Cardioprotective effects of sinomenine in myocardial ischemia/reperfusion injury in a rat model

BackgroundIschemia reperfusion (I/R) play an imperative role in the expansion of cardiovascular disease. Sinomenine (SM) has been exhibited to possess antioxidant, anticancer, anti-inflammatory, antiviral and anticarcinogenic properties. The aim of the study was scrutinized the cardioprotective effect of SM against I/R injury in rat.MethodsRat were randomly divided into normal control (NC), I/R control and I/R + SM (5, 10 and 20 mg/kg), respectively. Ventricular arrhythmias, body weight and heart weight were estimated. Antioxidant, inflammatory cytokines, inflammatory mediators and plasmin system indicator were accessed.ResultsPre-treated SM group rats exhibited the reduction in the duration and incidence of ventricular fibrillation, ventricular ectopic beat (VEB) and ventricular tachycardia along with suppression of arrhythmia score during the ischemia (30 and 120 min). SM treated rats significantly (P < 0.001) altered the level of antioxidant parameters. SM treatment significantly (P < 0.001) repressed the level of creatine kinase MB (CK-MB), creatine kinase (CK) and troponin I (Tnl). SM treated rats significantly (P < 0.001) repressed the tissue factor (TF), thromboxane B2 (TXB2), plasminogen activator inhibitor 1 (PAI-1) and plasma fibrinogen (Fbg) and inflammatory cytokines and inflammatory mediators.ConclusionOur result clearly indicated that SM plays anti-arrhythmia effect in I/R injury in the rats via alteration of oxidative stress and inflammatory reaction.     

Chagas cardiomyopathy and heart failure: From epidemiology to treatment

Chagas disease is among the neglected tropical diseases recognized by the World Health Organization that have received insufficient attention from governments and health agencies.Chagas disease is endemic in 21 Latin America regions. Due to globalization and increased migration, it has crossed borders and reached other regions including North America and Europe. The clinical presentation of the disease is highly variable, from general symptoms to severe cardiac involvement that can culminate in heart failure. Chagas heart disease is multifactorial, and can include dilated cardiomyopathy, thromboembolic phenomena, and arrhythmias that may lead to sudden death. Diagnosis is by methods such as enzyme-linked immunosorbent assay (ELISA) and the degree of cardiac involvement should be investigated with complementary exams including ECG, chest radiography and electrophysiological study. There have been insufficient studies on which to base specific treatment for heart failure due to Chagas disease. Treatment should therefore be derived from guidelines for heart failure that are not specific for this disease. Heart transplantation is a viable option with satisfactory success rates that has improved survival.     

膜周部室间隔缺损介入封堵术后心律失常危险因素及转归分析

目的 探讨膜周部室间隔缺损(PmVSD)介入封堵术后心律失常的危险因素和转归.方法 选择2019年1月至2021年2月在安徽省儿童医院心内科行PmVSD介入封堵术69例患儿为研究对象,回顾性分析患儿的临床资料、心电图和/或动态心电图、经胸超声心动图、术中心导管检查以及术后随访资料,按照是否发生心律失常,分为心律失常组(n=9)与非心律失常组(n=60),采用多因素logistic回归分析PmVSD介入封堵术后心律失常的危险因素.结果 心律失常组患儿QRS间期为109.00(93.50,127.50)ms,非心律失常组患儿QRS间期为74.00(71.25,78.00)ms,两组差异有统计学意义(P<0.05).两组患儿缺损直径、肺循环/体循环血流量比值(Qp/Qs)和曝光时间进行比较,差异有统计学意义(P<0.05),多因素logistic回归分析显示,曝光时间延长是PmVSD介入封堵术后心律失常发生的危险因素(OR=1.416,95％CI:1.120～1.790,P<0.05).随访12.00(6.00,12.00)个月,7例(包括2例严重心律失常)心律失常患儿恢复窦性心律.结论 PmVSD介入封堵术后心律失常以束支传导阻滞多见,大部分术后早期可恢复正常,曝光时间延长可增加PmVSD封堵术后心律失常的发生.     

Cardiac arrhythmias in the critically ill

Arrhythmias are a common problem in the critically ill and they can have significant effects on patient outcome. They often require immediate and swift action and it is, therefore, essential that clinicians have a structured approach to the recognition and management of arrhythmias. Here, we provide a framework for the appropriate management of the more frequently encountered cardiac arrhythmias in critical care. We include the algorithms from the 2015 Resuscitation Council Guidelines for reference.     

钙预适应对膨胀离体大鼠心室所致心律失常的影响

为了证实钙预适应对膨胀离体大鼠心室所诱发的心律失常具有抑制作用 ,采用Langendorff方法灌流离体大鼠心脏。用正常灌流液灌流平衡后 ,离体心被随机分为 4组 :牵张对照组 ,钙预适应组 ,钙预适应 +维拉帕米组和钙预适应 +格列本脲组。维拉帕米和格列本脲在灌流液中的浓度分别为 1μmol/L和 10 μmol/L ,对钙预适应进行干预后及时用正常灌流液将他们从离体心洗脱。将可充灌液体的乳胶球囊通过左房及二尖瓣置于左室 ,通过向乳胶球囊注射液体对左室进行膨胀 ,记录膨胀前和膨胀过程中左室心电图和左室压力、冠脉流量和心率 ,观察心电图ST段和T波的变化 ,并计算对照组和各实验组由膨胀诱发心律失常的发生率和持续时间。结果 :通过乳胶球囊膨胀左室 ,使左室舒张末压增加相同的情况下 ,对照组心律失常总发生率达 10 0 % ,持续时间为 2 .5 6± 0 .4 6s ;钙预适应组较对照组心律失常总发生率明显降低 (40 % ) ,持续时间缩短到 1.6 7± 0 .6 1s(P均 <0 .0 5 ) ;用维拉帕米对钙预适应进行干预后 ,心律失常总发生率较钙预适应组增高 (90 % ) ,持续时间延长 (2 .5 0± 0 .4 6s) ;钙预适应 +格列本脲组心律失常发生情况和钙预适应组相似。各组离体心在膨胀前后冠脉流量和心率、心电图ST段和T波均未见明显变化。结论 :?