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   2017| October-December  | Volume 2 | Issue 4  
    Online since March 12, 2018

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Effects of exercise training on systolic and diastolic function of mice with diabetic cardiomyopathy
Guo Lu, Xu Zhang, Zhongguang Sun, Xiaowei Shi, Tingliang Liu, Xin Xu
October-December 2017, 2(4):1-6
Objective: This study aims to evaluate the effects of exercise training on heart function of mice with diabetic cardiomyopathy. Materials and Methods: Twenty-four healthy C57 mice were randomly divided into three groups high-fat exercise group (n = 8), high-fat control group (n = 8), and low-fat control group (n = 8). High-fat groups were fed with a high-fat diet for 16 weeks, and the high-fat exercise group was subjected to aerobic treadmill exercise and resistance exercise for 8 weeks. After 24 weeks, the cardiac structure and function of the three groups were detected, and the indexes of the mouse heart were analyzed and compared. Results: The high-fat control group maintained hyperglycemia. The results of echocardiography showed that left ventricular eject fraction in the high-fat exercise group and the low-fat control group was significantly higher than that of the high-fat control group (68.99% ± 2.04% vs. 60.41% ± 2.31%, 66.16% ± 2.12% vs. 60.41% ± 2.31%, P < 0.01). In the diastolic function of the heart, blood flow peak velocities of the early peak at the mitral valve in the high-fat exercise group and the low-fat control group were significantly higher than that in the high-fat control group (709.73 ± 45.48 mm/s vs. 441.51 ± 44.83 mm/s, 632.92 ± 27.22 mm/s vs. 441.51 ± 44.83 mm/s, P < 0.01), the peak velocities of the atrial peak at the mitral valve were significantly lower than that of the high-fat control group (443.77 ± 18.09 mm/s vs. 523.67 ± 57.87 mm/s, 460.36 ± 18.24 mm/s vs. 523.67 ± 57.87 mm/s, P < 0.05), and the ratio of E/A was significantly higher than that of the high-fat control group (1.63 ± 0.06 vs. 0.85 ± 0.045, 1.38 ± 0.072 vs. 0.85 ± 0.045, P < 0.01). Myocardial performance index decreased (0.86 ± 0.095 vs. 0.97 ± 0.091, 0.88 ± 0.073 vs. 0.97 ± 0.091, P > 0.05), but there was no significant difference. Conclusion: The above data indicated that 8 weeks of exercise training can improve the heart function of mice with diabetic cardiomyopathy, especially diastolic heart function. Left ventricular systolic function had some trend to improve, but there is no statistical difference. Exercise intervention may promote the rehabilitation of diabetic cardiomyopathy.
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Treatment of Hyperlipidemia: Consensus and Controversies
Christoph H Saely, Reinhard R Saely, Heinz Drexel
October-December 2017, 2(4):18-25
Based on epidemiological, genetic, and clinical trial data, there is a consensus now that low-density lipoproteins (LDL) cholesterol causes atherosclerosis and that lowering LDL cholesterol reduces the risk of atherosclerotic cardiovascular disease. Current guidelines on lipid management, therefore, focus on LDL cholesterol. The absolute benefit derived from lowering LDL cholesterol is greatest with the highest baseline risk; the most intensive treatment, therefore, is appropriate in the patients at the highest risk. Regarding the choice of drugs, statins are the basis of lipid management; if treatment goals are not met with statins alone, ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitors can be added to further reduce cardiovascular risk. Several questions remain open to debate. For example, the long-term net benefit of statin treatment in young patients with a low 10-year, but a high lifetime risk of cardiovascular events has not been demonstrated; in the absence of robust data, also lipid management in very old patients remains a question of clinical judgment. Further, given the evidence from clinical trials for further risk reduction with lowering LDL cholesterol below currently recommended targets, there is no universal consent on how low to go with LDL cholesterol. Also, with the availability of potent but expensive treatment options, the cost-effectiveness of lipid management remains a field of controversy. Finally, new lipid drugs are under development that yet has to prove their role in lipid management.
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Guidelines for comprehensive prevention and treatment of cardiovascular diseases in community populations (The Trial)
Yong Huo, Junbo Ge
October-December 2017, 2(4):26-37
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Effects of Shensongyangxin capsule on myocardial connexin 40 expression in diabetic rat model
Da-Bin Pan, Ji-Min Chen, Shi-You Gao, Lin-Tao Zha, Xiang-Rong Xie, Heng Cao
October-December 2017, 2(4):11-17
Objective: To investigate the effects of Shensongyangxin (SSYX) capsule on myocardial expression of connexin 40 (Cx40) in diabetic rat model. Materials and Methods: Thirty-one male Sprague-Dawley rats (SD, 8 weeks old, weighing 220 g) were randomly divided into three groups: normal control group (NC, n = 10), diabetic group (diabetes mellitus [DM], n = 9), and diabetes plus SSYX group [SDM], n = 12). SD rats were injected intraperitoneally with streptozotocin (SZT, 65 mg/kg) to make the diabetic rat model. SDM group was given daily SSYX 1 g/kg by gavage and NC group and DM group were given a daily amount of distilled water by gavage. The expression levels of Cx40 in atrial and ventricular muscles were analyzed by Western blot techniques. Hematoxylin and eosin staining technique was used to observe the changes of myocardial structure; the distribution of myocardial Cx40 was analyzed by immunofluorescence technique. Results: Cx 40 levels in the atrial and ventricular muscle were lower in DM group than in the NC group (P < 0.05). The cardiac muscle cells were arranged in order in the NC group. Extensive necrosis and apoptosis of myocardial cells were noted accompanied by the disorder of permutation, adipose tissue, and fibrous tissue in DM group. In the SDM group, the cardiac muscle cells were arranged orderly, but fibrous tissue and vasculitis were observed. Immunostaining showed that the expression of Cx40 in the myocardium was distributed at the end of the long axis of myocardial cells with a ladder-like distribution in the NC group. The expression of Cx40 in the myocardium was mostly distributed on the side of the long axis of myocardial cells in the DM group. The expression level of Cx40 in atrial muscle was increased, and the distribution in the SDM group was primarily lateral. Conclusions: The expression of Cx40 in the myocardium was decreased and mainly distributed on the sides in DM group. SSYX capsule upregulated the expression of Cx40 in the atrium in diabetic rats. No significant effect was noted on the expression and distribution of Cx40 in the ventricular muscle.
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Hemostasis and clotting markers and its significances in unstable angina pectoris patients complicated with diabetes mellitus
Jian-lin Ma, Yan Zhou, Jia-ming Zhang, Li-ning Ma, Haitao Li, Xiangjie Ma, Liao Wang
October-December 2017, 2(4):7-10
Background: Recent studies have confirmed that patients with unstable angina pectoris (UAP) complicated with diabetes mellitus(DM) have obvious per-thrombosis state. However, it is not clear that the changes of the hemostasis and clotting markers are very clear. Therefore, this paper is to determine the hemostasis and clotting markers in patients with UAP complicated with DM and those without DM and compared with the control group. Methods: Forty patients with UAP, forty patients with UAP complicated with DM, and forty healthy participants were included in the study as UAP group, complication group, and control group, respectively. Levels of platelet membrane glycoprotein(GP), Von Willebrand (vWF), plasminogen, antithrombin III(ATIII), factor VIII-related antigen(VIII: Ag), platelet membrane glycoprotein-140(GMP-140), protein C(PC), factor II activity(FIIa), tissue plasminogen activity(t-PA), PA inhibitor(PAI), D-dimer, and thromboxane B2(TXB2) were measured in all groups. Results: Compared with a control group and UAP group, there were significant changes of GP, vWF, ATIII, VIII: Ag, GMP-140, PC, FIIa, t-PA, PAI, D-dimer, and TXB2 in complication group (P<0.05, or P <0.01). Compared with control group, there were significant changes of GP, vWF, ATIII, VIII: Ag, GMP-140, PC, FIIa, t-PA, PAI, D-dimer, and TXB2in UAP group (P <0.05, or P <0.01). Conclusions: There are significant changes of hemostasis and clotting markers in patients with UAP, especially in those complicated with DM, which may be an important reason for the poor prognosis of these patients.
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Surgical intervention for left main compression syndrome due to severe secondary pulmonary hypertension
Laichun Song, Ming Xu, Chao Tao, Lei Shi, Bo Wang, Huadong Yu, Xufa Chen, Liang Tao, Xi Su
October-December 2017, 2(4):38-42
A 51-year-old man presented with non-ST-elevation myocardial infarction due to extrinsic compression of the left main coronary artery (LMCA) caused by a dilated pulmonary artery (PA) with secondary pulmonary hypertension and was successfully treated with surgical intervention including pulmonary angioplasty, atrial septal defect correction, and thromboendarterectomy. Imaging modalities were extremely useful in making the diagnosis and providing follow-up of LMCA compression syndrome in this case. During the follow-up, a sufficient hemodynamic improvement was obtained, without exacerbation of the PA dilatation, resulting in the absence of compression of the LMCA.
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