Advances in animal models of chronic heart failure and its applications in traditional Chinese medicine / 中国中药杂志

Chronic heart failure(CHF) is a series of clinical syndromes in which various heart diseases progress to their end stage. Its morbidity and mortality are increasing year by year, which seriously threatens people's life and health. The diseases causing CHF are complex and varied, such as coronary heart disease, hypertension, diabetes, cardiomyopathy and so on. It is of great significance to establish animal models of CHF according to different etiologies to explore the pathogenesis of CHF and develop drugs to prevent and treat CHF induced by different diseases. Therefore, based on the classification of the etiology of CHF, this paper summarizes the animal models of CHF widely used in recent 10 years, and the application of these animal models in traditional Chinese medicine(TCM) research, in order to provide ideas and strategies for studying the pathogenesis and treatment of CHF, and provide ideas for TCM modernization research.

Network Pharmacology-based Analysis on Mechanism of Aconiti Lateralis Radix Praeparata and Epimedii Folium in Treatment of Chronic Heart Failure / 中国实验方剂学杂志

Objective:To explore the mechanism of the prescription consisting Aconiti Lateralis Radix Praeparata and Epimedii Folium in the treatment of chronic heart failure （CHF） based on network pharmacology，followed by verification in H9c2 myocardial cells with hypoxia-reoxygenation injury <italic>in vitro</italic> and in zebrafish with vascular endothelial growth factor receptor （VEGFR） tyrosine kinase inhibitor Ⅱ （VRI） -induced vascular insufficiency. Method:The active ingredients in Aconiti Lateralis Radix Praeparata and Epimedii Folium were searched from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP），the corresponding target genes from the Universal Protein Resource （UniProt）， and the CHF-related targets from Online Mendelian Inheritance in Man （OMIM） and GeneCards. Both the active ingredient-potential target network and the active ingredient-CHF-related target network were generated using Cytoscape 3.6.1， followed by the protein-protein interaction （PPI） network construction and Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genome （KEGG） enrichment analysis based on MetaScape. H9c2 myocardial cells exposed to hypoxia-reoxygenation were selected for determining the proliferation-promoting effect by methyl thiazolyl tetrazolium （MTT） assay. The protein expression of B-cell lymphoma-2（Bcl-2）， Bcl-2-associated X protein（Bax），cysteinyl aspartate-specific protease-3（Caspase-3）， protein kinase B（PKB/Akt），phosphorylated protein kinase B（p-Akt），phosphorylated extracellular signal-regulated kinases 1/2 （p-ERK1/2），extracellular signal-regulated kinase 1/2 （ERK1/2）， and poly adenosine diphosphate ribose polymerase（PARP）was detected by Western blotting. The efficacy of the prescription in promoting angiogenesis was verified in a zebrafish model of VRI-induced vascular injury. Result:There were 28 active ingredients for the prescription， 209 corresponding targets， 1 296 CHF-related targets， and 94 common gene targets shared by the prescription and CHF. PPI network clustering suggested that Aconiti Lateralis Radix Praeparata and Epimedii Folium alleviated CHF by interfering with cell differentiation and metabolism and angiogenesis. GO analysis revealed that CHF relief was achieved via the intervention in such biological processes as cell migration，vascular development， and angiogenesis. Pharmacodynamic experiments verified that Epimedii Folium （10 mg·L^-1） alone and the prescription （10 mg·L^-1）both enhanced the proliferation of H9c2 myocardial cells under the hypoxia-reoxygenation condition （<italic>P</italic><0.05），while the latter also increased the expression of Bcl-2，Bcl-2/Bax， and PARP （<italic>P</italic><0.05） and reduced the expression of Caspase-3， Akt， and ERK （<italic>P</italic><0.05）. The prescription at the concentrations of 0.3 and 0.1 g·L^-1 promoted angiogenesis （<italic>P</italic><0.05）. Conclusion:Aconiti Lateralis Radix Praeparata and Epimedii Folium exert the therapeutic effect against CHF via multiple ingredients，multiple targets， and multiple channels. Such combination promotes the proliferation of H9c2 myocardial cells under hypoxic condition and protects zebrafish from vascular injury by up-regulating the expression of Bcl-2 and PARP，increasing Bcl-2/Bax ratio，and down-regulating the expression of Caspase-3，Akt， and ERK.

Chronic heart failure due to Qi deficiency and blood stasis and intervention mechanism of Compound Renshen Buqi Granules:a proteomics-based study / 中国中药杂志

Compound Renshen Buqi Granules have been widely used to treat chronic heart failure(CHF) due to Qi deficiency and blood stasis, but the mechanism of action remains unclear. This paper explored the pathogenesis of CHF due to Qi deficiency and blood stasis and the intervention mechanism of Compound Renshen Buqi Granules based on quantitative proteomics for uncovering the biological basis. SD rats were divided into the normal control(N) group, normal+Compound Renshen Buqi Granules(ND) group, model(M) group, model+Compound Renshen Buqi Granules(D) group, and positive control(Y) group. The rat model of CHF due to Qi deficiency and blood stasis was established by ligation of the left anterior descending(LAD) coronary artery and chronic sleep deprivation. The rats in the ND group and D group were provided with Compound Renshen Buqi Granules, while those in the Y group received valsartan. Six weeks later, the serum was sampled and the data-dependent acquisition(DDA) was employed for the non-targeted quantitative proteomics analysis of the differences in protein expression among groups, followed by the targeted analysis of differentially expressed proteins(DEPs) generated by data-independent acquisition(DIA). Compared with the N group, the rats in the M group pre-sented with decreased body weight, grip strength, and pulse amplitude and increased RGB value on the tongue surface. The pathomorphological examination revealed inflammatory cell infiltration, cell degeneration and necrosis, tissue fibrosis, etc. After the intervention with Compound Renshen Buqi Granules, multiple indicators were reversed. As demonstrated by proteomics results, there were 144 and 111 DEPs found in the M group and ND group in comparison with the N group. Compared with the M group, 107 and 194 DEPs were found in the D group and the Y group, respectively. Compared with the ND group, 119 DEPs were detected in the D group. As illustrated by DIA-based verification, the quantitative results of six proteins in each group were consistent with those by DDA. The syndrome indicators and pathomorphological examination results demonstrated that the protein expression profile of rats with CHF due to Qi deficiency and blood stasis changed obviously. However, Compound Renshen Buqi Granules were able to reverse the differential expression of immune proteins to regulate CHF of Qi deficiency and blood stasis syndrome, which has provided clues for figuring out the pathogenesis of CHF due to Qi deficiency and blood stasis and the intervention mechanism of Compound Renshen Buqi Granules.

Effect of compatibility of Aconitum carmichaelii and Cornus officinalis on chronic heart failure rats / 中草药

Objective To study the efficacy enhancing and toxicity reducing effects of compatibility of Aconitum carmichaeli and Cornus officinalis on chronic heart failure (CHF) rats. Methods The CHF rats was established by ip injection of adriamycin (ADM), the CHF rats were administrated tested drugs for three weeks by means of ig administration, the tested drugs included extracts of A. carmichaeli, C. officinalis, and Compound. The serum brain natriuretic peptide (BNP) level, activity of Ca2+-ATP and Na+, K+-ATP enzymes in cardiac myocytes, and cardiac histopathology were measured. Results After three weeks of modeling, the CHF rats showed signs of ascites, loss of weight, loose stool, hogback, etc. The left ventricular ejection fraction (EF) and fraction shortening (FS) decreased significantly, and the level of BNP in serum was significantly improved; Pathological changes of ventricular tissue included rupture of myocardial fibers, degeneration and necrosis of cardiomyocytes, etc. After three weeks of gavage compatibility of A. carmichaeli and C. officinalis, the general state and cardiac histopathology of the animal was obviously improved, the level of BNP in serum was reduced significantly, the activity of Na+, K+-ATP enzymes was increased significantly. No notable improvement in the above indexes was obtained after administration of A. carmichaeli and C. officinalis alone. Conclusion The compatibility of A. carmichaeli and C. officinalis can increase the activity of Na+, K+-ATP enzyme in cardiac myocytes, and improve the energy metabolism and activity of cardiac myocytes in chronic heart failure. The compatibility of A. carmichaeli and C. officinalis play the key role of enhancing efficacy and reducing toxicity.

Management protocols for chronic heart failure in India

Heart failure is a common clinical syndrome and a global health priority. The burden of heart failure is increasing at an alarming rate worldwide as well as in India. Heart failure not only increases the risk of mortality, morbidity and worsens the patient’s quality of life, but also puts a huge burden on the overall healthcare system. The management of heart failure has evolved over the years with the advent of new drugs and devices. This document has been developed with an objective to provide standard management guidance and simple heart failure algorithms to aid Indian clinicians in their daily practice. It would also inform the clinicians on the latest evidence in heart failure and provide guidance to recognize and diagnose chronic heart failure early and optimize management.

Effects of exercise rehabilitation on the depression and anxiety state and quality of life in patients with chronic heart failure / 中华行为医学与脑科学杂志

Objective@#To explore the effects of exercise rehabilitation on the depression and anxiety state and quality of life in patients with chronic heart failure.@*Methods@#400 cases of chronic heart failure patients were selected as the research objects.They were randomly divided into control group(n=200)and exercise rehabilitation group(n=200) by random number table.Two groups were given symptomatic treatment and routine care on a regular basis, and exercise rehabilitation group again on this foundation to give rehabilitation therapy for 3 weeks.Self-rating anxiety scale(SAS) and Self-rating depression scale(SDS)were used to score the anxiety and depression of the two groups before and after rehabilitation.The SF-36 was used to assess the quality of life of patients.Rehabilitation satisfaction questionnaire was used to investigate the satisfaction degree of rehabilitation.@*Results@#There was no significant difference in SAS and SDS scores between the two groups before intervention (P>0.05). After intervention, the SAS and SDS scores of the two groups were significantly lower than those before intervention (P<0.05). SAS and SDS scores in exercise rehabilitation group ((27.47±4.82)vs(45.63±5.61))were significantly lower than those in control group ((43.17±4.81) vs (59.61±4.18))(P<0.05). Before intervention, there was no significant difference in the scores of SF-36 scale between the two groups (P>0.05). After intervention, the scores of SF-36 scale were significantly increased in the two groups, and the difference was statistically significant compared with that before intervention (P<0.05). All the factors of SF-36 in exercise rehabilitation group were significantly higher than those in control group (mental health: (72.06±7.48)vs(64.34±7.01), emotional function: (81.06±7.01)vs(76.05±6.92), social function: (81.14±7.83)vs(71.26±7.65), overall health: (70.14±8.05)vs(61.26±7.95), energy: (74.56±7.81)vs(69.46±7.40), the body pain: (68.51±7.36)vs(60.26±7.51), physical limitations: (64.99±7.31)vs(59.62±7.53 ), physiological function: (69.71±7.63)vs(63.84±7.04), all P<0.05). The satisfaction of the exercise rehabilitation group (92.5%)was significantly higher than that of the control group(75.0%) (P<0.05).@*Conclusion@#Exercise rehabilitation training can not only improve the anxiety and depression of patients with chronic heart failure, but also effectively improve the quality of life of patients.Exercise rehabilitation training has a high degree of recognition, and is worthy of extensive application in clinical practice.

The correlation of the ultrasound in cardiac function index and serum Hcy in chronic heart failure patients / 实用医学杂志

Objective To study the correlation between serum homocysteine (Hcy) levels and chronic heart failure (CHF) with ultrasound cardiac function patients.Methods The subjects were 88 cases of CHF (CHF group) in our hospital between April 2014 to June 2015 between patients,selected 65 cases of healthy people as a control group over the same period in our hospital,using color Doppler ultrasound measurement of two groups patients of the left ventricular ejection fraction of patients groups (LVEF) and left ventricular end-diastolic diameter (LVEDd),and compared serum Hcy and NT-proBNP levels,LVEF and LVEDd in different NYHA classification patients,analysis of serum Hcy and NT-proBNP levels and LVEF,LVEDd between correlation of serum Hcy levels on cardiovascular incident.Results CHF group of the Hcy,NT-proBNP levels and LVEDd were significantly higher than control group (P ＜ 0.01),LVEF was significantly lower than the control group (t =31.78,P =0.00);different NYHA functional class (Ⅱ ～ Ⅳ level) of Hcy,NT-proBNP,LVEDd and LVEF compared were statistically difference (P ＜ 0.01);Pearson correlation analysis showed,CHF patients with LVEF serum Hcy levels were negatively correlated (r2 =0.974,P ＜ 0.01),with LVEDd was positively correlated (r2 =0.896,P ＜ 0.05),and higher serum Hcy levels,the higher the rate of cardiovascular happened in patients with CHF.Conclusion The serum Hcy and NT-proBNP levels in patients with CHF were significantly higher than healthy,and with the deterioration of heart function and increased while the LVEF was negatively correlated positively with LVEDd,cardiovascular events in high Hcy levels may also increase the incidence risk,so Hcy levels is expected as a new diagnostic marker CHF conditions change.

Congestive Heart Failure among the Libyan Population (North Africa); A Community Based Survey of Risk Factors and Complication.

Congestive Heart failure (CHF) is a very common medical disorder and a major health problem in Libya. CHF is associated with an increase in the risk of stroke and hospitalization. Objectives: To estimate and describe the main risk factors and complications of CHF among people with a particular interest in Libyan community. Methodology: This project is classified as a community based descriptive cross-sectional study using the CHADS2 questionnaire as well as the local Libyan classification called the Community Stroke Risk Classification (CSRC). Area; North Africa (North of Libya, the capital Tripoli). Time; five years from 2010-2014 Population: Convenient sampling was done from a large cohort of individuals living in the Libyan community. 7497 individuals were screened for risk factors of stroke. CHF was one such factor which was studied in detail among the sample population and was diagnosed by taking detailed histories (including treatment), medical examinations and previous hospital confirmations. Results: The prevalence of CHF among our participants (7497 individuals) was 15.2% (1139 patients) among the sample population as a total with males and females being 51.2% and 48.8% respectively (P=0.87). Among different age groups, females had higher rates than the males except for age interval from 60 to 79 where males had higher rates. The male to female ratio among the total population screened for CHF was 7.8%: 7.4% (583:556 respectively with males being higher). CHF prevalence increased with the progress of age, with higher rates among age groups of over 40 (P <0.0001). 68.3% of CHF patients had hypertension (778 patients), 54.3% had DM (618 patients), 38.7% had transient ischemic attach (TIA) (441 patients), 27.2% had atrial fibrillation (AF) (310 patients), 25.9% had prior stroke (PS) (295 patients), All of these risk factors accompanying CHF increased with age (P<0.0001). 99.92% of CHF patients had risk points of stroke in CHADS2 scores (0.08% had no risk points), from whom 27.1% had intermediate scores (1-2 Risk Points) and 72.9% had high scores (≥3 risk points) (P<0.0001). Results of the CSRC scores showed that 99.91% had risk factors of stroke (0.09% had no risk factors), from whom 29.5% had intermediate scores (1-2 Risk Factors) and 70.5% had high scores (≥3 risk factors) (P<0.0001). Conclusion: CHF is a major risk factor of stroke among the Libyan population in North Africa of whom had very high CHADS2 risk scores. These scores are defined as a combination of six different risk points; 0 points being low risk, 1-2 being intermediate, and a score of 3 or more risk points is defined as being high risk. CHF appeared to dominate the high scores (≥3 risk points). Almost all CHF patients had risk factors of stroke on the CSRC scoring system of whom expressed intermediate and high scores with a significant proportion of high scores (≥3 risk factors of stroke). Hypertension, DM, AF and being aged of over 40 years were very important risk factors contributing to CHF. Both genders of male and female had similar chances of developing CHF in the Libyan community. CHADS2 & CSRC classification scores are very useful and simple tools to be used to classify and describe the risk factors of stroke in populations living within a community.

Curative effect of comprehensive nursing intervention on patients with chronic heart failure(CHF)during rehabilitation / 中国现代医生

Objective To discuss curative effect of comprehensive nursing intervention on patients with chronic heart failure (CHF) during rehabilitation. Methods Eighty-four cases of patients with CHF were selected and divided into routine nursing group and nursing intervention group at random. The patients in two groups were given routine drug medical treatment in Department of Medicine,and the patients in routine nursing group and nursing intervention group were given routine nursing and comprehensive nursing respectively for 6 months. The changes of compliance, heart function improvement and nursing satisfactory of patients in two groups were observed. Results After 6 months' inter-vention,the total treatment compliance rate of patients in nursing intervention group was much higher than that in rou-tine nursing group (95.24% vs 78.57%),the difference was significant(χ2=5.13, P<0.05). The total treatment compli-ance rates of patients in two groups obviously rose than before after 6 minutes' walking test (P<0.05 or P<0.01),and the rising rate in nursing intervention group was much higher than that in control group (P<0.05). The service at-titude,technique level,health education,caring for patients,mental support and other nursing satisfactory of patients in nursing intervention group were all much higher than those in routine nursing group (P<0.05 or P<0.01). Conclusion Comprehensive nursing intervention has reliable curative effect on patients with CHF during rehabilitation, which can enhance the treatment compliance of patients, improve the heart function,stabilize the condition of illness, motivate the early rehabilitation and increase the nursing satisfaction.

Effect of enhanced external counterpulsation therapy on myeloperoxidase in lowering cardiovascular events of patients with chronic heart failure.

Background: Chronic heart failure (CHF) is a slowly progressive disease with high morbidity and mortality; therefore, the management using pharmacological treatments frequently fails to improve outcome. Enhanced external counterpulsation (EECP), a non-invasive treatment, may serve as alternative treatment for heart failure. This study was aimed to evaluate the influence of EECP on myeloperoxidase (MPO) as inflammatory marker as well as cardiac events outcome. Methods: This was an open randomized controlled clinical trial on 66 CHF patients visiting several cardiovascular clinics in Manado between January-December 2012. The subjects were randomly divided into two groups, i.e. the group who receive EECP therapy and those who did not receive EECP therapy with 33 patients in each group. Myeloperoxidase (MPO) as inflammatory marker was examined at baseline and after 6 months of observation. Cardiovascular events were observed as well after 6 months of observation. Unpaired t-test was use to analyze the difference of MPO between the two groups, and chi-square followed by calculation of relative risk were used for estimation of cardiovascular event outcomes. Results: MPO measurement at baseline and after 6 months in EECP group were 643.16 ± 239.40 pM and 422.31 ± 156.26 pM, respectively (p < 0.001). Whereas in non EECP group, the MPO values were 584.69 ± 281.40 pM and 517.64 ± 189.68 pM, repectively (p = 0.792). MPO reduction was observed in all patients of EECP group and in 13 patients (48%) of non-EECP group (p < 0.001). Cardiovascular events were observed in 7 (21.21%) and 15 (45.45%) of patients in EECP and non-EECP groups, respectively (p = 0.037). Conclusion: EECP therapy significantly decreased the level of MPO as inflammatory marker and this decrease was correlated with the reduction of cardiovascular events in CHF patients.

Valne of BNP and NT-Pro BNT testing in diagwsis of heart failure / 中国基层医药

Objective To evaluate the clinical significance of the changes of plasma B-type natriuretic paprid and NT-pro BNP levels in patients with chronic heart failure(CHF).Methods 120 consecutive patients hospitalized for CHF were retrospectively studied.NT-pro BNP and LVEDD,LVESD,LVEF were measured and compared in 120 patients and 50 normal control subjects before medical treatment and on discharge.Results The plasma NT-pro BNP levels in patients with CHF were significantly higher than controls( P <0.05).The plasma NT-pro BNP levels in patients with cardiac function NYHA Ⅰ were significantly higher than controls( P < 0.05).As the cardiac function deteriorated from NYNA Ⅰ to NYNA Ⅳ,the NT-pro BNP levels increased consecutively with significant differences from each other ( P < 0.05).The plasma NT-pro BNP levels was low when CHF was cured ( P < 0.05 ).Conclusion Determination of plasma NT-pro BNP levels in patients with CHF were helpful to study the severity and prognosis of disease.

Effects of continuous positive airway pressure on right and left ventricular function in patients with CHF / Монголын Анагаах Ухаан

Background: Continuous positive airway pressure (CPAP) can improve left and right ventricular (LV and RV) func¬tion in patients with congestive heart failure (CHF). Material and Methods: We have chosen 30 patients with CHF who were treated in Department of Cardiology, Shastin’s Central hospital. CHF etiology was ischemic and dilatation cardiomyopathy. Baseline respiratory rate, SpO2, heart rate, systolic and diastolic blood pressure, cardiac output, ejection fraction and Tricuspid Annular Plane Systolic Excursion (TAPSE) values were noted. All the measurements were repeated at the end of CPAP. Statistical analysis: Statistical analysis performed by SPSS 17.0 program and we compared pre and post CPAP findings. P<0.05 was considered to be significant. Results: After CPAP patients respiratory rate decreased from 23.63±4.72 to 20±3.74 per minute (р=0.01), SpO2 increased from 91.25±4.1% to 98.25±1.16%, heart rate decreased from 86.75±8.28 to 77.38±7.35 per minute (p=0.05), systolic blood pressure decreased from 107.88±17.94 mmHg to 97.75±14.78 mmHg (p=0.01), diastolic blood pressure decreased from 81.13±17.16 mmHg to 73.38±15.89 mmHg (p=0.01), cardiac output increased from 5.57±1.55 l/min to 5.76±1.86 l/min (p=0.01), ejection fraction increased from 27.81±7.66% to 31.7±7.97% (p=0.05), TAPSE increased from 1.49±0.25 mm to 1.69±0.23 mm (p=0.01) respectively. Pearson’s coefficient between dia¬stolic blood pressure and cardiac output is -0.282, between diastolic blood pressure and ejection fraction is -0,493, between diastolic blood pressure and TAPSE is -0.581 respectively. Conclusion: CPAP improves LV, RV function and some respiratory parameters in patients with CHF

INCLINATION OF EXPONENTIAL CURVE-FITTING MODEL FOR HEART RATE AND OXYGEN UPTAKE DURING INCREMENTAL EXERCISE AS INDEX OF CARDIO-PULMONARY FUNCTIONAL IN PATIENTS WITH ISCHEMIC HEART DISEASE / 体力科学

This study was conducted to clarify the validity and availability of inclination of exponential curve-fitting model for oxygen uptake (VO₂) and heart rate (HR) during incremental exercise (I-ECOH) as an index of cardio-pulmonary functional reserve in patients with ischemic heart disease (IHD). A treadmill exercise test was used to measure the VO₂(L/kg/min) and HR (beat/min) during incremental exercise of all subjects. I-ECOH was derived from the following equation : HR=A·exp^B·VO2. The constant "B" represents I-ECOH. The following two identifications were made : 1) the relation between peak oxygen uptake (VO₂peak) and I-ECOH in IHD patients with normal left ventricular function and with chronic heart failure (CHF); 2) the relation between I-ECOH and the New York Heart Association (NYHA) functional classification of IHD patients with CHF.There were significant differences among IHD patients with normal left ventricular function, CHF patients, normal controls and long distance runners in I-ECOH and VO2peak, respectively (p<0.001). There were inverse correlations between I-ECOH and VO2peak in IHD patients with normal left ventricular function (r=-0.64, p<0.001) and CHF (r=-0.63, p<0.001). I-ECOH could be used to discriminate effectively between NYHA functional classes (p<0.001).In conclusion, these results suggest that I-ECOH is adequate and useful as an index of cardio-pulmonary functional reserve in patients with ischemic heart disease.

Observe the Relativity between Thyroid Gland Hormone and Plasm BNP Level and TCM Differentiation Types of Senile Patients of Congestive Heart Failure / 浙江中医药大学学报

[Objective]To observe the relativity between congestive heart failure(CHF) differentiation types of TCM and thyroid gland hormone,BNP and heart function parameters.[Method] Divide CHF patients into 4 groups,measure their heart function parameters,BNP and thyroid hormone,compare it to that of control group(21 cases).[Result] In CHF combined with blood stasis group,T3 level is much more reduced than that of control group and groups of heart Qi deficiency and combination of Yin deficiency(P

Exploration of the Syndrome of Vital Energy Deficiency and Blood Stasis of CHF Rat Model / 中国中医药信息杂志

Objective To explore the syndrome of vital energy deficiency and blood stasis of CHF rat model. Methods The Wistar male rats were deligated the main stem of left coronary artery. The succeeded twenty rats were cut the diet half from the second week, and swam exhausted every day, compared with normal group. After four weeks, the general condition, heart function, heart construction and NE, PRA, AngⅡ,TXB2, PAI-1 were observed. Results General condition: Model group seemed tired, pelage dimed, tongue ecchymosis, meanwhile breath and heart rate raised. Heart function: There was significant difference between model group and normal group (P

Effects of low dose androgen treatment on serum androgen levels in male adult rabbits postinfarction CHF model / 中国康复理论与实践

@#ObjectiveTo investigate the effects of low dose testosterone undecanonate (TU) and dehydroepiandrosterone (DHEA) on serum androgen levels in male adult rabbits postinfarction congestive heart failure (CHF) model.Methods48 male 4～5 months old New Zealand rabbits were randomly assigned to ligation of first branch of left coronary artery (n=40) or sham operation (n=8). 3 weeks later, 30 survived model rabbits were randomly treated with TU 3 mg/kg per 2 weeks intramuscular injection (TU group, n=10), DHEA 3 mg/kg/d oral (DHEA group, n=10) or placebo (placebo group, n=10) for 3 months. Serum androgen changes were recorded at 0th, 3rd and 15th week.ResultsAt 3rd week after peration, left ventricular ejection fraction of model animals was 47.6±4.5% lower than that of the sham group (66.7±5.8%) (P<0.05). Serum free testosterone level of model animals returned to normal ranges after low dose TU or DHEA treatment, otherwise DHEAS level was higher than the sham group (P<0.05).ConclusionThe doses used in this research reached physiological dosage to male adult rabbits in postinfarction CHF model.

Effect of Shengmai capsules on MMP-3&TIMP-1 of cardiac muscle in rats with chronic congestive heart failure / 中华中医药杂志

Objective:To research the effect of Shengmai capsules on the matrix metalloproteinase(MMPs)& tissue inhibitor of metalloproteinase(TIMPs)in chronic congestive heart failure(CHF)rats.Methods:75 SD female rats weredivided randomly into 5 groups:sham-operation group(A),CHF model group(B),CHF model treated by Shengmai capsules group(Shengmai capsule group,C),CHF model treated by Captopril group(Captopril group,D),CHF model treated by Shengmai capsule and Captopril group(shengmai capsule&captopril group,E),15 rats each group.Suprarenal abdominal artery constriction was operated to prepare CHF rat models.After 7 week treating respectively,the contents of MMP-3&TIMP-1 of cardiac muscle in rats were detected.Results:The content of cardiac MMP-3 was higher in group B than in group A(P

Clinical benefits of serum BNP measurement in patients with chronic kidney disease / 대한내과학회지

BACKGROUND: B-type natriuretic peptide (BNP) regulates excretion of water and sodium in the kidney, and serum levels of BNP are increased in the settings of decreased ventricular contractility and myocardial overload. Serum levels of BNP and renal function are important prognostic factors in congestive heart failure, and when renal function deteriorates, BNP level is increased. This study aimed to assess the clinical benefits of BNP measurement in patients with chronic kidney disease (CKD) for prediction of congestive heart failure (CHF). METHODS: Serum levels of BNP were measured in 75 patients with CKD who admitted to Soonchunhyang university Bucheon hospital between the period of April 2003 and April 2004. The clinical data, laboratory findings and echocardiographic findings in these patients were compared retrospectively. RESULTS: The average BNP level of the 75 patients was 1,645.3+/-1,830.9 pg/mL. There were no differences in BNP levels between K/DOQI CKD stages. Levels of BNP were higher in CKD patients with heart failure compared to those without heart failure. BNP levels showed a negative correlation to left ventricular ejection fraction and significant elevation in patients with pulmonary congestion and weight gain on admission. There was no difference in BNP levels in patients with or without left vetricular hypertrophy, and diabetes mellitus. The best cutoff level of BNP for evaluation of heart failure in patients with CKD was 500 pg/mL, with a sensitivity of 78%, specificity of 53%, positive predictive value of 34%, and negative predictive value of 88%, respectively. CONCLUSION: BNP levels showed no difference with the degree of renal failure in patients with CKD, and levels were increased with heart failure in patients with CKD. We discovered though, that in patients with CKD the measurement of serum BNP is a useful factor in assessment of coexisting heart failure, volume status and ischemic heart disease.

Computer-aided learning program in congestive heart failure (CHF) patient history taking for pharmacy students.

Introduction: Throughout the years, the learning process is still on going in the way of class lecturing, reading textbooks, and demonstrating via multimedia. However, there are some limitations regarding this issue such as time limit, lack of staff, budget, etc. Because of that, we are currently introducing a new multimedia to improve the knowledge and skill learning process. This project aims to develop a computer-aided learning program (CAL) to improve patient case history taking skills for health care professional students. Methodology: This project aims to assess the effectiveness of the CAL program regarding Congestive Heart Failure (CHF) patient history taking skills. There were a total of 45 volunteers, divided into three different groups, a CAL, a lecture, and a control group. The CAL group went through the CAL session and filled out patient information throughout both a case form and an attitude survey form. Meanwhile, the lecture group attended a CHF lecture and went for patient interviews approximately 20 minutes later. They would ask the questions to the patient and fill in the patient information in a case form provided. The control group went through a process similar to that of the lecture group, except that they did not go through the CAL program or take a class lecture. All volunteers were assigned to write the SOAP notes and send them back to the researchers. All data were then analyzed using statistical tests including the one-way ANOVA, Scheffe tests, and Likert’s scales. Results: There were 30 volunteers in this project; 9 males and 21 females. Regarding the total score CHF patient data, the CAL group was statistically higher than the other groups (p<0.05), especially in topics of underlying diseases, medication history, and social & family histories. However, the SOAP note scores were not statistically significantly different between groups (p>0.05). Nevertheless, the total scores of the CAL group were significantly higher than those of the other groups (p = 0.025, 0.002, respectively). Regarding attitudes toward the CAL, SOAP note: a clinical pharmacy note which contains subjective, objective, assessment, and plans for health care professionals program, for the most part participants appreciated the program, although there were some limitations such as the time limit of running the program, language, etc. Conclusion: Overall, the computer-aided learning program (CAL) for CHF patient history taking helped users learn more about history taking skills compared with a lecturing method. This means the program provided adequate patient information and accurately simulated a patient interview. Users will develop their skills gradually. A lecturing methods, however, which includes learning from class and taking a real patient interview, might not be practical because it takes too much time and involves some other limitations, including the busy schedule of health care professionals, expenses, numbers of patients and professional mistakes. Nevertheless, the CAL program will continue to be improved in order to modify the functions and the quality of the program. Finally, this material can certainly be a good supplement for a traditional learning process.

Heart rate turbulence in patients with chronic heart failure and relationship to clinical factors / 中国实用内科杂志

Objective To investigate the change of heart rate turbulence in patients with chronic heart failure and relationship to age、LVEF、LVED、heart rate before ventricular premature complex (VPC)、coupling interval、compensatory interval、the number and origin of VPC.Methods HRT was measured in 30 CHF patients and 30 healthy controls.HRT onset and slope were measured by the original definitions using Holter records and compared with the clinical factors.Results The HRT TS was significantly lower in patients wtih heart failure than in control (3.17?2.03vs9.64?6.47,P