BACKGROUND A growing amount of evidence provides support for the hypothesis that acute myocardial infarction(AMI)patients should go through cardiopulmonary exercise testing(CPET)about 3-5 d after AMI is diagnosed,make...BACKGROUND A growing amount of evidence provides support for the hypothesis that acute myocardial infarction(AMI)patients should go through cardiopulmonary exercise testing(CPET)about 3-5 d after AMI is diagnosed,make reasonable exercising prescription,and conduct exercise training under guidance.AIM To investigate the effect of exercise training(ET)on left ventricular systolic function and left ventricular remodeling(LVRM)and to study the possible mechanisms of LVRM by the changes of matrix metallopeptidase 9(MMP-9)and tissue inhibitor of metalloproteinases 1(TIMP-1)in patients with acute STsegment elevation myocardial infarction(STEMI).METHODS Sixty patients with first STEMI undergoing direct percutaneous coronary intervention from February 2008 to October 2008 were randomly assigned to an exercise group(n=30)and a control group(n=30).The levels of MMP-9 and TIMP-1 were measured in all patients at 1 d,10-14 d,30 d,and 6 mo after admission.Two-dimensional echocardiography and cardiopulmonary exercise testing were done in patients at 10-14 d and 6 mo after admission.RESULTS There was no significant difference in CPET at baseline between the exercise group and the control group.At 6 mo,the time of exercise,peak and anaerobic threshold values of O2 uptake,and metabolic equivalents increased in both groups,but markedly increased in the exercise group.At baseline,there were no significant differences in left ventricular ejection fraction(LVEF)between the two groups.At 6 mo,LVEF increased in the exercise group,but not in the control group.At 6 mo,the percentage of patients with positive result of LVRM was 26.6%in the exercise group and 52.6%in the control group(P<0.05).The levels of plasma MMP-9 and TIMP-1 and the ratio of MMP-9 to TIMP-1 in both groups had no significant difference at 1 d and 10-14 d after AMI,but at 30 d and 6 mo,the levels of plasma MMP-9 and TIMP-1 in the exercise group were significantly lower than those in the control group;the ratio of MMP-9 to TIMP-1 in the exercise group was significantly higher than that in the control group.CONCLUSION ET under supervision based on home condition in early and recovery stage of AMI can improve exercise cardiopulmonary function and prevent the LVRM.Therefore,it may reduce unfavorable remodeling response by decreasing the levels of plasma MMP-9 and TIMP-1 and adjusting the ratio of MMP-9 to TIMP-1 hereafter.展开更多
Objective: To investigate the effects of Shenqi Fuzheng injection (参芪扶正注射液, SQFZI) on ventricular remodeling (VR) after acute myocardial infarction (AMI). Methods: Sixty patients with AMI were randomly divided ...Objective: To investigate the effects of Shenqi Fuzheng injection (参芪扶正注射液, SQFZI) on ventricular remodeling (VR) after acute myocardial infarction (AMI). Methods: Sixty patients with AMI were randomly divided into two groups and received conventional therapy and conventional therapy plus SQFZI separately. Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-9 (TIMP-9) in plasma was measured on the 1st and 14th days after AMI. Results: MMP-9 and MMP-9/TIMP-9 were increased after AMI, after 2-week treatment, the level of MMP-9 and MMP-9/TIMP-9 decreased more significantly in SQFZI group than that in the conventional group (P<0. 05). Conclusion: Early treatment with SQFZI after AMI could reduce the level of MMPs and the production of collagen. It may be useful for the prevention of VR and heart failure after AMI.展开更多
Ventricular remodeling （VR） after myocardial infarction （MI） makes a full impact on left ventricular dilation and dysfunction, severe arrhythmias and even sudden death. Thus it is very interesting and instructive ...Ventricular remodeling （VR） after myocardial infarction （MI） makes a full impact on left ventricular dilation and dysfunction, severe arrhythmias and even sudden death. Thus it is very interesting and instructive to study the underlying regulatory mechanism for VR. Recently, evidenceI suggests that tumor necrosis factor-α （TNF-α） activity can independently influence VR, and aggravate myocardial dysfunction and cell death in the ventricle. The activation of pro-TNF〈t is adjusted by a disintegrin metalloproteinase （ADAM） 10 and ADAM17, the latter might take part in extracellular matrix （ECM） modulation in the borderline region of cardiac infarction.2 However, little is known about the relationship between ADAMsl0, 17 expressions and TNF-α activity in the process of VR after MI. The present study tested the hypothesis in rats that the interaction between ADAMsl0, 17 expressions and TNF-α activity was a contributory mechanism for VR of the healing myocardium, and metoprolol treatment might ameliorate VR inhibiting the mechanism.展开更多
目的:探讨皖南产蝮蛇毒(AHV)蛋白C激活物(protein C activator,PCA)改善急性心肌梗死大鼠心功能作用与机制。方法:Sprague-Daw-ly大鼠60只,随机分为假手术(SH)组、心肌梗死模型(MI)组、PCA低、中、高剂量组(0.5、2、8mg/kg)、阳性对照组...目的:探讨皖南产蝮蛇毒(AHV)蛋白C激活物(protein C activator,PCA)改善急性心肌梗死大鼠心功能作用与机制。方法:Sprague-Daw-ly大鼠60只,随机分为假手术(SH)组、心肌梗死模型(MI)组、PCA低、中、高剂量组(0.5、2、8mg/kg)、阳性对照组(阿司匹林5mg/kg),每组10只。通过结扎冠状动脉前降支建立急性心肌梗死(AMI)模型,采用Medlab生物信号处理系统监测大鼠心脏血流动力学变化。Westernblot检测心肌基质金属蛋白酶-9(MMP-9)蛋白表达;光镜观察心肌组织学改变。结果:与心肌梗死组比较,PCA高、中剂量大鼠左室内压最低值(LVDP)、左心室舒张末期压(LVEDP)、左心室压力最大上升速率(+dp/dtmax)、左心室压力最大下降速率(-dp/dtmax)明显升高(P<0.05),MMP-9的蛋白表达下降(P<0.05)。病理观察显示PCA干预组较梗死模型组炎症细胞浸润显著减轻,梗死面积缩小。结论:蝮蛇毒PCA组分可以限制急性心肌梗死早期心肌梗死扩大,有效改善心脏血液动力学,抑制MMP-9表达,对急性心肌梗死后心室重构有一定的干预作用。展开更多
【目的】探讨氨基末端B型脑钠肽前体（N T‐proBN P ）、基质金属蛋白酶‐9（M M P‐9）对急性心肌梗死（AMI）患者经皮冠脉介入治疗（PCI）术后早期心室重构的影响及其相关性。【方法】根据PCI术后4周时92例AMI患者左心室容积增加率的...【目的】探讨氨基末端B型脑钠肽前体（N T‐proBN P ）、基质金属蛋白酶‐9（M M P‐9）对急性心肌梗死（AMI）患者经皮冠脉介入治疗（PCI）术后早期心室重构的影响及其相关性。【方法】根据PCI术后4周时92例AMI患者左心室容积增加率的不同，将其分为左室重构组，非左室重构组，并设稳定性冠心病对照组。比较患者NT‐proBNP、MMP‐9水平及其与PCI术后患者的左室收缩末期容积（ LVESV）和舒张末期容积（LVEDV）、左室射血分数（LVEF）、左室收缩末容积指数（ LVESVI）、左室舒张末容积指数（LVEDVI）等的关系。【结果】AMI患者PCI治疗前后血浆NT‐proBNP和MMP‐9水平较稳定型冠心病对照组明显升高；左室重构组血浆 NT‐proB‐NP、MMP‐9水平持续增高，与非左室重构组在PCI术后7 d比较差异有统计学意义（ P＜0．01）。血浆NT‐proB‐NP、MMP‐9水平与LVEDV均呈明显正相关（ P ＜0．01），与LVEF均呈明显负相关（ P ＜0．05）。【结论】AMI患者血浆NT‐proBNP、MMP‐9水平与左室重构指标有相关性，可作为AMI早期左室重构的预测因子。展开更多
基金Supported by Beijing Hospitals Authority Incubating Program,No.PZ2021007Beijing Hospitals Authority Youth Program,No.QML20200604Beijing Municipal Health Commission(No.17-3)and the Beijing Natural Science Foundation,No.7184205.
文摘BACKGROUND A growing amount of evidence provides support for the hypothesis that acute myocardial infarction(AMI)patients should go through cardiopulmonary exercise testing(CPET)about 3-5 d after AMI is diagnosed,make reasonable exercising prescription,and conduct exercise training under guidance.AIM To investigate the effect of exercise training(ET)on left ventricular systolic function and left ventricular remodeling(LVRM)and to study the possible mechanisms of LVRM by the changes of matrix metallopeptidase 9(MMP-9)and tissue inhibitor of metalloproteinases 1(TIMP-1)in patients with acute STsegment elevation myocardial infarction(STEMI).METHODS Sixty patients with first STEMI undergoing direct percutaneous coronary intervention from February 2008 to October 2008 were randomly assigned to an exercise group(n=30)and a control group(n=30).The levels of MMP-9 and TIMP-1 were measured in all patients at 1 d,10-14 d,30 d,and 6 mo after admission.Two-dimensional echocardiography and cardiopulmonary exercise testing were done in patients at 10-14 d and 6 mo after admission.RESULTS There was no significant difference in CPET at baseline between the exercise group and the control group.At 6 mo,the time of exercise,peak and anaerobic threshold values of O2 uptake,and metabolic equivalents increased in both groups,but markedly increased in the exercise group.At baseline,there were no significant differences in left ventricular ejection fraction(LVEF)between the two groups.At 6 mo,LVEF increased in the exercise group,but not in the control group.At 6 mo,the percentage of patients with positive result of LVRM was 26.6%in the exercise group and 52.6%in the control group(P<0.05).The levels of plasma MMP-9 and TIMP-1 and the ratio of MMP-9 to TIMP-1 in both groups had no significant difference at 1 d and 10-14 d after AMI,but at 30 d and 6 mo,the levels of plasma MMP-9 and TIMP-1 in the exercise group were significantly lower than those in the control group;the ratio of MMP-9 to TIMP-1 in the exercise group was significantly higher than that in the control group.CONCLUSION ET under supervision based on home condition in early and recovery stage of AMI can improve exercise cardiopulmonary function and prevent the LVRM.Therefore,it may reduce unfavorable remodeling response by decreasing the levels of plasma MMP-9 and TIMP-1 and adjusting the ratio of MMP-9 to TIMP-1 hereafter.
文摘Objective: To investigate the effects of Shenqi Fuzheng injection (参芪扶正注射液, SQFZI) on ventricular remodeling (VR) after acute myocardial infarction (AMI). Methods: Sixty patients with AMI were randomly divided into two groups and received conventional therapy and conventional therapy plus SQFZI separately. Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-9 (TIMP-9) in plasma was measured on the 1st and 14th days after AMI. Results: MMP-9 and MMP-9/TIMP-9 were increased after AMI, after 2-week treatment, the level of MMP-9 and MMP-9/TIMP-9 decreased more significantly in SQFZI group than that in the conventional group (P<0. 05). Conclusion: Early treatment with SQFZI after AMI could reduce the level of MMPs and the production of collagen. It may be useful for the prevention of VR and heart failure after AMI.
基金This work was supported by the grants from the National Natural Science Foundation of Chian(No.30470687)Heilongjiang Doctorate Foundation grant(No.SCX2005020)
文摘Ventricular remodeling （VR） after myocardial infarction （MI） makes a full impact on left ventricular dilation and dysfunction, severe arrhythmias and even sudden death. Thus it is very interesting and instructive to study the underlying regulatory mechanism for VR. Recently, evidenceI suggests that tumor necrosis factor-α （TNF-α） activity can independently influence VR, and aggravate myocardial dysfunction and cell death in the ventricle. The activation of pro-TNF〈t is adjusted by a disintegrin metalloproteinase （ADAM） 10 and ADAM17, the latter might take part in extracellular matrix （ECM） modulation in the borderline region of cardiac infarction.2 However, little is known about the relationship between ADAMsl0, 17 expressions and TNF-α activity in the process of VR after MI. The present study tested the hypothesis in rats that the interaction between ADAMsl0, 17 expressions and TNF-α activity was a contributory mechanism for VR of the healing myocardium, and metoprolol treatment might ameliorate VR inhibiting the mechanism.
文摘目的:探讨皖南产蝮蛇毒(AHV)蛋白C激活物(protein C activator,PCA)改善急性心肌梗死大鼠心功能作用与机制。方法:Sprague-Daw-ly大鼠60只,随机分为假手术(SH)组、心肌梗死模型(MI)组、PCA低、中、高剂量组(0.5、2、8mg/kg)、阳性对照组(阿司匹林5mg/kg),每组10只。通过结扎冠状动脉前降支建立急性心肌梗死(AMI)模型,采用Medlab生物信号处理系统监测大鼠心脏血流动力学变化。Westernblot检测心肌基质金属蛋白酶-9(MMP-9)蛋白表达;光镜观察心肌组织学改变。结果:与心肌梗死组比较,PCA高、中剂量大鼠左室内压最低值(LVDP)、左心室舒张末期压(LVEDP)、左心室压力最大上升速率(+dp/dtmax)、左心室压力最大下降速率(-dp/dtmax)明显升高(P<0.05),MMP-9的蛋白表达下降(P<0.05)。病理观察显示PCA干预组较梗死模型组炎症细胞浸润显著减轻,梗死面积缩小。结论:蝮蛇毒PCA组分可以限制急性心肌梗死早期心肌梗死扩大,有效改善心脏血液动力学,抑制MMP-9表达,对急性心肌梗死后心室重构有一定的干预作用。
文摘【目的】探讨氨基末端B型脑钠肽前体（N T‐proBN P ）、基质金属蛋白酶‐9（M M P‐9）对急性心肌梗死（AMI）患者经皮冠脉介入治疗（PCI）术后早期心室重构的影响及其相关性。【方法】根据PCI术后4周时92例AMI患者左心室容积增加率的不同，将其分为左室重构组，非左室重构组，并设稳定性冠心病对照组。比较患者NT‐proBNP、MMP‐9水平及其与PCI术后患者的左室收缩末期容积（ LVESV）和舒张末期容积（LVEDV）、左室射血分数（LVEF）、左室收缩末容积指数（ LVESVI）、左室舒张末容积指数（LVEDVI）等的关系。【结果】AMI患者PCI治疗前后血浆NT‐proBNP和MMP‐9水平较稳定型冠心病对照组明显升高；左室重构组血浆 NT‐proB‐NP、MMP‐9水平持续增高，与非左室重构组在PCI术后7 d比较差异有统计学意义（ P＜0．01）。血浆NT‐proB‐NP、MMP‐9水平与LVEDV均呈明显正相关（ P ＜0．01），与LVEF均呈明显负相关（ P ＜0．05）。【结论】AMI患者血浆NT‐proBNP、MMP‐9水平与左室重构指标有相关性，可作为AMI早期左室重构的预测因子。
