Zhuang Jinlong, Zhu Jian, Dou Yan, Chen Xiaoqing, Chen Hua, Liu Xuean, Lin Genghai, Ruan Fahui
Department of Cardiology, Xiamen University Affiliated Dongnan Hospital, Zhangzhou, China.
Ann Transl Med. 2021 Oct;9(20):1592. doi: 10.21037/atm-21-5350.
Heart failure (HF) is a complex clinical syndrome and a serious manifestation or late stage of various heart diseases. This study aimed to explore the protective effects and underlying mechanisms of Shenqi Lixin Decoction (SQLXD) in HF.
A HF rat model was induced by intraperitoneal injection of adriamycin (3 mg/kg in the first 3 weeks, 2 mg/kg in the next 3 weeks, once a week, subcutaneous injection, 6 weeks cumulative dose is 15 mg/kg). After 4 weeks of intragastric administration of SQLXD (9.975, 19.95, 39.90 g/kg, once a day, gavage), the indexes of cardiac function were measured by cardiac color Doppler ultrasound, the cardiac muscle structure and pathological changes were observed by transmission electron microscope, hematoxylin-eosin (HE) staining and Masson. The plasma N-terminal B-type natriuretic peptide (NT-proBNP) level and myocardial tissue adenosine triphosphate (ATP) content were detected by ELISA. FITC detected the cardiomyocyte apoptosis rate (CMAR) labeled Annexin V/PI. Expression of B cell lymphoma factor 2 (Bcl-2), Bcl-2 associated X (Bax), cysteine protease-3 (Caspase-3), and peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) mRNA in myocardial tissue were detected by real-time PCR (RT-PCR). The expression of Bcl-2, Bax, Caspase-3 and P53 protein in myocardial tissue were detected by Western blot.
Compared to the normal group, left ventricular end systolic diameter (LVSD), left ventricular end diastolic diameter (LVDD), CMAR and the expression of P53 protein, mRNA and protein of Bax and Caspase-3 were significantly increased in model group, while left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), stroke volume (SV) and the expression of Bcl-2 protein, mRNA of PGC-1α and Bcl-2 were significantly reduced. Compared to the model group, LVSD, LVDD, CMAR and the expressions of P53 protein, mRNA and protein of Bax and Caspase-3 in the medium and high dose SQLXD groups and the control group were significantly decreased, while LVEF, LVFS, SV and the expression of Bcl-2 protein, mRNA of PGC-1α and Bcl-2 were obviously increased. Pathological findings by transmission electron microscope, Masson, and HE staining all revealed protective effects of SQLXD on heart.
SQLXD can effectively protect HF rats' hearts. The potential mechanism may be related to the modulation of the expression of PGC-1α and the mitochondrial apoptosis pathway.
心力衰竭(HF)是一种复杂的临床综合征,是各种心脏病的严重表现或晚期阶段。本研究旨在探讨参芪利心汤(SQLXD)对HF的保护作用及其潜在机制。
通过腹腔注射阿霉素诱导HF大鼠模型(前3周3mg/kg,后3周2mg/kg,每周一次,皮下注射,6周累积剂量为15mg/kg)。给予SQLXD灌胃4周(9.975、19.95、39.90g/kg,每日一次)后,采用心脏彩色多普勒超声测量心功能指标,通过透射电子显微镜、苏木精-伊红(HE)染色和Masson染色观察心肌结构及病理变化。采用ELISA法检测血浆N末端B型利钠肽(NT-proBNP)水平和心肌组织三磷酸腺苷(ATP)含量。用FITC标记的膜联蛋白V/PI检测心肌细胞凋亡率(CMAR)。通过实时荧光定量聚合酶链反应(RT-PCR)检测心肌组织中B细胞淋巴瘤因子2(Bcl-2)、Bcl-2相关X蛋白(Bax)、半胱氨酸蛋白酶-3(Caspase-3)和过氧化物酶体增殖物激活受体γ共激活因子-1α(PGC-1α)mRNA的表达。采用蛋白质免疫印迹法检测心肌组织中Bcl-2、Bax、Caspase-3和P53蛋白的表达。
与正常组相比,模型组左心室收缩末期内径(LVSD)、左心室舒张末期内径(LVDD)、CMAR以及P53蛋白、Bax和Caspase-3的mRNA和蛋白表达均显著升高,而左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、每搏输出量(SV)以及Bcl-2蛋白、PGC-1α和Bcl-2的mRNA表达均显著降低。与模型组相比,中、高剂量SQLXD组和对照组的LVSD、LVDD、CMAR以及P53蛋白、Bax和Caspase-3的mRNA和蛋白表达均显著降低,而LVEF、LVFS、SV以及Bcl-2蛋白、PGC-1α和Bcl-2的mRNA表达均明显升高。透射电子显微镜、Masson染色和HE染色的病理结果均显示SQLXD对心脏有保护作用。
SQLXD可有效保护HF大鼠心脏。其潜在机制可能与调节PGC-1α表达及线粒体凋亡途径有关。