Cardiotonic Agents

强心剂
  • 文章类型: Journal Article
    本研究旨在评估ghrelin对脓毒症小鼠的心脏保护作用。专注于其抗炎和抗氧化性能。35只雄性瑞士小鼠(8-12周龄,23-33g)随机分为五组(每组n=7):(1)正常,通常的饮食,(2)Sham,接受麻醉和剖腹手术,(3)脓毒症,接受盲肠结扎和穿刺,(4)车辆,盲肠结扎和穿刺后立即给予等量的腹膜内生理盐水注射,和(5)Ghrelin处理,盲肠结扎和穿刺后立即腹膜内注射80µg/kg生长素释放肽。血清肿瘤坏死因子-α(TNF-α)水平,巨噬细胞移动抑制因子(MIF),toll样受体4(TLR4),测定8-epi-前列腺素F2α(8-epi-PGF2α)。还对心脏损伤的程度进行了组织学评估。平均血清TNF-α水平,MIF,脓毒症和媒介物组的TLR4和8-epi-PGF2α水平明显高于正常和假手术组。生长素释放肽治疗组的水平显著低于媒介物和败血症组。组织学分析显示正常组和假手术组的心肌结构正常,而脓毒症和溶媒组有严重的心肌损伤。生长素释放肽治疗组表现出与假手术组相似的组织学特征,表明心肌损伤减少。Ghrelin通过表现出强抗炎和抗氧化作用改善小鼠脓毒症诱导的心脏毒性。这些发现表明ghrelin可能是预防败血症引起的心脏毒性的有希望的治疗候选物。
    This study aimed to evaluate the cardioprotective effects of ghrelin in septic mice, focusing on its anti-inflammatory and antioxidant properties. Thirty-five male Swiss mice (8-12 weeks old, 23-33g) were randomly assigned to five groups (n = 7 each): (1) Normal, fed usual diets, (2) Sham, subjected to anesthesia and laparotomy, (3) Sepsis, subjected to cecal ligation and puncture, (4) Vehicle, given an equivalent volume of intraperitoneal saline injections immediately after cecal ligation and puncture, and (5) Ghrelin-treated, administered 80 µg/kg ghrelin intraperitoneal injections immediately following cecal ligation and puncture. Serum levels of tumor necrosis factor-alpha (TNF-α), macrophage migration inhibitory factor (MIF), toll-like receptor 4 (TLR4), and 8-epi-prostaglandin F2 alpha (8-epi-PGF2α) were measured. The extent of cardiac damage was also evaluated histologically. The mean serum levels of TNF-α, MIF, TLR4, and 8-epi-PGF2α levels were significantly higher in the sepsis and vehicle groups than in the normal and sham groups. The levels were significantly lower in the ghrelin-treated group than in the vehicle and sepsis groups. Histological analysis revealed normal myocardial architecture in the normal and sham groups, whereas the sepsis and vehicle groups had severe myocardial injury. The ghrelin-treated group displayed histological features similar to the sham group, indicating reduced myocardial damage. Ghrelin ameliorated sepsis-induced cardiotoxicity in mice by exhibiting strong anti-inflammatory and antioxidant effects. These findings suggest that ghrelin may be a promising therapeutic candidate for the prevention of sepsis-induced cardiotoxicity.
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  • 文章类型: Journal Article
    心血管疾病(CVDs)是导致全球死亡率上升的主要原因,由于现有治疗方法的限制和CVDs的流行。创新研究和确定心血管疾病的潜在预防措施对于减轻全球死亡和并发症至关重要。海洋环境是生物活性物质的丰富来源,并由于其无与伦比的生物多样性而提供了针对多种疾病的独特化学武器库。海洋多酚化合物(MPC)由于其结构多样性和生物学上重要的活性而独特。Further,据报道,MPC具有宝贵的生物活性,如抗炎,心脏保护,和抗氧化剂,在预防和治疗心血管疾病方面取得了令人鼓舞的结果。因此,对MPC和CVD之间的结构-活性关系(SAR)的研究提供了见解,揭示了这些化合物的结构成分如何影响其有效性。Further,理解这种相关性对于推进来自海洋来源的药物和营养品至关重要,这可以改变治疗和预防心血管疾病的策略。因此,本研究通过强调MPCs在CVD治疗中的作用以及评估MPCs和CVD之间的SAR,对现有研究进行了全面分析,并提出了挑战和未来方向.
    Cardiovascular diseases (CVDs) are responsible for significant mortality rates globally that have been raised due to the limitation of the available treatments and prevalence of CVDs. The innovative research and identification of potential preventives for CVDs are essential to alleviate global deaths and complications. The marine environment is a rich source of bioactive substances and provides a unique chemical arsenal against numerous ailments due to its unrivaled biodiversity. Marine polyphenolic compounds (MPCs) are unique because of their structural variety and biologically significant activity. Further, MPCs are well-reported for their valuable biological activities, such as anti-inflammatory, cardioprotective, and antioxidant, demonstrating encouraging results in preventing and treating CVDs. Therefore, investigation of the structure-activity relationship (SAR) between MPCs and CVDs provides insights that reveal how the structural components of these compounds affect their effectiveness. Further, comprehending this correlation is essential for advancing medications and nutraceuticals sourced from marine sources, which could transform the strategy for treating and preventing cardiovascular diseases. Therefore, this study provides a comprehensive analysis of existing research by emphasizing the role of MPCs in CVD treatments and evaluating the SAR between MPCs and CVDs with challenges and future directions.
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  • 文章类型: Journal Article
    本研究旨在准备,表征和评估黄色稻草提取物(YBE)的抗氧化活性,专注于识别具有高抗氧化能力的提取物。将所选择的提取物加载到口服液体制剂中,并进一步研究其在降低自发性高血压Wistarkyoto大鼠(SHR)的血压和相关并发症中的治疗潜力。将大鼠分成未处理的SHR和用基于YBE的口服制剂处理4周的SHR。治疗后,测量血压,使用Langendorff技术评估心脏功能以模拟离体缺血状况。在血浆中评估促氧化剂水平,而在红细胞中评估抗氧化活性。心脏组织学分析,肾,并进行肝脏样本以评估高血压引起的病理变化。我们的结果表明,口服制剂装载乙醇YBE有效降低血压,缺血应激下保留的心肌功能,和降低血液中的氧化应激标志物。重要的是,我们的YBE制剂在减轻与高血压相关的结构性肾损伤方面具有潜力.总的来说,这些发现表明口服YBE制剂的心脏保护作用,突出了它作为草药补充剂的潜力。然而,有必要进行临床研究以验证这些发现,并探索提取物的临床适用性。
    This study aimed to prepare, characterize and assess the antioxidant activity of yellow bedstraw extracts (YBEs), focusing on identifying extracts with high antioxidant capacity. The selected extract was loaded into an oral liquid formulation and further investigated for its therapeutic potential in reducing blood pressure and associated complications in spontaneously hypertensive Wistar kyoto rats (SHR). Rats were divided into untreated SHR and SHR treated with a YBE-based oral formulation over four weeks. After treatment, blood pressure was measured, and cardiac function was assessed using the Langendorff technique to simulate ex vivo ischemic conditions. Prooxidant levels were assessed in plasma while antioxidant activity was evaluated in red blood cells. Histological analyses of heart, kidney, and liver samples were conducted to assess pathological changes induced by hypertension. Our results showed that the oral formulation loaded with ethanol YBE effectively reduced blood pressure, preserved myocardial function under ischemic stress, and decreased oxidative stress markers in blood. Importantly, our formulation with YBE demonstrated potential in attenuating structural kidney damage associated with hypertension. Overall, these findings suggest a cardioprotective effect of orally administered YBE formulation, highlighting its potential as an herbal supplement. However, clinical studies are warranted to validate these findings and explore the extract\'s suitability for clinical use.
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  • 文章类型: Journal Article
    心源性休克(CS)是一种危及生命的疾病。这项研究的目的是评估临床特征,管理,意大利一家高容量医院收治的CS患者的并发症发生率。我们回顾性回顾了临床,超声心动图,和实验室数据,治疗管理,2020年1月1日至2023年1月1日期间入住PoliclinicoGemelli(罗马)的CS患者的结局。我们纳入了96名患者[中位年龄71岁,四分位数间距60-79;65(68%)男性],其中49例(51%)出现继发于急性心肌梗死的CS,60例(63%)出现从头出现CS。多巴酚丁胺是最常用的强化剂,去甲肾上腺素是最常用的血管加压药(56%和82%的病例采用,分别)。45名(47%)患者在住院期间死亡。非幸存者年龄较大,入院时炎症负担较高,乳酸水平升高,乳酸水平的增加更大,左心室充盈压较高,右心室功能更差.C反应蛋白水平[比值比(OR)1.03,95%置信区间(CI)(1.00-1.04),P=0.027],入院时的乳酸水平(OR3.49,95%CI,1.59-7.63,P=0.02),乳酸水平升高(OR2.8,95%CI,1.37-5.75,P=0.005)是住院全因死亡的独立预测因子。我们的数据有助于评估CS患者的管理和结果的区域差异。我们观察到高死亡率和并发症发生率。入院时测量乳酸酸中毒和C反应蛋白可能有助于识别住院不良结局风险较高的患者。
    UNASSIGNED: Cardiogenic shock (CS) is a life-threatening condition. The aim of this study is to evaluate the clinical characteristics, management, and complication rate of patients with CS admitted to a high-volume hospital in Italy. We retrospectively reviewed the clinical, echocardiographic, and laboratory data, therapeutic management, and outcomes of patients with CS admitted to the Policlinico Gemelli (Rome) between January 1, 2020, and January 1, 2023. We included 96 patients [median age 71 years, interquartile range 60-79; 65 (68%) males], of whom 49 patients (51%) presented CS secondary to acute myocardial infarction and 60 (63%) with a de novo presentation of CS. Dobutamine was the most frequently used inotrope and noradrenaline the most frequently used vasopressor (adopted in 56% and 82% of cases, respectively). Forty-five (47%) patients died during the hospitalization. Nonsurvivors were older and had a higher inflammatory burden at admission, elevated lactate levels, a greater increase in lactate levels, higher left ventricular filling pressures, and worse right ventricular function. C-reactive protein levels [odds ratio (OR) 1.03, 95% confidence interval (CI) (1.00-1.04), P = 0.027], lactate levels at admission (OR 3.49, 95% CI, 1.59-7.63, P = 0.02), and increase in lactate levels (OR 2.8, 95% CI, 1.37-5.75, P = 0.005) were independent predictors of in-hospital all-cause death. Our data contribute to the assessment of the regional variations in the management and outcomes of patients with CS. We observed a high mortality and complication rate. Lactate acidosis and C-reactive protein measured at admission may help in identifying patients at higher risk of adverse in-hospital outcomes.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    棕色脂肪组织(BAT)通过分泌脂肪因子在调节心血管稳态中起关键作用,如成纤维细胞生长因子21(FGF21)。右美托咪定(DEX)是一种选择性α2-肾上腺素能受体激动剂,具有抗心肌缺血/再灌注损伤(MI/RI)的保护作用。在MI/RI的背景下,BAT衍生的FGF21是否参与DEX诱导的心脏保护仍然是未知的。在这里,我们证明DEX通过促进肩胛骨间BAT(iBAT)释放FGF21减轻MI/RI并改善心功能.手术iBAT消耗或补充FGF21中和抗体削弱了DEX的有益作用。棕色脂肪细胞中AMPK/PGC1α信号诱导的成纤维细胞生长因子21(FGF21)的释放是DEX介导的心脏保护作用所必需的,因为阻断AMPK/PGC1α轴削弱了DEX的有益作用。共培养实验表明,DEX诱导的棕色脂肪细胞FGF21通过调节Keap1/Nrf2途径增加了心肌细胞对缺氧/复氧(H/R)损伤的抵抗力。我们的结果提供了强有力的证据,证明BAT-心肌细胞相互作用是DEX心脏保护所必需的,并揭示了BAT在DEX介导保护心脏免受MIRI的内分泌作用。
    Brown adipose tissue (BAT) plays a critical role in regulating cardiovascular homeostasis through the secretion of adipokines, such as fibroblast growth factor 21 (FGF21). Dexmedetomidine (DEX) is a selective α2-adrenergic receptor agonist with a protection against myocardial ischemia/reperfusion injury (MI/RI). It remains largely unknown whether or not BAT-derived FGF21 is involved in DEX-induced cardioprotection in the context of MI/RI. Herein, we demonstrated that DEX alleviated MI/RI and improved heart function through promoting the release of FGF21 from interscapular BAT (iBAT). Surgical iBAT depletion or supplementation with a FGF21 neutralizing antibody attenuated the beneficial effects of DEX. AMPK/PGC1α signaling-induced fibroblast growth factor 21 (FGF21) release in brown adipocytes is required for DEX-mediated cardioprotection since blockade of the AMPK/PGC1α axis weakened the salutary effects of DEX. Co-culture experiments showed that DEX-induced FGF21 from brown adipocytes increased the resistance of cardiomyocytes to hypoxia/reoxygenation (H/R) injury via modulating the Keap1/Nrf2 pathway. Our results provided robust evidence that the BAT-cardiomyocyte interaction is required for DEX cardioprotection, and revealed an endocrine role of BAT in DEX-mediating protection of hearts against MIRI.
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  • 文章类型: Journal Article
    这项综合研究调查了α-细辛脑减轻心肌氧化损伤的治疗潜力,主要由小鼠六价铬(Cr(VI))暴露诱导。
    在本实验中,将24只小鼠分为四组以评估α-细辛脑的心脏保护作用。该研究集中于两个治疗组,接受25毫克和50毫克的α-细辛脑,分别。将这些组与未经α-细辛脑治疗的Cr(VI)对照组进行比较,和正常对照阴性组。评估的关键生化指标包括血清肌酸激酶-MB(CK-MB)和肌钙蛋白I水平,指示心肌损伤的标记物。此外,测量丙二醛(MDA)的水平以评估脂质过氧化,除了评估心脏组织匀浆中的关键炎症生物标志物,如肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)。结果值得注意的是,与对照组相比,α-细辛脑处理导致这些标志物的显著减少。该治疗还提高了主要抗氧化酶如过氧化氢酶(CAT)和超氧化物歧化酶(SOD)的活性,并减少了谷胱甘肽(GSH)。此外,观察到心脏组织匀浆中过氧化物酶体增殖物激活受体γ(PPAR-γ)的显着上调,突出了α-细辛脑发挥保护作用的潜在途径。心脏组织的组织病理学分析表明,α-细辛醚改善了Cr(VI)引起的结构损伤。因此,该研究提供了大量证据,表明α-细辛醚通过多方面的方法改善了Cr(VI)诱导的心脏毒性。它增强心脏酶功能,调节自由基的产生,改善抗氧化状态,减轻心脏组织的组织病理学损伤。鉴于这些发现,α-细辛醚是一种有前途的抗Cr(VI)引起的心肌损伤的药物。
    这项研究为进一步研究α-细辛醚的心脏保护特性及其在临床环境中的潜在应用铺平了道路,具体探索了α-细辛醚对Cr(VI)诱导的心脏毒性的保护功效,并描述了所涉及的潜在生化和分子机制。
    UNASSIGNED: This comprehensive study investigated the therapeutic potential of α-asarone in mitigating myocardial oxidative damage, primarily induced by hexavalent chromium (Cr(VI)) exposure in mice.
    UNASSIGNED: In this experiment, 24 mice were divided into four groups to assess the cardioprotective role of α-asarone. The study focused on two treatment groups, receiving 25 mg and 50 mg of α-asarone, respectively. These groups were compared against a control group subjected to Cr(VI) without α-asarone treatment, and a normal control negative group. The key biochemical parameters evaluated included serum levels of Creatine Kinase-MB (CK-MB) and Troponin I, markers indicative of myocardial damage. Additionally, the levels of Malondialdehyde (MDA) were measured to assess lipid peroxidation, alongside the evaluation of key inflammatory biomarkers in cardiac tissue homogenates, such as Tumor Necrosis Factor-α (TNF-α) and Interleukin-1β (IL-1β). Results Remarkably, α-asarone treatment resulted in a significant reduction in these markers compared to the control group. The treatment also elevated the activity of cardinal antioxidant enzymes like catalase (CAT) and superoxide dismutase (SOD), and reduced the glutathione (GSH). Furthermore, a notable upregulation of Peroxisome Proliferator-Activated Receptor Gamma (PPAR-γ) in cardiac tissue homogenates was observed, highlighting a potential pathway through which α-asarone exerts its protective effects. Histopathological analysis of cardiac tissues revealed that α-asarone ameliorated the structural lesions induced by Cr(VI). The study thus provides substantial evidence that α-asarone ameliorates Cr(VI)-induced cardiotoxicity through a multifaceted approach. It enhances cardiac enzyme function, modulates free radical generation, improves antioxidant status, and mitigates histopathological damage in cardiac tissues. Given these findings, α-asarone emerges as a promising agent against Cr(VI)-induced myocardial injury.
    UNASSIGNED: This study paves the way for further research into the cardioprotective properties of α-asarone and its potential application in clinical settings by specifically exploring the protective efficacy of α-asarone against Cr(VI)-induced cardiotoxicity and delineating the underlying biochemical and molecular mechanisms involved.
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  • 文章类型: Journal Article
    本研究旨在探讨奎纳克林对心肌缺血再灌注损伤的保护作用。在麻醉的Wistar大鼠中建模30分钟的局部心肌缺血,然后进行2小时的再灌注。从缺血的最后一分钟开始和再灌注的前9分钟,对照组(n=8)和实验组(n=9)的大鼠注射0.9%NaCl和奎纳克林溶液(5mg/kg),分别。通过伊文思蓝和氯化三苯基四唑“双重染色”评估风险区域和梗死面积。为了评估危险区区域的血管通透性,再灌注90和120分钟静脉注射吲哚菁绿(ICG)和硫黄素S(ThS),分别,评估无回流区。使用FLUM多光谱荧光有机镜获得大鼠心脏横截面中的ICG和ThS荧光图像。静脉注射奎纳克林后,HR趋于降低13%,然后在50分钟内恢复。奎纳克林缩小坏死区的大小(p=0.01),坏死区域的血管通透性,和无回流面积(p=0.027);同时,两组之间的风险区域无显著差异.在大鼠心肌再灌注开始时静脉注射奎纳克林可以减少无复流现象和梗死面积。
    This study aimed to investigate the cardioprotective effect of quinacrine in an in vivo model of myocardial ischemia/reperfusion injury. A 30-min regional myocardial ischemia followed by a 2-h reperfusion was modeled in anesthetized Wistar rats. Starting at the last minute of ischemia and during the first 9 min of reperfusion the rats in the control (n=8) and experimental (n=9) groups were injected with 0.9% NaCl and quinacrine solution (5 mg/kg), respectively. The area at risk and infarct size were evaluated by \"double staining\" with Evans blue and triphenyltetrazolium chloride. To assess vascular permeability in the area at risk zone, indocyanine green (ICG) and thioflavin S (ThS) were injected intravenously at the 90th and 120th minutes of reperfusion, respectively, to assess the no-reflow zone. The images of ICG and ThS fluorescence in transverse sections of rat hearts were obtained using a FLUM multispectral fluorescence organoscope. HR tended to decrease by 13% after intravenous administration of quinacrine and then recovered within 50 min. Quinacrine reduced the size of the necrotic zone (p=0.01), vascular permeability in the necrosis region, and the no-reflow area (p=0.027); at the same time, the area at risk did not significantly differ between the groups. Intravenous administration of quinacrine at the beginning of reperfusion of the rat myocardium reduces no-reflow phenomenon and infarct size.
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  • 文章类型: Journal Article
    地高辛,已知最古老的心血管药物,今天仍用于治疗心力衰竭和心房颤动。因为它具有狭窄的治疗指数和多种相互作用,它经常引起具有广泛症状和心律失常的毒性。更重要的是,血清地高辛水平升高与心力衰竭或心房颤动患者的死亡风险较高有关,甚至没有症状或症状的毒性。本文回顾了地高辛的使用现状,它的药理学原理,和机制,临床表现,和毒性管理。
    Digoxin, the oldest known cardiovascular drug, is still used today to treat heart failure and atrial fibrillation. Because it has a narrow therapeutic index and multiple interactions, it frequently causes toxicity with a wide range of symptoms and cardiac arrhythmias. More importantly, elevated serum digoxin levels have been linked to a higher risk of death in patients with heart failure or atrial fibrillation, even without signs or symptoms of toxicity. This article reviews the current state of digoxin use, its pharmacologic principles, and the mechanisms, clinical presentation, and management of toxicity.
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  • 文章类型: Journal Article
    铁凋亡是由铁依赖性脂质过氧化触发的调节细胞死亡的一种形式,并与心脏病有关。然而,目前在临床实践中还没有被批准的特异性抑制铁性凋亡的药物,这在很大程度上限制了这种新靶标的翻译潜力。这里,我们证明了β-石竹烯(BCP;150μM),一种天然的膳食大麻素,保护心肌细胞免受半胱氨酸剥夺或谷胱甘肽过氧化物酶4(GPX4)失活诱导的铁细胞死亡。此外,BCP在铁凋亡诱导过程中保留了线粒体形态和功能。出乎意料的是,BCP支持铁凋亡抗性,而不依赖于经典的抗铁凋亡途径。我们的结果进一步表明,BCP可能通过与分子氧的相互作用终止自由基链反应,这也解释了为什么它的氧化衍生物不能抑制铁凋亡。最后,口服BCP(50mg/kg,每日)显着缓解阿霉素(15mg/kg,单次腹膜内注射)诱导的小鼠心脏铁蛋白和心肌病。总之,我们的数据揭示了BCP作为一种天然抗生育化合物的作用,并提出了基于BCP的药物修饰作为治疗铁凋亡相关心脏病的一种有前景的治疗策略.
    Ferroptosis is a form of regulated cell death triggered by iron-dependent lipid peroxidation and has been associated with heart diseases. However, there are currently no approved drugs that specifically inhibit ferroptosis in clinical practice, which largely limits the translational potential of this novel target. Here, we demonstrated that β-caryophyllene (BCP; 150 μM), a natural dietary cannabinoid, protects cardiomyocytes against ferroptotic cell death induced by cysteine deprivation or glutathione peroxidase 4 (GPX4) inactivation. Moreover, BCP preserved the mitochondrial morphology and function during ferroptosis induction. Unexpectedly, BCP supported ferroptosis resistance independent of canonical antiferroptotic pathways. Our results further suggested that BCP may terminate radical chain reactions through interactions with molecular oxygen, which also explains why its oxidation derivative failed to suppress ferroptosis. Finally, oral BCP administration (50 mg/kg, daily) significantly alleviated doxorubicin (15 mg/kg, single i.p. injection)-induced cardiac ferroptosis and cardiomyopathy in mice. In conclusion, our data revealed the role of BCP as a natural antiferroptotic compound and suggest pharmacological modification based on BCP as a promising therapeutic strategy for treating ferroptosis-associated heart disorders.
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