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Fluorescence intensity scatter diagrams of CEPCs in the 4th subgroup rats. (A-D) represents the Ctrl, HL, AMI, and HL-AMI group, respectively. Cells in gate P2-Q2 (PE + /FITC + or CD34 + /VEGFR2 + ) are CEPCs.
Source publication
This study aims to explore the role of hyperlipidemia in the mobilization of bone marrow (BM) endothelial progenitor cells (EPCs) induced by acute myocardial ischemia (AMI). To establish the hyperlipidemia complicated with AMI (HL-AMI) model, SD rats were intragastrically administered the high-fat emulsion for 4 weeks. Then their left anterior desc...
Citations
... Atypical RBBB which conveyed a larger area of infarction and was associated with a prognosis had been demonstrated by our previous study (8). Recently, an article reported that hyperlipidemia hampered the repairs of AMIinduced cardiac injury (31), and multiple studies proposed that hyperlipidemia and multi-vessel disease were associated with an adverse prognosis of AMI patient, which were also applicable in AMI patients combined with RBBB, consisting with the results of our study. In summary, we can consider to quote this new ECG parameter as a new indicator for prognosis in AMI patients combined with new-onset RBBB in clinic[28], which will help physicians judge high-risk patients. ...
Background
A few studies have focused on electrocardiography (ECG) parameters correlating with clinical prognosis in patients with acute myocardial infarction (AMI) combined with new-onset right bundle branch block (RBBB).
Objective
To assess the prognostic value of a new ECG parameter, namely, the ratio of QRS duration/RV 6 -V 1 interval (QRS/RV 6 -V 1 ), in patients with AMI combined with new-onset RBBB.
Materials and methods
A total of 272 AMI patients combined with new-onset RBBB who received primary percutaneous coronary intervention (P-PCI) were retrospectively enrolled in the study. First, the patients were divided into survival group and non-survival group. Demographic, angiographic, and ECG characteristics were compared between the two groups. Receiver operating characteristic (ROC) curve was used to screen the best ECG parameter for predicting 1-year mortality. Second, the ratio of QRS/RV 6 -V 1 , a continuous variable, was converted to the high ratio group and low ratio group according to the optimal cutoff value point determined by the X-tile software. We compared the patient’s demographic, angiographic, and ECG characteristics, in-hospital major adverse cardiovascular events (MACE), and 1-year mortality between the two groups. Multivariate logistic and Cox regressions were used to evaluate whether the ratio of QRS/RV 6 -V 1 was an independent prognostic factor of in-hospital MACE and 1-year mortality.
Results
The ROC curve showed that the ratio of QRS/RV 6 -V 1 had a higher value for predicting in-hospital MACE and 1-year mortality than the QRS duration, RV 6 -V 1 interval, and RV 1 interval. The patients in the high ratio group had significantly higher CK-MB peak and Killip class, lower ejection fraction (EF%), higher ratio of the left anterior (LAD) descending artery as infarct-related artery (IRA), and longer total ischemia time (TIT) than those in the low ratio group. The QRS duration was wider in the high ratio group than that in the low ratio group, whereas RV 6 -V 1 was narrower in the high ratio group compared with that in the low ratio group. The in-hospital MACE rate (93.3% vs. 31.0%, p < 0.001) and 1-year mortality rate (86.7% vs. 13.2%, p < 0.001) in the high ratio group were higher than those in the low ratio group. The higher ratio of QRS/RV 6 -V 1 was an independent predictor of in-hospital MACE (odds ratio, 8.55; 95% CI, 1.40–52.37; p = 0.02) after adjusting other confounders. Cox regression showed that the higher ratio of QRS/RV 6 -V 1 predicted higher 1-year mortality of the patients with AMI combined with new-onset RBBB [hazard ratios (HR), 12.4; 95% CI, 7.26–21.22); p < 0.001] than the lower ratio of QRS/RV 6 -V 1 , and the HR still stayed at 2.21 even after a multivariable adjustment (HR, 2.21; 95% CI, 1.05–4.64); p = 0.037).
Conclusion
According to the results of our study, the high ratio of QRS/RV 6 -V 1 (>3.0) was a valuable predictor of short- and long-term adverse clinical outcomes in AMI patients combined with new-onset RBBB. The implications of the high ratio of QRS/RV 6 -V 1 were severe ischemia and pseudo synchronization between bi-ventricle.
Ethnopharmacological relevance:
Danggui Buxue Decoction (DBD) is a classic prescription of traditional Chinese medicine that is mainly used for treating clinical anemia for more than 800 years. This prescription has been utilized for nourishing "Qi" and enriching"Blood" for women suffering from menopausal symptoms. Meanwhile, DBD has the role of improving angiogenesis and promoting the neuroprotective functions. Bone marrow-derived endothelial progenitor cells (EPCs) was suboptimal to treat the focal cerebral ischemia (FCI). Thus, it's may be a novel strategy of DBD combined with EPCs transplantation for the FCI.
Aim of the study:
To investigate the mechanistic effects of DBD in combination with EPCs transplantation to improve behavioral function of the FCI and hyperlipidemia.
Materials and methods:
We used rats with hyperlipidemia to develop a FCI model using photo-thrombosis, and treated the DBD in combination with EPCs transplantation. We adopted the Modified Neurological Severity Score to evaluate the neurological deficit, undertook the 2,3,5-triphenyltetrazolium chloride staining to calculate the total infarct volume. We carried out the RT-qPCR, Immunohistochemical analyses, TUNEL, ELISA, and Western blotting to measure the gene and protein levels which related to anti-apoptosis mechanisms and angiogenesis.
Results:
Administration of DBD in combination with EPCs transplantation was found to improve behavioral function, reducing the infarct volume and decrease the level of total-cholesterole (TC) and low-density lipoprotein-cholesterol (LDL-C). Treatment of DBD plus EPCs increased the mRNA and protein expression of vascular endothelial growth factor A, fibroblastic growth factor-2, and angiopoietin-1 and decreased the apoptosis of endothelial cells by activating the phosphoinositide 3-kinase/protein kinase B/Bcl-xL/Bcl-2 associated death promoter (PI3K/Akt/BAD) pathway and promoting activation of the extracellular signal-regulated kinase (ERK) pathway, which induced angiogenesis directly.
Conclusions:
Our findings provided that DBD administration combined with EPCs transplantation promoted reconstruction of nervous function. This was achieved by enhancing expression of the growth factors related to anti-apoptosis mechanisms and angiogenesis thanks to regulation of the PI3K/Akt/BAD and ERK signaling pathways, and might be relate to the lowering of TC and LDL-C levels.
This study aimed to evaluate the effect of Wogonoside (Wog), a flavonoid monomer, on hyperlipidemia and explore its possible mechanisms. APOE -/- mice were used to establish the animal model of hyperlipidemia by feeding the high-fat diet (HFD). The serum level of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and inflammatory cytokines were measured by enzyme-linked immunosorbent assay (ELISA), oil red O staining, and real-time PCR assay. The oxidative stress was measured by ELISA assay. Immunoblot assay and ELISA assay were used to detect the mechanism of Wogonoside on hyperlipidemia. We found that Wogonoside ameliorated lipid metabolism disorders in ApoE -/- mice induced by HFD (P<0.01). Wogonoside also ameliorated HFD-induced inflammation in ApoE -/- mice (P<0.01). Wogonoside ameliorated oxidative stress in HFD-induced ApoE -/- mice (P<0.01). Further study showed that Wogonoside improved HFD-induced hyperlipidemia and inflammation by upregulating SIRT1 expression (P<0.01). These results suggested that Wogonoside has the potential to be used as a promising approach for the intervention of hyperlipidemia.
