Ma Lina, Chuang Chia-Chen, Weng Weiliang, Zhao Le, Zheng Yongqiu, Zhang Jinyan, Zuo Li
Graduate School, Beijing University of Chinese MedicineBeijing, China; Institute of Basic Medical Sciences, Xiyuan Hospital, China Academy of Chinese Medical SciencesBeijing, China.
Radiologic Sciences and Respiratory Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University College of MedicineColumbus, OH, USA; Interdisciplinary Biophysics Graduate Program, The Ohio State UniversityColumbus, OH, USA.
Front Physiol. 2016 Jul 21;7:298. doi: 10.3389/fphys.2016.00298. eCollection 2016.
No-reflow phenomenon, defined as inadequate perfusion of myocardium without evident artery obstruction, occurs at a high incidence after coronary revascularization. The mechanisms underlying no-reflow is only partially understood. It is commonly caused by the swelling of endothelial cells, neutrophil accumulation, and vasoconstriction, which are all related to acute inflammation. Persistent no-reflow can lead to hospitalization and mortality. However, an effective preventive intervention has not yet been established. We have previously found that paeonol, an active extraction from the root of Paeonia suffruticosa, can benefit the heart function by inhibiting tissue damage after ischemia, reducing inflammation, and inducing vasodilatation. To further investigate the potential cardioprotective action of paeonol on no-reflow, healthy male Wistar rats were randomly divided into four groups: sham, ischemia-reperfusion (I/R) injury (left anterior descending coronary artery was ligated for 4 h followed by reperfusion for 8 h), and I/R injury pretreated with paeonol at two different doses. Real-time myocardial contrast echocardiography was used to monitor regional blood perfusion and cardiac functions. Our data indicated that paeonol treatment significantly reduces myocardial infarct area and no-reflow area (n = 8; p < 0.05). Regional myocardial perfusion (A·β) and cardiac functions such as ejection fraction, stroke volume, and fractional shortening were elevated by paeonol (n = 8; p < 0.05). Paeonol also lowered the serum levels of lactate dehydrogenase, creatine kinase, cardiac troponin T, and C-reactive protein, as indices of myocardial injury. Paeonol exerts beneficial effects on attenuating I/R-associated no-reflow injuries, and may be considered as a potential preventive treatment for cardiac diseases or post-coronary revascularization in which no-reflow often occurs.
无复流现象是指在无明显动脉阻塞的情况下心肌灌注不足,在冠状动脉血运重建后发生率很高。无复流现象的潜在机制仅得到部分理解。它通常由内皮细胞肿胀、中性粒细胞聚集和血管收缩引起,所有这些都与急性炎症有关。持续性无复流可导致住院和死亡。然而,尚未建立有效的预防性干预措施。我们之前发现,丹皮酚是从牡丹根中提取的一种活性成分,可通过抑制缺血后组织损伤、减轻炎症和诱导血管舒张来改善心脏功能。为了进一步研究丹皮酚对无复流的潜在心脏保护作用,将健康雄性Wistar大鼠随机分为四组:假手术组、缺血再灌注(I/R)损伤组(结扎左冠状动脉前降支4小时,然后再灌注8小时),以及用两种不同剂量丹皮酚预处理的I/R损伤组。采用实时心肌对比超声心动图监测局部血流灌注和心脏功能。我们的数据表明,丹皮酚治疗可显著减少心肌梗死面积和无复流面积(n = 8;p < 0.05)。丹皮酚可提高局部心肌灌注(A·β)以及诸如射血分数、每搏输出量和缩短分数等心脏功能(n = 8;p < 0.05)。丹皮酚还降低了作为心肌损伤指标的血清乳酸脱氢酶、肌酸激酶、心肌肌钙蛋白T和C反应蛋白水平。丹皮酚对减轻I/R相关的无复流损伤具有有益作用,可被视为一种针对常发生无复流的心脏病或冠状动脉血运重建术后的潜在预防性治疗方法。