, P = 0.001 ）, and the Qsb, Rsb, and Rst time showed a significantly higher sensitivity than LVEF （Rst： P =0.032; Rsb： P = 0.003; and Qsb： P = 0.004）. Conclusions： The cardiac electromechanical coupling time is more sensitive than LVEF in evaluating cardiac systolic function.展开更多
目的分析75岁以上老年急性非ST段抬高型心肌梗死(NSTEMI)患者外周血淋巴细胞G蛋白偶联受体激酶2(GRK2)与血清可溶性ST2(sST2)水平在心力衰竭(心衰)预警中的意义。方法选取75岁以上老年男性急性NSTEMI患者80例作为急性心肌梗死(AMI)组,...目的分析75岁以上老年急性非ST段抬高型心肌梗死(NSTEMI)患者外周血淋巴细胞G蛋白偶联受体激酶2(GRK2)与血清可溶性ST2(sST2)水平在心力衰竭(心衰)预警中的意义。方法选取75岁以上老年男性急性NSTEMI患者80例作为急性心肌梗死(AMI)组,平均年龄(85.4±3.2)岁;选取同期体检的健康老年男性30例作为对照组,平均年龄(84.8±2.9)岁。测定2组患者GRK2、血清sST2水平,并行超声心动图检测LVEF、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)。AMI组患者在发病后3、6、12、24个月时进行随访。结果AMI组患者GRK2的表达、血清sST2水平均高于对照组[3.60 vs 0.72,(30.63±1.36)μg/L vs (26.87±0.55)μg/L,P<0.01],LVEF低于对照组[(50.87±4.58)%vs (55.15±5.87)%,P<0.01]。AMI组GRK2在发病后3、6、12、24个月随访时逐渐增高(P<0.05,P<0.01),sST2水平在发病后6、12、24个月随访时显著增高(P<0.05),LVEF在发病后6、12、24个月随访时显著降低(P<0.01)。结论 75岁以上老年男性急性NSTEMI患者GRK2对AMI后心衰的预警作用优于sST2。展开更多
目的观察美托洛尔对老年男性心肌梗死病人外周血淋巴细胞G蛋白偶联受体激酶2(GRK2)表达的影响。方法选取65岁以上急性非ST段抬高型心肌梗死病人80例,分为对照组和美托洛尔组。对照组行常规治疗,美托洛尔组在常规治疗基础上应用美托洛尔...目的观察美托洛尔对老年男性心肌梗死病人外周血淋巴细胞G蛋白偶联受体激酶2(GRK2)表达的影响。方法选取65岁以上急性非ST段抬高型心肌梗死病人80例,分为对照组和美托洛尔组。对照组行常规治疗,美托洛尔组在常规治疗基础上应用美托洛尔,随访2年。分别于发病24 h内和治疗3、6、12、24个月时行心脏超声检查,并分别抽取外周血2 m L,分离淋巴细胞,提取RNA及蛋白,检测GRK2 mRNA和蛋白的表达水平。结果治疗前2组心脏超声各项指标、外周血淋巴细胞GRK2的表达无明显差异;治疗后,美托洛尔组GRK2表达逐渐降低,治疗12个月后GRK2表达水平明显低于对照组,而心脏射血分数则显著高于对照组。结论老年急性非ST段抬高型心肌梗死病人经美托洛尔治疗后,外周血淋巴细胞GRK2表达水平明显降低,心脏射血分数等指标无明显变化。随着疗程的增加,治疗效果越显著。展开更多
Cardiac dysfunction is a well-known consequence of diabetes,with sustained hyperglycaemia leading to the development of a cardiomyopathy that is independent of cardiovascular disease or hypertension.Animal models of d...Cardiac dysfunction is a well-known consequence of diabetes,with sustained hyperglycaemia leading to the development of a cardiomyopathy that is independent of cardiovascular disease or hypertension.Animal models of diabetes are commonly used to study the pathophysiology of diabetic cardiomyopathy,with the hope that increased knowledge will lead ultimately to better therapeutic strategies being developed.At physiological temperature,left ventricular trabeculae isolated from the streptozotocin rat model of type 1 diabetes showed decreased stress and prolonged relaxation,but with no evidence that decreased contractility was a result of altered myocardial Ca2+handling.Although sarcoplasmic reticulum(SR)Ca2+reuptake appeared slower in diabetic trabeculae,it was offset by an increase in actionpotential duration,thereby maintaining SR Ca2+content and favouring increased contraction force.Frequency analysis of t-tubule distribution by confocal imaging of ventricular tissue labeled with wheat germ agglutinin or ryanodine receptor antibodies showed a reduced T-power for diabetic tissue,but the differences were minor in comparison to other models of heart failure.The contractile dysfunction appeared to be the result of disrupted F-actin in conjunction with the increased typeⅠcollagen,with decreased myofilament Ca2+sensitivity contributing to the slowed relaxation.展开更多
Objective： To investigate the effects and mechanisms of hawthorn leaves flavonoids （HLF） on acute myocardial ischemiaJreperfusion in anesthetized dogs. Methods： The acute ischemia models were prepared by ligating ...Objective： To investigate the effects and mechanisms of hawthorn leaves flavonoids （HLF） on acute myocardial ischemiaJreperfusion in anesthetized dogs. Methods： The acute ischemia models were prepared by ligating left anterior descending （LAD） artery for 60 min. Qualified 15 male dogs were randomly divided into 3 groups with 5 in each group： blank control （treated with normal saline 3 mL/kg） group, HLF low dosage （5 mg/kg） group and high dosage （10 mg/kg） group, with an once injection through a femoral vein 5 min before reperfusion. Epicardial electrocardiogram was adopted to measure the scope and degree of myocardial ischemia. Simultaneously, neutrophil infiltration in infarct （Inf） and remote site （RS） of myocardial tissue was measured by myeloperoxidase （MPO） activity assay. The serum interleukin-1 （IL-1） and tumor necrosis factor~ （TNF-~） content were quantified by radioimmuno-assay. Furthermore, expression of G protein-coupled receptor kinase 2 （GRK2） and nuclear factor K B （NF- K B） in Inf and RS tissue were detected by Western blotting technique. Results： Ischemia and reperfusion increased the MPO activity and IL-1 and TNF-~ content. HLF （10 and 5 mg/kg） could significantly decrease the degree and scope of myocardial ischemia; markedly inhibit the increase of MPO activity, and IL-1 and TNF-o~ content induced by myocardial ischemia/infarction. Furthermore, HLF increased GRK2 expression and inhibited NF- K B expression in Inf tissue. Conclusion： HLF could improve the situation of acute myocardial ischemia and inhibit the inflammation in anesthetized dogs, which might be due to its increasing effect on the GRK2 and NF- K B expressions.展开更多
基金supported by a grant from the Shanghai Health and Family Planning Commission,China(No.201440290)
文摘The elastic and functional coupling of heart and vessels makes the stroke work （SW） of the heart optimal. Speckle tracking imaging （STI） can evaluate the myocardial strain and function. We studied ventricular-vascular coupling in 80 diabetic patients with different systolic function using STI. The patients were divided into two groups according to ejection fraction （EF）： the diabetes mel- litus with normal EF （DMN） group and the diabetes mellitus with abnormal EF （DMA） group. Forty-two volunteers served as control group. The relative wall thickness （RWT）, left ventricular mass index （LVMI）, stroke volume （SV）, SW, rate-pressure product （RPP）, systemic vascular resis- tance index （SVRI）, left ventricular end-systolic elastance （Ees）, effective arterial elasticity （Ea） and ventricular-vascular coupling index （VVI） were measured and calculated by conventional echocardi- ography. The longitudinal strain （LS） at basement （LSBA）, papillary muscle （LSvM） and cardiac apex （LSAv） was assessed with STI. It was found： （A） compared with control group, in DMN and DMA groups, LSBA, LSvM and LSAp decreased, and they were lower in DMA group. （B） VVI, RPP and SVRI increased, and they were higher in DMN group; Ees decreased, and it was lower in DMA group. （C） LSBA, LSpM, and LSAv had negative correlation with VVI. LSAp, RWT, LVMI and SW were independent predictors for VVI. The area under the receiver operating characteristic （ROC） curves was used for identification of DMA and DMN with LSBA, LSpM, and LSAp, and the area under the ROC of LSAp was the largest. This study supports that myocardial LS could reflect the ventricu- lar-vascular coupling. Different segments had an order to “respond to” the state of the coupling, and the cardiac apex might be the earliest.
基金This study was supported by grants from the National Natural Science Foundation of China （no. 91339105 and no. 81625001） and the Beijing Municipal Science and Technology Commission （no. Z 141100000214006）.
文摘Background： Pressure overload-induced myocardial hypertrophy is a key step leading to heart failure. Previous cellular and animal studies demonstrated that deteriorated excitation-contraction coupling occurs as early as the compensated stage of hypertrophy before the global decrease in left ventricular ejection fraction （LVEF）. This study was to evaluate the cardiac electromechanical coupling time in evaluating cardiac systolic function in the early stage of heart failure. Methods： Twenty-six patients with Stage B heart failure （SBHF） and 31 healthy controls （CONs） were enrolled in this study. M-mode echocardiography was performed to measure LVEF. Tissue Doppler imaging （TDI） combined with electrocardiography （ECG） was used to measure cardiac electromechanical coupling time. Results： There was no significant difference in LVEF between SBHF patients and CONs （64.23 ± 8.91% vs. 64.52 ± 5.90%; P= 0.886）. However, all four electromechanical coupling time courses （Qsb： onset of Q wave on ECG to beginning of S wave on TDI, Qst： onset of Q wave on ECG to top of S wave on TDI, Rsb： top of R wave on ECG to beginning orS wave on TDI, and Rst： top of R wave on ECG to top orS wave on TDI） of SBHF patients were significantly longer than those of CONs （Qsb： 119.19 ± 35.68 ms vs. 80.30 ± 14.81 ms, P 〈 0.001 ; Qst： 165.42 ± 60.93 ms vs. 129.04 ± 16.97 ms, P = 0.006; Rsb： 82.43 ± 33.66 ms vs. 48.30 ± 15.18 ms, P 〈 0.001; and Rst： 122.37 ± 36.66 ins vs. 93.25 ± 16.72 ms, P = 0.001 ）, and the Qsb, Rsb, and Rst time showed a significantly higher sensitivity than LVEF （Rst： P =0.032; Rsb： P = 0.003; and Qsb： P = 0.004）. Conclusions： The cardiac electromechanical coupling time is more sensitive than LVEF in evaluating cardiac systolic function.
文摘目的分析75岁以上老年急性非ST段抬高型心肌梗死(NSTEMI)患者外周血淋巴细胞G蛋白偶联受体激酶2(GRK2)与血清可溶性ST2(sST2)水平在心力衰竭(心衰)预警中的意义。方法选取75岁以上老年男性急性NSTEMI患者80例作为急性心肌梗死(AMI)组,平均年龄(85.4±3.2)岁;选取同期体检的健康老年男性30例作为对照组,平均年龄(84.8±2.9)岁。测定2组患者GRK2、血清sST2水平,并行超声心动图检测LVEF、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)。AMI组患者在发病后3、6、12、24个月时进行随访。结果AMI组患者GRK2的表达、血清sST2水平均高于对照组[3.60 vs 0.72,(30.63±1.36)μg/L vs (26.87±0.55)μg/L,P<0.01],LVEF低于对照组[(50.87±4.58)%vs (55.15±5.87)%,P<0.01]。AMI组GRK2在发病后3、6、12、24个月随访时逐渐增高(P<0.05,P<0.01),sST2水平在发病后6、12、24个月随访时显著增高(P<0.05),LVEF在发病后6、12、24个月随访时显著降低(P<0.01)。结论 75岁以上老年男性急性NSTEMI患者GRK2对AMI后心衰的预警作用优于sST2。
文摘目的观察美托洛尔对老年男性心肌梗死病人外周血淋巴细胞G蛋白偶联受体激酶2(GRK2)表达的影响。方法选取65岁以上急性非ST段抬高型心肌梗死病人80例,分为对照组和美托洛尔组。对照组行常规治疗,美托洛尔组在常规治疗基础上应用美托洛尔,随访2年。分别于发病24 h内和治疗3、6、12、24个月时行心脏超声检查,并分别抽取外周血2 m L,分离淋巴细胞,提取RNA及蛋白,检测GRK2 mRNA和蛋白的表达水平。结果治疗前2组心脏超声各项指标、外周血淋巴细胞GRK2的表达无明显差异;治疗后,美托洛尔组GRK2表达逐渐降低,治疗12个月后GRK2表达水平明显低于对照组,而心脏射血分数则显著高于对照组。结论老年急性非ST段抬高型心肌梗死病人经美托洛尔治疗后,外周血淋巴细胞GRK2表达水平明显降低,心脏射血分数等指标无明显变化。随着疗程的增加,治疗效果越显著。
基金Supported by The Health Research Council of New Zealand
文摘Cardiac dysfunction is a well-known consequence of diabetes,with sustained hyperglycaemia leading to the development of a cardiomyopathy that is independent of cardiovascular disease or hypertension.Animal models of diabetes are commonly used to study the pathophysiology of diabetic cardiomyopathy,with the hope that increased knowledge will lead ultimately to better therapeutic strategies being developed.At physiological temperature,left ventricular trabeculae isolated from the streptozotocin rat model of type 1 diabetes showed decreased stress and prolonged relaxation,but with no evidence that decreased contractility was a result of altered myocardial Ca2+handling.Although sarcoplasmic reticulum(SR)Ca2+reuptake appeared slower in diabetic trabeculae,it was offset by an increase in actionpotential duration,thereby maintaining SR Ca2+content and favouring increased contraction force.Frequency analysis of t-tubule distribution by confocal imaging of ventricular tissue labeled with wheat germ agglutinin or ryanodine receptor antibodies showed a reduced T-power for diabetic tissue,but the differences were minor in comparison to other models of heart failure.The contractile dysfunction appeared to be the result of disrupted F-actin in conjunction with the increased typeⅠcollagen,with decreased myofilament Ca2+sensitivity contributing to the slowed relaxation.
基金The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag Berlin Heidelberg 2012 ＊Supported by Project of National Natural Science Foundation of Beijing （No. 7092089） and the National Key New Drug Project （2009ZX09301-005）
文摘Objective： To investigate the effects and mechanisms of hawthorn leaves flavonoids （HLF） on acute myocardial ischemiaJreperfusion in anesthetized dogs. Methods： The acute ischemia models were prepared by ligating left anterior descending （LAD） artery for 60 min. Qualified 15 male dogs were randomly divided into 3 groups with 5 in each group： blank control （treated with normal saline 3 mL/kg） group, HLF low dosage （5 mg/kg） group and high dosage （10 mg/kg） group, with an once injection through a femoral vein 5 min before reperfusion. Epicardial electrocardiogram was adopted to measure the scope and degree of myocardial ischemia. Simultaneously, neutrophil infiltration in infarct （Inf） and remote site （RS） of myocardial tissue was measured by myeloperoxidase （MPO） activity assay. The serum interleukin-1 （IL-1） and tumor necrosis factor~ （TNF-~） content were quantified by radioimmuno-assay. Furthermore, expression of G protein-coupled receptor kinase 2 （GRK2） and nuclear factor K B （NF- K B） in Inf and RS tissue were detected by Western blotting technique. Results： Ischemia and reperfusion increased the MPO activity and IL-1 and TNF-~ content. HLF （10 and 5 mg/kg） could significantly decrease the degree and scope of myocardial ischemia; markedly inhibit the increase of MPO activity, and IL-1 and TNF-o~ content induced by myocardial ischemia/infarction. Furthermore, HLF increased GRK2 expression and inhibited NF- K B expression in Inf tissue. Conclusion： HLF could improve the situation of acute myocardial ischemia and inhibit the inflammation in anesthetized dogs, which might be due to its increasing effect on the GRK2 and NF- K B expressions.
