一种新型的心室束缚装置(ASD)可重复将丹参输送至心脏外膜,在心衰管理中具有良好的疗效。

A novel ventricular restraint device (ASD) repetitively deliver Salvia miltiorrhiza to epicardium have good curative effects in heart failure management.

机构信息

Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China; Department of Surgery, Aviation General Hospital, Beijing, 100012, PR China.

Department of Surgery, Aviation General Hospital, Beijing, 100012, PR China.

出版信息

Biomed Pharmacother. 2017 Nov;95:701-710. doi: 10.1016/j.biopha.2017.07.126. Epub 2017 Sep 5.

Abstract

A novel ventricular restraint is the non-transplant surgical option for the management of an end-stage dilated heart failure (HF). To expand the therapeutic techniques we design a novel ventricular restraint device (ASD) which has the ability to deliver a therapeutic drug directly to the heart. We deliver a Traditional Chinese Medicine (TCM) Salvia miltiorrhiza (Danshen Zhusheye) through active hydraulic ventricular support drug delivery system (ASD) and we hypothesize that it will show better results in HF management than the restraint device and drug alone. SD rats were selected and divided into five groups (n=6), Normal, HF, HF+SM (IV), HF+ASD, HF+ASD+SM groups respectively. Post myocardial infarction (MI), electrocardiography (ECG) showed abnormal heart function in all groups and HF+ASD+SM group showed a significant therapeutic improvement with respect to other treatment HF, HF+ASD, and HF+SM (IV) groups on day 30. The mechanical functions of the heart such as heart rate, LVEDP, and LVSP were brought to normal when treated with ASD+SM and show significant (P value<0.01) compared to other groups. BNP significantly declines in HF+ASD+SM group animals compared with other treatment groups. Masson's Trichrome staining was used to study histopathology of cardiac myocytes and quantification of fibrosis was assessed. The large blue fibrotic area was observed in HF, HF+ASD, and HF+SM (IV) groups while HF+ASD+SM showed negligible fibrotic myocyte at the end of study period (30days). This study proves that novel ASD device augments the therapeutic effect of the drug and delivers Salvia miltiorrhiza to the cardiomyocytes significantly as well as provides additional support to the dilated ventricle by the heart failure.

摘要

一种新型的心室约束装置是治疗终末期扩张性心力衰竭(HF)的非移植手术选择。为了扩展治疗技术,我们设计了一种新型的心室约束装置(ASD),它具有将治疗药物直接输送到心脏的能力。我们通过主动液压心室支持药物输送系统(ASD)输送一种中药丹参注射液(Danshen Zhusheye),并假设它在 HF 管理方面的效果将优于约束装置和药物单独使用。选择 SD 大鼠并分为五组(n=6),分别为正常组、HF 组、HF+SM(IV)组、HF+ASD 组、HF+ASD+SM 组。心肌梗死(MI)后,所有组的心电图(ECG)均显示心功能异常,HF+ASD+SM 组在第 30 天与其他 HF 治疗组(HF+ASD、HF+SM(IV))相比,心脏功能得到了显著改善。心脏的机械功能,如心率、LVEDP 和 LVSP,在 ASD+SM 治疗后恢复正常,与其他组相比具有显著差异(P 值<0.01)。与其他治疗组相比,HF+ASD+SM 组动物的 BNP 显著下降。使用 Masson 三色染色研究心肌细胞的组织病理学,并评估纤维化的定量。HF、HF+ASD 和 HF+SM(IV)组观察到较大的蓝色纤维化区域,而 HF+ASD+SM 组在研究结束时(30 天)观察到可忽略不计的纤维化心肌细胞。这项研究证明,新型 ASD 装置增强了药物的治疗效果,并显著将丹参输送到心肌细胞,同时通过心力衰竭为扩张的心室提供额外的支持。

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