Objective To investigate the effects of tissue inhibitor-3 of matrix metalloproteinases(TIMP-3) genetransfected vascular smooth muscle cells(VSMCs) transplantation on heart structure after acute myocardial infarction (AMI) in rats and to explore the potential mechanisms. Methods Sixty-one female Wistar rats were produced AMI models by ligating the descending left coronary artery. Fifty-four rats were survived and divided into 3 groups randomly(n=18): 0.5 ml PBS containing 1×106 TIMP-3 gene-transfected VSMCs(group A), 1×106 VSMCs(group B) or 0.5 ml PBS without cell(group C) were injected into the ischemic myocardium immediately. Ischemic myocardium samples were harvested at 1 weekafter operation. The heart structure was observed through the tissue morphologic examination. The activity of TIMP-3 gene-transfected VSMCs were measured by immunohistochemical method. Proteins of TIMP-3 and matrix metalloproteinase 9(MMP-9) were determined by Western blot. Results VSMCs were cultivated and had a high purity(98%). TIMP-3 gene was transfected into VSMCs successfully. One week after operation in groups A, B and C, the average percentage of infarction myocardium size 〖KG6〗and left ventricle free wal area were 28.73%±1.56%, 39.63%±1.84% and 46.32%±2.16% separately.Group A was significantly lower than groups B and C(P＜0.01), group B was significantly lower than group C(P＜0.01). In groups A, B and C the averageleft ventricle volume indexes were 5.27±0.21 mm3／g, 6.69±0.34 mm3／g and 9.67±0.88 mm3／g respectively. Group A was significantly smaller than groups B and C(P＜0.01), group B was significantly smaller than group C(P＜0.01). The immunohistochemical observation confirmed that the implanted VSMCs and TIMP-3 gene were survival in ischemic area. The protein content of TIMP-3 in ischemicmyocardium was significantly higher in group A (300 704.8±3 692.8) than in groups B and C(195 548.8±3 014.2，177 991.1±2 502.1)(P＜0.01), the protein content of MMP-9 in ischemic myocardium was significantly lower in group A(594 827.4±5 708.5) than in groups B and C(921 461.4±8 887.4，1 044 445.0±8 788.6)(P＜0.01). Conclusion Implanted TIMP3 gene transfected VSMCs in ischemic myocardium can conspicuously reduce the myocardium remodeling after AMI.
Objective To study the influence of autologous bone mesenchymal stem cells (BMSCs) on myocardial structure and cardiac function after being implantated into acute infarcted myocardial site. Methods Bone marrow was aspirated from the posterosuperior iliac spine of Guizhou Xiang swine. After being isolated, cultured and co cultured with 5 azacytidine, either autologous BMSCs (total cells 2×10 6, experimental group, n =12), or a comparable volume of culture medium (control group, n =12), was injected into the left anterior descending(LAD) branch of coronary artery just distal to the ligation site of the LAD. The same volume of BMSCs or culture medium was injected into several spots in the infarcted myocardium. Echocardiographic measurements were performed three or six weeks after implantation to assess the myocardial structure and cardiac function. Results Left ventricular function, including eject fraction(EF), fractional shortening and wall thickening, were higher in experimental group when compared with control group. The thickness of the ventricular wall and septum was also found increased while the left ventricular chamber size was smaller in experimental group. Conclusion Implantation of BMSCs into the infarcted myocardium is believed to attenuate the remodeling process, inhibit the extent of wall thinning and dilatation of the ventricular chamber. BMSCs implantation may also improve the contractile ability of the myocardium and cardiac function.
ObjectiveTo observe and analyze the short-term efficacy of different statins on acute myocardial infarction in patients with premature coronary heart disease. MethodWe selected 70 patients with acute myocardial infarction admitted into our hospital for treatment of premature coronary artery disease between January 2012 and June 2013. The patients were randomly divided into experimental group (n=35) and control group (n=35). The experimental group were treated with rosuvastatin, and the control group of patients were given atorvastatin. We observed the rate of overall efficiency within 6 months after treatment, and total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), hepersensitive C-reactive protein (hs-CRP), left ventricular ejction fraction (LVEF), and flow-mediated dilation (FMD) were also observed before and after treatment. ResultsThe overall efficacy rate in the experimental group at 6 months was 94.3% and in the control group was 88.6% with no significant difference between each other (P>0.05). TG and FMD of patients in the experimental group at 6 months did not significantly change (P>0.05), while LVEF of the experimental group was significantly higher (P<0.05), and hs-CRP, TC, LDL-C, and HDL-C of the experimental group were significantly lower than the control group (P<0.05). ConclusionsShort-term comprehensive efficacy of rosuvastatin for treatment of premature coronary artery disease in patients with acute myocardial infarction is superior to atorvastatin.
ObjectiveTo evaluate the prognosis factors for early death (within 60 days) of acute myocardial infarction (AMI) patients for early identification and prevention of the disease. MethodsWe analyzed the information of AML patients who were admitted to the emergency department between May 2009 and July 2010, and analyzed their clinical data, such as gender, age, prehospital time, myocardial enzyme, electrocardiogram, complications, whether the patients had thrombolysis therapy, time of thrombolysis, end point observation and time of death, ect. Cox multivariate survival analysis was performed with the use of SPSS 18.0 software. ResultsSeventy-one cases were collected with one of them excluded for fragmented data. After analysing, we found that patients' age and isoenzymes of creatine kinase (CK-MB) level were prognosis factors for early death. Further analysis showed that the relative risk (RR) of age was 1.166 (P=0.023), and the RR of CK-MB was 1.001 (P=0.004). ConclusionPatients' age has predictive value for early death of AML. More attention should be paid to AML patients with advanced age. Detecting myocardial enzymes levels, especially the CK-MB level, is significant for predicting early death. Other indicators need to be further explored due to the possible limitation of our study.
Objective To search, evaluate and summarize the relevant evidence of the treatment and management of patients with acute myocardial infarction (AMI) under the chest pain center mode by using the evidence-based medicine method, so as to provide references for optimizing the clinical pathway, improving the medical quality and improving the prognosis of patients. Methods Relevant evidence on the treatment and management of AMI patients in relevant databases and websites at home and abroad was retrieved, and the retrieval time limit was from the establishment of databases to January 1, 2025. The quality of the included literature was evaluated, and the evidence was extracted and summarized. Results A total of 15 articles were included, including 2 clinical decisions, 2 systematic reviews, 8 guidelines, and 3 expert consensuses. Finally, 23 pieces of best evidence were extracted, including the basic conditions of chest pain center, the evaluation and treatment of patients with acute chest pain, the integration of pre-hospital emergency system and hospital green channel, and training and education. Conclusions The best evidence for the treatment and management of AMI under the chest pain center mode can provide evidence-based basis for clinical practice. It is necessary to combine the situation of the chest pain center, fully consider the validity and feasibility of the evidence, and help the chest pain center improve the medical quality and improve the prognosis of patients in a standardized and scientific way.