Objectives Previous studies have exhibited the protective effects of synthesised polymers alone oras scaffold for myocardial infractions (MI) treatment. However, the exact roll of synthesised polymers when used for MI treatment is still unknown. Besides that, the suitable degradation time of synthesised biomaterilas is still undercontroversy. In our present study, we synthetise two kinds of poly N-isopropylacrylamide thermoresponsive hydrogel with theoretic different degradation time, and aim to investigate the interaction of physical characteristics and function of the synthesised polymerin MI-induced rat model. Methods Twotypes of poly N-isopropylacrylamide thermoresponsive hydrogel (defined as Gel A and GelB) were synthesised by our previous report. In vivo hydrogel formation and maintenance were observed and confirmed in male KM mice (20±5 g) to make sure the degredation days of hydrogel in vivo. MI was induced in male Wistar rats (200±20 g) by the ligation of left anterior descending conronary artery. The MI rats were grouped to receive intra-myocardialinjection of 100 µl phosphate buffered saline, 3% (w/v) GelA or 3% (w/v) Gel B solution randomly by intra-myocardium injection. The geometric structure of the hydrogel was also test by electron scanning microscopy. Echocardiographyand hemodynamic analysis were used to evaluate left ventricular systolic and diastolic function. Isolated infarcted or sham myocardium was tailored for contractility measurement in vitro. Western blotting and immunohistochemistry were used for detecting collagen metabolism. Results In vivo degradation investigation showed the biodegradation time of Gel A is approximate 85 days and the days of Gel B is nearly 28 days. Electron scanning microscopy images exhibited the three-dimensional structure of cross-linked and skeleton-liked networks contributing to form holes which could adhere to red blood cells. At the aspect of inhibiting ventricular infarction enlargement, Gel A or Gel B showed no significant difference, while, Gel B performed better than Gel A on improving left ventricular systolic and diastolic function (p<0.05). Collagen hyper-deposition around the infarcted and non-infarcted myocardium is a common phenomenon after infarction. However, the injection of thermoresponsive hydrogel could significantly down-regulated collagen deposition. Notably, the effectiveness of hydrogel on regulate collagen metabolism is not through TFG-β signal pathway. Additionally, contractitility of isolated infarcted myocardium was significantly deteriorated, however, contractionforce significant increased due to the improvement of contractive ordination after hydrogel used. Conclusions Synthesised poly N-isopropylacrymide hydrogel is an excellent option for MI treatment. Properphysical featrues may be the potential reason for the effective cardiacprotection of the thermoresponsive hydrogel post-MI. Additionally, suitabledegradation time of synthesised poly N-isopropylacrymide hydrogel is a anotherconsideration for biomaterials designing. We deem the physical properties of polyN-isopropylacrymide hydrogel promote its effects on structural and functional replacement of damaged myocardium tissue.

Objective To investigate the effects of Wenxin granules on cardiac function in rabbits with heart failure(HF).Methods 40 New Zealand rabbits were randomly divided into four groups:sham-operated placebo group,sham-operated Wenxin granuels group,HF placebo group and HF Wenxin granules group.Heart failure was induced by combined aortic regurgitation and aortic stenosis in 20 New Zealand rabbits.Eight weeks later,cardiac function and structure was measured by echocardiography.Results Compared with sham-operated placebo group,the rabbits in the HF placebo group exhibited significantly larger HW/BW,lung wet weight/body weight,left ventricular end-diastole dimension(LVEDD),left ventricular end-systole dimension(LVESD),left ventricular end-diastole volume(LVEDV) and left ventricular end-systole volume(LVESV),lower left ventricular ejection fraction(LVEF) and left ventricular shortening fraction(LVFS)(P0.05).Compared with HF placebo group,HW/BW,lung wet weight/BW,LVEDD,LVESD,LVEDV and LVEDS were decreased,the LVEF and LVFS were increased in HF Wenxin granules group.Conclusion Wenxin Granules can ameliorate cardiac function in rabbits with CHF.

Objective To evaluate the left ventricular synchronicity in patients with dilated cardiomyopathy(DCM) by real-time three-dimensional echocardiography(RT-3DE).Methods Twenty-eight DCM patients and twenty-nine healthy volunteers were enrolled in this study,and clear full volume pictures were aquired using RT-3DE.The time to minimal systolic volume (Tmsv) of each segment was measured,and a mean value of Tmsv for the same segment in each group(Tmsv') was caculated.The standard deviation (Tmsv-SD) and the maximal difference (Tmsv-Dif) of Tmsv were calculated for basal level,mid level,apical lever,12 segments and 16 segments (Tmsv1-6-SD,Tmsv7-12-SD,Tmsv13-16-SD,Tmsv12-SD,Tmsv16-SD,Tmsv1-6-Dif,Tmsv7-12-Dif,Tmsv13-16-Dif,Tmsv12-Dif,Tmsv16-Dif).Results There were no significant differences among 1-17 Tmsv' within each group.No significant differences were found between two groups for Tmsv' derived from the same segment.All asynchrony indexs of DCM patients were remarkably higher than those of the healthy volunteers (P＜0.01 or P＜0.05),and correlated closely with LVEF determined by RT-3DE (r=-0.576～-0.768,P＜0.01 or P＜0.05) except for those of the mid level(r=-0.402～-0.449,P＞0.05).Conclusions Dyssynchrony exist in globle and each level of DCM patients' left ventricle.RT-3DE is an available technique for left ventricular synchronicity quantification.

AIM To investigate the effect of valsartan on the left ventricular remodeling and heart function in rats with acute myocardial infarction(AMI).METHODS Six hours after ligating left coronary artery,80 female Sprague Dawley rats were divided randomly into Sham operation group(Sham group,n=20),MI control group(MI-C group,n=30) and MI valsartan group(MI-V group,n=30).MI-C group and MI-V group undergone acute myocardial infarction by ligation of left anterior descending coronary artery.Sham group were treated in the same way as previously described except for coronary ligation.In MI-V group,valsartan was orally administered 20 mg/(kg·d),twice a day and this procedure lasted 7 days.In Sham group and MI-C group,only 4 g/L saline was orally administered.After 12 hours,3 days and 7 days of therapy,we analyzed the echocardiography parameters and structure parameters.RESULTS Compared with those in Sham group,left ventricular systolic pressure,left ventricular +dp/dtmax and-dp/dtmax markedly decreased(P0.05),while left ventricular end diastolic pressure markedly increased(P0.05) and left ventricular weight index markedly increased(P0.05) in 7 days in MI-C group.Left ventricular end diastolic volume,short axes and left ventricular weight index markedly decreased(P0.05 or 0.01) in 7 days.Long axes,Sphericity index and fractional shortening markedly decreased(P0.05 or 0.01) in 7 days in MI-C group.Compared with those in MI-C group,LVSP,+dp/dt,-dp/dt and LVEDP markedly increased(P0.05)while LVWI markedly decreased(P0.05) in 7 days in MI-V group.Infarction regional markedlyalso decreased(P0.05) in 3 days and 7 days in MI-V group.LVEDV,D and LVWI markedly decreased(P0.05 or 0.01) in 7 days.L,sphericity index and FS markedly increased(P0.05 or 0.01) in 7 days in MI-V group.CONCLUSION Valsartan restrains left ventricular remodeling and improves heart function after AMI.

OBJECTIVE:The objective of this study was to determine whether there is an association between mitral annular calcification (MAC), aortic valve annulus calcification (AVAC) and aortic valve calcification (AVC) with coronary artery disease (CAD) in subjects < or =65 years. METHODS:386 patients under 65 years of age underwent transthoracic echocardiography and coronary arteriography at the same time. RESULTS:The following results were obtained: (I) The patients with calcium deposits were older than the patients without calcium deposits (P < 0.01). Hypertension (P < 0.05) and diabetes mellitus (P < 0.001) were significantly associated with MAC. Hypertension (P < 0.01), diabetes mellitus (P < 0.05) and a smoking history (P < 0.05) were significantly more prevalent in patients with AVC than in those without AVC. Hypertension was significantly more frequent in patients with AVAC (P < 0.05). (II) There was a positive correlation between age (P < 0.001), hypertension (P < 0.001), diabetes (P < 0.05) and the number of sites with calcium deposits. (III) Coronary arteriography was more frequently positive in patients with calcium deposits than in those without (P < 0.01). (IV) Multivariable logistic regression analysis identified multiple calcium deposits (P < 0.01), age (P < 0.05), male gender (P < 0.001), diabetes mellitus (P < 0.001), and hypercholesterolaemia (P < 0.05) as significant predictors for a positive coronary arteriography. Multiple calcium deposits (P < 0.001) and diabetes mellitus (P < 0.001) were also significant predictors in female patients. In patients aged < or =55 years, multiple calcium deposits (P < 0.05), diabetes mellitus (P <0.05), smoking history (P < 0.05) and male gender (P < 0.05) were statistically significant predictors of a positive coronary arteriography. CONCLUSION:There is a significant association between the presence of calcium deposits and coronary artery disease. The presence of multiple calcium deposits is an independent predictor of coronary artery disease.

Objective To explore the effect of coronary artery bypass grafting(CABG) on left atrial (LA) function by strain rate imaging(SRI). Methods Twenty-three patients with coronary heart disease who underwent coronary artery bypass grafting were involved. SRI was performed on those patients to evaluate LA function quantitatively at baseline (before CABG),and at 1 week, 1 month and 3 months after CABG. Peak strain rate(SR) was measured at each segment (septal, lateral, posterior, anterior, and inferior walls) and mean peak systolic SR (SRs),peak early diastolic SR (SRe) and peak atrial systolic SR (SRa) were calculated by averaging data in each segment. Results Compared with the baseline,LV pre-systolic volume(LAVp), maximal volume (LAVmax), minimal volume (LAVmin), LV active emptying fraction (LAAEF) and passive empting fraction(LAPEF) had on significant differences at 1 week (P >0.05). LAVp,LAVmin,LAVmax and LAAEF decreased gradually after CABG, LAPEF increased gradually after CABG (P <0.05). Compared with the baseline, the peaks of SR curve showed no significant differences at 1 week (P >0.05). Nevertheless,the peaks of SR were increased at systole and early diastole,decreased at atrial contraction at 1 month (P <0.05). Those changes were turned more significantly at 3 months (P 0.01). Left ventricular ejection fraction (LVEF) both increased at 1 month and 3 months,and its changing rate correlated inversely with the changing rate of SRa respectively (r = -0.751, -0.783,all P<0.01).Conclusions LA function is affected by CABG, presented as reservoir and pump functions decreased and conduit function increased. SRI can evaluate the atrial function quantitatively and monitor the changing of LA function dynamically after CABG.

Objective: To explore the changes of left atrial(LA) function before and after intracoronary stent implantation by strain rate imaging(SRI).Methods: SRI was performed on 28 patients with coronary artery disease before implantation,and one week and one month after intracoronary stent implantation,to evaluate left atrial function quantitatively.Results: The SRI indices reflecting left atrial function such as LAVp,LAVmax,LAVmin and AEF decreased,LAPEF and LVEF increased one month after operation(P<0.05).Meanwhile,the peaks of strain rate curve in one month after the operation increased at systole and early diastole,and decreased at atrial contraction(P<0.05).While the above changes were not significant in one week after the operation.Conclusion: SRI can evaluate the atrial function quantitatively and monitor the improvement of left atrial function dynamically after intracoronary stent implantation.

Objective To explore the changes of left atrial systolic function in patients with coronary heart disease after coronary artery bypass grafting(CABG).Methods Strain rate imaging(SRI)was performed on 23 patients with coronary heart disease before CABG,1 week,1 and 3 months after CABG to evaluate left atrial systolic function quantitatively.Results No significant change of left atrial systolic function was detected 1 week after CABG(P>0.05).E/A and LVEF increased,LAFS,AEF and SRa decreased 1 month after CABG compared with those before CABG(P<0.05).Three months after CABG,changes turned more significantly(P<0.01).Left ventricular ejection fraction(LVEF)increased 1 and 3 months after CABG,and its changing rate negatively correlated with those of Sra(r=-0.751,-0.783;all P<0.01).Conclusion Left atrial systolic function is affected by CABG,presenting as decrease of pump function.SRI can be used to evaluate the atrial systolic function quantitatively and monitor the changing of left atrial systolic function dynamically after CABG.

Objective: To establish an animal model of experimental autoimmune myocarditis in Lewis rats and to investigate the expression and its significance of APRIL,a member of TNFSFs,in the experimental autoimmune myocarditis.Methods: Genetically predisposed Lewis rats were immunized with purified myosin plus complete Freund's adjuvant(CFA) in equal volume on day 1 and day 8,and the control rats were immunized with CFA only.The indexes of heart function(EF%,FS%,LVEDd and LVEDs) in the model group and control group were detected by echocardiogram on day 21 and day 90 after immunization.Hearts were harvested in both groups after the detection of echocardiogram.Histopathological changes of myocardium were measured by HE staining.The expression of APRIL mRNA was measured by reverse transcription polymerase chain reaction(RT-PCR).Results: On day 21 after immunization,inflammation was detected in the myocardium of experimental rats and inflammatory cells were mainly distributed around the blood vessels.On day 90,inflammatory cells decreased obviously and the myocardial cell became fibrosis,but no obvious inflammation emerged in the myocardium of control rats.The heart function in model group was worsen than in the control group(P0.05),but there was no significant difference between the two model groups(P0.05).The expression of APRIL mRNA was detected in the myocardium of experimental autoimmune myocarditis much more remarkably than in the normal myocardium(P0.05).Conclusion: The expression of APRIL mRNA increases in the myocardium of the experimental autoimmune myocarditis,and maybe play a role in the occurrence and development of autoimmune myocarditis.

BACKGROUND:Previous study demonstrated the improvement of cardiac function was proportional to the number of cells implanted. Therefore, increasing cell survival in the infarcted myocardium might contribute to the improvement of the functional benefit of cell transplantation.METHODS AND RESULTS:MSCs were treated with IGF-1 in vitro and infused into the acute myocardial infarction rats via the tail vein. After treatment of MSCs with IGF-1 for 48 h, flow cytometric analysis showed marked enhancement of expression of CXCR4 in the cell surface. After 4 weeks of transplantation, we found 1) a greater number of engrafted MSCs arrived and survived in the peri-infarct region; 2) TnT protein expression and capillary density were enhanced; 3) LV cavitary dilation, transmural infarct thinning, deposition of total collagen in the peri-infarct region and cardiac dysfunction were attenuated.CONCLUSION:1) IGF-1 treatment has time-dependent and dose-dependent effects on CXCR4 expression in MSCs in vitro. 2) IGF-1 improves the efficacy of MSCs transplantation in a rat model of myocardial infarction mainly via enhancement of the number of cells attracted into the infarcted heart. These findings provide a novel stem cell therapeutic avenue against ischemic heart disease.

Objective To explore clinical value of strain rate imaging(SRI) in evaluating regional myocardial function after stent implantation in patients with coronary heart disease(CHD).Methods Twenty eight patients with CHD before and after stent implantation and twenty normal control subjects were enrolled in the study.Longitudinal peak strain rate of left ventricular walls during systole(SRS),postsystolic shortening(SRPSS) and rapid filling(SRE) were measured,as well as the incidence of PSS and ratio of SRPSS/SRS.Results Compared with normal segments of control,SRS and SRE of ischemic segments of CHD reduced significantly(P0.01),the incidence of PSS,SRPSS and SRPSS/SRS increased significantly(P0.05).Between before and after stent implantation,the incidence of PSS,SRPSS,SRS and SRE have no statistical differences(P0.05),while SRPSS/SRS of after operation obviously decreased than that of before operation(P0.01).Conclusion Compare with SRS、SRE、SRPSS,SRPSS/SRS can more sensitively evaluate the functional improvement of regional myocardium after stent implantation.

Objective: To explore clinical value of strain rate imaging(SRI) in evaluating left ventricular diastolic function before and after stent implantation in coronary heart disease(CHD).Methods: Twenty-five patients with CHD were enrolled in the study before and after stent implantation.LV filling variables were obtained from pulsed wave Doppler recordings of the transmitral flow velocity.Then peak early diastolic velocity(E),peak atrial systolic velocity(A),deceleration time of the E wave and △VE% were measured.Peak strain rate during systole(SRS),rapid filling(SRE),the percent increase of SRE(△SRE%) in the stenotic segments and non-stenotic segments of left ventricular were measured.Results: Before stent implantation,SRS had no significant differences among all segements(P0.05).Compared with non-stenotic segments,SRE in stenotic segments decreased significantly(P0.01).SRE and △SRE% in stenotic segments increased significantly after stent implantation(P0.01) and were obviously higher than those in non-stenotic segments(P0.01).There was a significant positive correlation between △SRE and △VE in ischemic segments(r=0.54,P0.01).Conclusion: SRI can quantitatively detect changes of myocardial motion and quantify left ventricular diastolic function after stent implantation as a real-time method,which can evaluate the curative effect of stent implantation objectively.

Objective: To establish animal model of experimental autoimmune myocarditis in Lewis rats and investigate the expression of LIGHT (TNFSF14) and HVEM in the experimental autoimmune myocarditis and its significance. Methods: Cardiac myosin was extracted from porcine ventricular myocardium. Genetically predisposed Lewis rats were immunized with cardiac myosin covered by complete Freund's adjuvant (CFA) on day 0 and 7 to establish the experiment autoimmune myocarditis(EAM) models. The control rats were immunized with CFA only. On day 21 and 90 after the first immunization, echocardiography was examined, histopathological changes of myocardium were detected by HE pigmentation, and gene levels of LIGHT and HVEM was measured by semi-quantitative RT-PCR. Results: In model rats, histopathological examination of cardiac tissue showed an obvious inflammatory cell infiltration with myocytes necrosis on day 21, simultaneously, echocardiography examination showed that heart function decreased as compared with control group(P<0.05). On day 90, fibrosis and a few of inflammatory cells could be observed. No inflammation and fibrosis was emerged in the myocardium of control rats. In addition, as compared with that in control groups, mRNA abundance for both LIGHT and HVEM were up-regulated (P<0.05) at acute phase (day 21) in the EAM models. On day 90, the mRNA abundance for LIGHT and HVEM was still up-regulated (P<0.05). Conclusion: The expression of LIGHT and HVEM mRNA in myocardium was up-regulated in experimental autoimmune myocarditis. The LIGHT/HVEM pathway maybe plays a role in the occurrence and development of autoimmune myocarditis.

Objective: To determine whether there is an relation between senile degenerative heart valvular disease(SDHVD) with coronary artery disease(CAD) in subjects age≤65 years old. Methods: The age of the 298 patients were ≤65 years old. All patients underwent transthoracic echocardiography and coronary arteriography at the same time. Results: ①There was a progressive increase incidence of hypertension(P0.001) and diabetes(P0.05) with an increasing rate of calcium deposits of SDHVD as increase in age(P0.001). ②With an increasing sites with calcium deposits of SDHVD, there was a progressive increase in positive results of coronary arteriography(P0.001). ③Multiple logistic analyses identified SDHVD as significant predictors for the positive prevalence of coronary arteriography(P0.01). In female patients and age ≤55 years, SDHVD was statistically significant predictors of the positive prevalence of coronary arteriography(P0.001, P0.05, respectively). Conclusions: There is a significant relation between SDHVD and coronary artery disease. The presence of SDHVD is an independent predictor of coronary artery disease.

近年来,随着对高血压病研究的不断深入,左心房功能越来越受到人们的重视.本研究旨在探讨应变率成像评价高血压患者左房功能的临床价值.

Objective: To determine whether there is an association between the presence of aortic valve calcification(AVC) and carotid artery atherosclerotic disease. Methods: 214 patients with AVC diagnosed by transthoracic echocardiography underwent carotid artery ultrasound at the same time. They were compared with 182 age-and sex-matched persons without AVC who underwent carotid artery ultrasound during the same period. Results: ①Compared with the control group, the AVC group showed a significantly higher prevalence of systolic blood pressure(SBP) and diastolic blood pressure(DBP)[(162±18)mmHg versus (120±14)mmHg, P<0.01; (101±16)mmHg versus (78±12)mmHg, P<0.01). ②IMTs of CCA and ICA in the AVC group were significantly thicker than that in the control group[(1.17±0.18)mm versus (0.90±0.10)mm, P=0.000; (1.06±0.18)mm versus (0.81±0.12)mm, P=0.000, respectively].③Compared with the control group, the AVC group showed a significantly higher prevalence of carotid atherosclerotic plaque(44.39% versus 18.13%, P=0.000). ④The AVC group showed a significantly higher prevalence of carotid stenosis ≥20%(78.50% versus 57.14%, P=0.000), ≥40%(36.45% versus 22.53%, P=0.003), ≥60%(15.42% versus 8.24%, P=0.029), and ≥20%(38.32% versus 22.53%, P=0.001), ≥40%(19.63% versus 9.89%, P=0.007), ≥60%(7.01% versus 1.10%, P=0.004) of bilateral carotid artery. ⑤Vm of CCA and ICA in the AVC group were decreased significantly than that in the control group[(30.26±7.83)cm/s versus (41.25±8.32)cm/s, P=0.000; (35.46±6.85)cm/s versus (47.36±11.35)cm/s, P=0.000]. But PI(1.64±0.48 versus 1.35±0.32, P=0.010; 0.96±0.28 versus 0.85±0.16, P=0.039) and RI(0.78±0.07 versus 0.65±0.06, P=0.000; 0.81±0.11 versus 0.60±0.05, P=0.000) of CCA and ICA in the AVC group were increased significantly than that in the control group. ⑥On multivariate analysis, AVC was the only independent predictor of carotid atherosclerotic disease(stenosis of ≥40%, P=0.004). Conclusions: There is a significant association between the presence of AVC and carotid artery atherosclerotic disease. AVC may be an important marker for atherosclerotic disease of the carotid arteries. Carotid artery high frequency ultrasound should be underwent to the patients with AVC diagnosed by transthoracic echocardiography as a common.

主动脉瓣钙化(aortic valve calcification,AVC)是一种常见的超声心动图征象,本研究通过对AVC和冠状动脉粥样硬化的检测,探讨二者之间的关系,现将结果报告如下.