Effect of sequential mechanical ventilation on cardiac function, endothelial injury and oxidative stress response in patients with cor pulmonale

Objective: To study the effect of sequential mechanical ventilation on cardiac function, endothelial injury and oxidative stress response in patients with cor pulmonale (CCP). Methods: Patients with cor pulmonale complicated by respiratory failure who were treated in Dongfeng People's Hospital between May 2014 and February 2017 were selected and randomly divided into the sequential group who received sequential mechanical ventilation combined with conventional therapy and the control group who received invasive positive pressure ventilation combined with conventional therapy. The serum levels of cardiac function-related neurohumoral indicators, endothelial injury indicators and oxidative stress response indicators were detected before treatment as well as 3 d and 7 d after treatment. Results: 3 d and 7 d after treatment, serum NT-proBNP, Copeptin, Ang-II, ALD, ET-1, vWF, sST2 levels of both groups of patients were significantly lower than those before treatment while NO, SOD, GSH-Px and T-AOC levels were significantly higher than those before treatment;serum NT-proBNP, Copeptin, Ang-II, ALD, ET-1, vWF, sST2, NO, 8-iso-PGF2a, MDA, SOD, GSH-Px and T-AOC levels of sequential group 3 d after treatment were not significantly different from those of control group;serum NT-proBNP, Copeptin, Ang-II, ALDET-1, vWF, sST2, 8-iso-PGF2a and MDA levels of sequential group 7 d after treatment were significantly lower than those of control group while NO, SOD, GSH-Px and T-AOC levels were significantly higher than those of control group. Conclusion: Sequential mechanical ventilation for cor pulmonale can improve the cardiac function and reduce the degree of endothelial injury and oxidative stress response.

Oxygen affinity and 2,3-diphosphoglycerate level of erythrocytes in patients with cor pulmonale

Arterial blood gases,intraerythrocytic pH (pHi),2,3-diphosphoglycerate,standardP 50 (P 50std) and in vivo P 50 (P 50iv) were determined in 54 patients with cor pulmonale and23 normal subjects.It was found that no significant change of pHi was observed but the differ-ence of pHi and extraerythrocytic pH was decreased.P 50std was significantly decreased whileP 50iv remained essentially unchanged in those cases showing type I respiratory failure.Thesefindings suggest that P 50std cannot accurately reflect the changes of P 50iv in patients of corpulmonale;P 50iv in cases of cor pulmonale usually keeps relatively stable and coincides withthe ‘optimal P 50’,which indicates the adaptation of the organism to chronic hypoxia;and rel-ative intraerythrocytic alkalosis plays an important role in the relief of hypercapnia in cases ofcor pulmonale.

Effect of Yiqi Huoxue (益气活血) Herbs on Vascular Endothelial Cells and Platelets in Patients with Chronic Cor Pulmonale

Objective: To observe the clinical effect of Yiqi Huoxue (益气活血, YQHX) herbs in treating the patients with chronic cor pulmonale and to explore its mechanism by determining the relationship of oxida-tion/antioxidation system and how such herbs change on the function of endothelial cells and platelets. Methods: Fifty-eight patients were divided into two groups: conventional therapy group (control group, 28 patients) and convention plus YQHX herbs group (treated group, 30 patients). The control group received conventional management. The treated group were treated with YQHX 150 ml, twice a day, plus the conventional treatment, and the clinical efficacy was recorded. The lipid peroxidation (LPO), superoxide dismutase (SOD), ot-granule membrane protein (GMP140), partial pressure of arterial oxygen (PaO2), partial pressure of carbon dioxide in artery (PaCO2) and circulating endothelial cells (CEC) were measured respectively before and after treatment, and the relationship between various parameters were analyzed. The results were compared with those of 10 healthy subjects got at the same period. Results: (1) The effective rate and PaO2 of the treated group was higher than that of the control group and there were no difference in PaCO2 between the two groups. (2) The levels of LPO, GMP140, CEC in all the patients before therapy were significantly higher than those of the healthy group, and there were marked decrease in the levels of those after treatment (all P<0. 01). On the contrary, the levels of SOD in all the patients before therapy were markedly lower than those in the healthy subjects and increased after treatment, P<0. 01. (3) The increase of SOD in the treated group was significantly more obvious than that of the control group. In the treated group, the decrease of LPO, GMP140, CEC were markedly more obvious than those in the control group (all P<0. 01). (4) The number of CEC, as well as GMP140, was negatively correlated to PaO2(P<0.01) and SOD (P< 0. 01), which was positively correlated to LPO (P<0. 01). There was a positive correlation between CEC and GMP140 (P<0.05). Conclusion: YQHX herbs in treating chronic cor pulmonale proved to be effective by balancing the oxidation and antioxidation, protecting the pulmonary endothelial cells and activated platelets and helpful in treating respiratory failure.

Cor pulmonale

950272 A clinicopathological study of cor pulmonalewith coronary heart disease.TANG Peihua(汤佩华),et al.Beijing Red Cross Chaoyang Hosp.Beijing,100020.Chin J Intern Med 1995;34(3):185-189.The necropsy findings of 18 patients with cot pui-monale and coronary heart disease(CHD) were com-pared with those of a control group of 30 patients withcor pulmonale alone.The results showed that therewas no significant statistical difference between

Cor pulmonale

930475 The study of prethrombotic state in pa-tients with COPD and cor pulmonale.MA Duan（马端）,et al.Thrombosis & HaemostasisLab,Shandong Traffic Hosp,Jinan,250031.ChinJ Tuberc & Respir Dis 1993;16（2）:95—97.We measured PT,TT,KPTT,Fg,vWF,AT—IILAg,AT—ⅢA,a2M,TXB2,6—keto—PGFla,PLg,tPAAg,tPAA and PAl of patients with a-cute onset of chronic bronchitis,pulmonary em-physema,and cor pulmonale.The results

Cor Pulmonale

930077 The aminophyllin and cefatoxin fortreatment pulmonary heart disease of mutual in-fluence.LI Shenqi(李胜岐),et al.2nd ClinColl Dept,China Med Univ,Shenyang 110003.Chin J Tuberd & Respir Dis 1992;15(5):272-273.The serum Aminophyllin(TP)and Cefatoxin(CTX)concentration of the patients with pul-monary heart disease during acute attack weremeasured by HLPC at 2 hrs and 6 hrs after infu-sion.(1)TP and CTX alone were used.(2)TPand CTX were used simultaneously.The resultshowed that the concentrations of TP weremuch higher,but those of CTX were much low-er when CTX and TP simultaneously,at 2 hrsand 6 hrs(P【0.01,P【0.05).The concentra-

Cor pulmonale

970286 Efficacy of prostaglandin EI in treatment ofcor pulmonale patients with heart failure. ZHOUShuneheng(周顺成), et al. Dept Respir Dis, 2ndPeople’S Hosp, Hubei, 434000. Chin J Tuberc RespirDis 1997; 20(2): 88-90. objective: To investigate the effects of

Assessment of the right and left ventricular function in patients with cor pulmonale using high-definition CT

Background Cor pulmonale is often associated with changes of structure and function of the right ventricle （RV） and thus further affects functional changes of the left heart.Our study aimed to assess the left ventricular （LV） and RV function in patients with cor pulmonale using high-definition CT （HDCT）.Methods We prospectively studied 18 cor pulmonale patients determined by the pulmonary function test,clinical examination,chest radiograph,electrocardiogram,and echocardiogram.The subject group was compared to a control group consisting of 18 subjects.The RV and LV functions and RV myocardial mass （MM） were obtained by HDCT in the two groups.The results were compared between the two groups using the independent sample t test.Echocardiographic examination for cardiac function analysis was performed on the same day.Results The RV end-diastolic volume （EDV）,RV end-systolic volume （ESV） and RV myocardial mass were significantly larger in the 18 cor pulmonale patients than in the control group （P〈0.05）.The right ventricular ejection fraction （RVEF） was significantly lower in the 18 cor pulmonale patients than in controls （P〈0.01）.The left ventricular EDV （LVEDV） and LVEF were significantly lower in cor pulmonale patients than in controls （P〈0.01）.There were strong correlations between MDCT and echocardiography,rRVEF=0.839 and rLVEF=0.916,respectively.Conclusions HDCT can accurately quantify RV and LV function.The right ventricular function is impaired in patients with cor pulmonale,while at the same time the left ventricular function is also impaired.

A cross-sectional study of acute cor pulmonale in acute respiratory distress syndrome patients in China

Background:Increased right ventricle afterload during acute respiratory distress syndrome(ARDS)may induce acute cor pulmonale(ACP),which is associated with a poor clinical outcome.Echocardiography is now considered as a rapid and non-invasive tool for diagnosis of ACP.The aims of this study were to investigate the morbidity and mortality rates of ACP in ARDS patients in intensive care units(ICUs)across the mainland of China and to determine the severity and prognosis of ACP in ARDS patients through an ultrasound protocol(TRIP).And the association between ACP related factors and the ICU mortality will be revealed.Methods:This study is a multicenter and cross-sectional study in China which will include ICU participants when diagnosed as ARDS.The ultrasound protocol,known as the TRIP,is proposed as severity assessment for ACP,which includes tricuspid regurgitation velocity(T),right ventricular size(R),inferior vena cava diameter fluctuation(I),and pulmonary regurgitation velocity(P).The 28-day mortality,ICU/hospital mortality,the length of stay in ICU,mechanical ventilation days,hemodynamic parameters and lab parameters of liver function and kidney function are all recorded.Discussion:This large-scale study would give a sufficient epidemic investigation of ACP in ARDS patients in China.In addition,with the TRIP protocol,we expect that we could stratify ACP with more echocardiography parameters.

The Relationship Between P-Selectin on Platelet Membrane and Platelet Function in Chronic Cor Pulmonale.

Platelet plays an importent role in thromboembolic diseases. It is demonstrated that recurrent pulmonary embolism may cause pulmonary hypertention. In recent years，P-selectin（granule membrane protein，GMP40）was found to be a surface marker for platelet activation.

Cor pulmonale

2010318 Diagnosis value of electrocardiogram in patients with pulmonary artery hypertension. ZHAO Qinhua(赵勤华),et al.Dept Pulm Cir,Shanghai Pulm Hosp,Tongji Univ,Shanghai 200433.Chin J Cardiol 2010;38(4):346-349. Objective To analyze the diagnostic value of

Role of the Pericytes of Intra－acinar Pulmonary Artery in the Structural Remodeling of Pulmonary Vessels

Whether or not the pericytes exist in the intra-acinar pulmonary arteries and their normal structure and morphological changes during development of the structural remodeling of pulmonary vessels were observed using a pulmonary hypertension model in rats induced by monocrotaline injection.The results showed that the pericytes in the peripheral pulmonary vessels proliferated and transformed into smooth muscle cells during development of pulmonary hypertension,and at the same time,the pericytes could synthesize and secrete extracellular matrix including collagen,suggesting that the pericytes play an important role in the development of pulmonary hypertension and structural remodeling of the pulmonary vessels.

慢性肺源性心脏病患者血浆CGRP和SP水平的测定

目的 探讨血浆降钙素基因相关肽(calcitonin gene-related peptide,CGRP)和P物质(substance P, SP)在慢性肺源性心脏病(肺心病)发生发展中的病理生理作用.方法 采用放射免疫分析法测定30例肺心病组急性发作期和治疗后缓解期及20例正常对照组血浆CGRP和SP 浓度.肺心病组同时检测动脉氧分压(PaO2).结果 血浆CGRP水平肺心病组急性发作期(12±5)pg/ml和治疗后缓解期(19±7)pg/ml均低于正常对照组(24±5)pg/ml,差异有统计学意义(P<0.01).急性发作期血浆CGRP水平低于治疗后缓解期,差异有统计学意义(P<0.01).肺心病组急性发作期血浆SP 水平(39±12)pg/ml显著低于治疗后缓解期(46±11)pg/ml和正常对照组(45±8)pg/ml(P<0.01或P<0.05).治疗后缓解期和正常对照组血浆SP水平差异无统计学意义(P>0.05).PaO2急性发作期和治疗后缓解期分别为(6.3±2.0)kPa、(9.5±1.6)kPa,差异有统计学意义(P<0.01).结论 慢性缺氧与血浆CGRP、SP水平下降有关,尤其是CGRP,缺氧时两者的变化共同促进了肺动脉高压的形成,在慢性肺源性心脏病发生发展中起重要作用.

Potential role of human visceral pleura in pleural fluid turnover

With continuing advanced research into pleural fluid turnover, the majority of scientists hold the view that pleural fluid is derived from the microvessels in parietal pleura and drained via parietal lymphatic vessels which empty into systemic veins. The lymphatic vessels that contribute to the pulmonary lymphatic circulation originate in the subpleural connective tissue, not directly from the visceral mesothelium. Therefore, according to the current point of view, pleural effusion absorption through the visceral pleural is normally neclligible and visceral pleura,