• Title/Summary/Keyword: Cardiac ischemia

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Reduction of Muscarinic $K^+$ Channel Activity by Transferrin in Ischemic Rat Atrial Myocytes

  • Park, Kyeong-Tae;Kang, Da-Won;Han, Jae-Hee;Hur, Chang-Gi;Hong, Seong-Geun
    • The Korean Journal of Physiology and Pharmacology
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    • v.7 no.6
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    • pp.333-339
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    • 2003
  • It has been demonstrated that an unidentified cytosolic factor(s) reduces $K_{ACh}$ channel function. Therefore, this study attempted to elucidate the cytosolic factor. Fresh cytosol isolated from normal heart (FC) depressed the $K_{ACh}$ channel activity, but cytosol isolated from the ischemic hearts (IC) did not modulate the channel function. Electrophorectic analysis revealed that a protein of ${\sim}80 kDa was markedly reduced or even lost in IC. By using peptide sequencing analysis and Western blot, this 80 kDa protein was identified as transferrin (receptor-mediated $Fe^{3+}$ transporter, 76 kDa). Direct application of transferrin (100 nM) to the cytoplasmic side of inside-out patches decreased the open probability ($P_o$, 12.7${\pm}6.4%, n=4) without change in mean open time (${\tau}_o$, $98.5{\pm}1.3$%, n=4). However, the equimolar apotransferrin, which is free of $Fe^{3+}$, had no effect on the channel activity (N*$P_o$, $129.1{\pm}13.5$%, n=3). Directly applied $Fe^{3+}$ (100 nM) showed results similar to those of transferrin (N*$P_o$: $21.1{\pm}3.9$%, n=5). However $Fe^{2+}$ failed to reduce the channel function (N*$P_o$, $106.3{\pm}26.8$%, n=5). Interestingly, trivalent cation La3+ inhibited N*$P_o$ of the channel ($6.1{\pm}3.0$%, n=3). Taken together, these results suggest that $Fe^{3+}$ bound to transferrin can modulate the $K_{ACh}$ channel function by its electrical property as a polyvalent cation.

Development of a Model for Comparing Risk-adjusted Mortality Rates of Acute Myocardial Infarction Patients (급성심근경색증 환자의 진료 질 평가를 위한 병원별 사망률 예측 모형 개발)

  • Park, Hyeung-Keun;Ahn, Hyeong-Sik
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.216-231
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    • 2003
  • Objectives: To develop a model that predicts a death probability of acute myocardial infarction(AMI) patient, and to evaluate a performance of hospital services using the developed model. Methods: Medical records of 861 AMI patients in 7 general hospitals during 1996 and 1997 were reviewed by two trained nurses. Variables studied were risk factors which were measured in terms of severity measures. A risk model was developed by using the logistic regression, and its performance was evaluated using cross-validation and bootstrap techniques. The statistical prediction capability of the model was assessed by using c-statistic, $R^2$ as well as Hosmer-Lemeshow statistic. The model performance was also evaluated using severity-adjusted mortalities of hospitals. Results: Variables included in the model building are age, sex, ejection fraction, systolic BP, congestive heart failure at admission, cardiac arrest, EKG ischemia, arrhythmia, left anterior descending artery occlusion, verbal response within 48 hours after admission, acute neurological change within 48 hours after admission, and 3 interaction terms. The c statistics and $R^2$ were 0.887 and 0.2676. The Hosmer-Lemeshow statistic was 6.3355 (p-value=0.6067). Among 7 hospitals evaluated by the model, two hospitals showed significantly higher mortality rates, while other two hospitals had significantly lower mortality rates, than the average mortality rate of all hospitals. The remaining hospitals did not show any significant difference. Conclusion: The comparison of the qualities of hospital service using risk-adjusted mortality rates indicated significant difference among them. We therefore conclude that risk-adjusted mortality rate of AMI patients can be used as an indicator for evaluating hospital performance in Korea.

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A Low-noise Multichannel Magnetocardiogram System for the Diagnosis of Heart Electric Activity

  • Lee, Yong-Ho;Kim, Ki-Woong;Kim, Jin-Mok;Kwon, Hyuk-Chan;Yu, Kwon-Kyu;Kim, In-Seon;Park, Yong-Ki
    • Journal of Biomedical Engineering Research
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    • v.27 no.4
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    • pp.154-163
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    • 2006
  • A 64-channel magnetocardiogram (MCG) system using low-noise superconducting quantum interference device (SQUID) planar gradiometers was developed for the measurements of cardiac magnetic fields generated by the heart electric activity. Owing to high flux-to-voltage transfers of double relaxation oscillation SQUID (DROS) sensors, the flux-locked loop electronics for SQUID operation could be made simpler than that of conventional DC SQUIDs, and the SQUID control was done automatically through a fiber-optic cable. The pickup coils are first-order planar gradiometers with a baseline of 4 em. The insert has 64 planar gradiometers as the sensing channels and were arranged to measure MCG field components tangential to the chest surface. When the 64-channel insert was in operation everyday, the average boil-off rate of the dewar was 3.6 Lid. The noise spectrum of the SQUID planar gradiometer system was about 5 fT$_{rms}$/$\checkmark$Hz at 100 Hz, operated inside a moderately shielded room. The MCG measurements were done at a sampling rate of 500 Hz or 1 kHz, and realtime display of MCG traces and heart rate were displayed. After the acquisition, magnetic field mapping and current mapping could be done. From the magnetic and current information, parameters for the diagnosis of myocardial ischemia were evaluated to be compared with other diagnostic methods.

Triptolide improves myocardial fibrosis in rats through inhibition of nuclear factor kappa B and NLR family pyrin domain containing 3 inflammasome pathway

  • Shen, Jianyao;Ma, Hailiang;Wang, Chaoquan
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.6
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    • pp.533-543
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    • 2021
  • Myocardial fibrosis (MF) is the result of persistent and repeated aggravation of myocardial ischemia and hypoxia, leading to the gradual development of heart failure of chronic ischemic heart disease. Triptolide (TPL) is identified to be involved in the treatment for MF. This study aims to explore the mechanism of TPL in the treatment of MF. The MF rat model was established, subcutaneously injected with isoproterenol and treated by subcutaneous injection of TPL. The cardiac function of each group was evaluated, including LVEF, LVFS, LVES, and LVED. The expressions of ANP, BNP, inflammatory related factors (IL-1β, IL-18, TNF-α, MCP-1, VCAM1), NLRP3 inflammasome factors (NLRP3, ASC) and fibrosis related factors (TGF-β1, COL1, and COL3) in rats were dete cted. H&E staining and Masson staining were used to observe myocardial cell inflammation and fibrosis of rats. Western blot was used to detect the p-P65 and t-P65 levels in nucleoprotein of rat myocardial tissues. LVED and LVES of MF group were significantly upregulated, LVEF and LVFS were significantly downregulated, while TPL treatment reversed these trends; TPL treatment downregulated the tissue injury and improved the pathological damage of MF rats. TPL treatment downregulated the levels of inflammatory factors and fibrosis factors, and inhibited the activation of NLRP3 inflammasome. Activation of NLRP3 inflammasome or NF-κB pathway reversed the effect of TPL on MF. Collectively, TPL inhibited the activation of NLRP3 inflammasome by inhibiting NF-κB pathway, and improved MF in MF rats.

A Case of Patient with Brady-arrhythmia Complaining Dizziness Treated with complex Korean Medicine treatments (어지럼증을 호소하는 서맥성 부정맥 환자의 한의복합치료 1례)

  • So-Min, Jung;Seong-Wook, Lee;Won-Jung, Ha;Ki-Ho, Cho;Sang-Kwan, Moon;Woo-Sang, Jung;Seungwon, Kwon;Han-Gyul, Lee
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.23 no.1
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    • pp.41-54
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    • 2022
  • Brady-arrhythmia is defined as an arrhythmia in which the heart rate slows to less than 60 beats per minute. Brady-arrhythmia reduces cardiac output and causes changes in blood flow. As a result, dizziness occurs because not only ischemia occurs in the central nervous system, but also blood flow in major organs decreases. The insertion of an artificial pacemaker is known as almost the only treatment alternative for patients with brady-arrhythmia with symptoms. This study reports a case of 85 year old male diagnosed with brady-arrhythmia complaining presyncope type of dizziness. The patient underwent complex Korean medicine treatments by herbal medicine, acupuncture and moxibustion. The daily average value of pulse rate, K-DHI score, NRS score and the patient's subjective expression of symptoms were used as evaluation tools. This study suggested a significant improvement in symptoms through complex Korean medicine treatments without the use of anti-arrhythmic drugs or insertion of an artificial pacemaker in the patient with brady-arrhythmia complaining dizziness.

Modulation of Inula racemosa Hook Extract on Cardioprotection by Ischemic Preconditioning in Hyperlipidaemic Rats

  • Arun Kumar Tiwari;Pushpraj S Gupta;Mahesh Prasad;Paraman Malairajan
    • Journal of Pharmacopuncture
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    • v.25 no.4
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    • pp.369-381
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    • 2022
  • Objectives: Hyperlipidemia (HL) is a major cause of ischemic heart diseases. The size-limiting effect of ischemic preconditioning (IPC), a cardioprotective phenomenon, is reduced in HL, possibly because of the opening of the mitochondrial permeability transition pore (MPTP). The objective of this study is to see what effect pretreatment with Inula racemose Hook root extract (IrA) had on IPC-mediated cardioprotection on HL Wistar rat hearts. An isolated rat heart was mounted on the Langendorff heart array, and then ischemia reperfusion (I/R) and IPC cycles were performed. Atractyloside (Atr) is an MPTP opener. Methods: The animals were divided into ten groups, each consisting of six rats (n = 6), to investigate the modulation of I. racemosa Hook extract on cardioprotection by IPC in HL hearts: Sham control, I/R Control, IPC control, I/R + HL, I/R + IrA + HL, IPC + HL, IPC + NS + HL, IPC + IrA+ HL, IPC + Atr + oxidative stress, mitochondrial function, integrity, and hemodynamic parameters are evaluated for each group. Results: The present experimental data show that pretreatment with IrA reduced the LDH, CK-MB, size of myocardial infarction, content of cardiac collagen, and ventricular fibrillation in all groups of HL rat hearts. This pretreatment also reduced the oxidative stress and mitochondrial dysfunction. Inhibition of MPTP opening by Atr diminished the effect of IrA on IPC-mediated cardioprotection in HL rats. Conclusion: The study findings indicate that pretreatment with IrA e restores IPC-mediated cardioprotection in HL rats by inhibiting the MPTP opening.

A Case of Coronary Vasospasm in a Patient with Esophageal Cancer Receiving Chemotherapy with 5-fluorouracil (5-fluorouracil 사용 중인 식도암 환자에서 발생한 관상동맥연축)

  • Jin Wook Lee;Moo In Park;Seun Ja Park;Won Moon;Sung Eun Kim;Jae Hyun Kim;Kyoungwon Jung
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.58-61
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    • 2017
  • 5-Fluorouracil (5-FU) has been widely used in the treatment of various solid tumors. However, 5-FU cardiotoxicity is being reported with increasing frequency. The main symptom of cardiotoxicity is chest pain at rest with ischemic electrocardiographic changes. Up until now, the underlying mechanism has been suspected to be coronary artery spasm. However, this chest pain associated with 5-FU has several characteristics that are incompatible with coronary artery spasm; eg, inefficacy of calcium-channel blocker and a slow increase in cardiac enzyme levels. We experienced a case of 5-FU-induced cardiotoxicity which showed clinical findings consistent with acute myocardial infarction. Based on the clinical findings, coronary angiography, and no stenosis was noted. However, we concluded that the cardiotoxicity in this case was due to ischemia caused by coronary artery spasm. Because vasodilatator was effective and secondary attack was followed.

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Comorbid Conditions in Persons Exposed to Ionizing Radiation and Veterans of the Soviet-Afghan War: A Cohort Study in Kazakhstan

  • Saule Sarkulova;Roza Tatayeva;Dinara Urazalina;Ekaterina Ossadchaya;Venera Rakhmetova
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.1
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    • pp.55-64
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    • 2024
  • Objectives: This study investigated the prevalence and characteristics of comorbid conditions in patients exposed to ionizing radiation and those who were involved in the Soviet-Afghan war. Methods: This study analyzed the frequency and spectrum of morbidity and comorbidity in patients over a long-term period (30-35 years) following exposure to ionizing radiation at the Semipalatinsk nuclear test site or the Chornobyl nuclear power plant, and among participants of the Soviet-Afghan war. A cohort study, both prospective and retrospective, was conducted on 675 patients who underwent comprehensive examinations. Results: Numerical data were analyzed using the Statistica 6 program. The results are presented as the mean±standard deviation, median, and interquartile range (25-75th percentiles). The statistical significance of between-group differences was assessed using the Student t-test and Pearson chi-square test. A p-value of less than 0.05 was considered statistically significant. We found a high prevalence of cardiovascular diseases, including hypertension (55.0%) and cardiac ischemia (32.9%); these rates exceeded the average for this age group in the general population. Conclusions: The cumulative impact of causal occupational, environmental, and ultra-high stress factors in the combat zone in participants of the Soviet-Afghan war, along with common conventional factors, contributed to the formation of a specific comorbidity structure. This necessitates a rational approach to identifying early predictors of cardiovascular events and central nervous system disorders, as well as pathognomonic clinical symptoms in this patient cohort. It also underscores the importance of selecting suitable methods and strategies for implementing treatment and prevention measures.

Effect of Pyruvate and Aspartate Enriched University of Wisconsin Solution on Myocardial Protection (피루브산염과 아스파라진산염을 첨가한 위스콘신대학 용액의 심근보호 효과)

  • 이정렬;김준석;한재진;강문철
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.11-19
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    • 2002
  • Background: Ischemia-reperfusion myocardial injury is an important factor to determine the early and the late mortality of transplanted patients. Recently, modulation of the cytosolic NADH/NAD+ ratio by Pyruvate and aspartate was tested to Protect the heart from ischemia-reperfusion injury. Material and Method: We added pyruvate and aspartate to the University of Wisconsin solution, and evaluated their effect on myocardial protection. We used 16 piglet(age 1 to 3 days) hearts. Eight hearts were arrested with and stored in the University of Wisconsin solution(UW solution) for 24 hours(control group), and the other eight hearts were arrested with and stored in the modified UW solution added pyruvate(3mmol/L) and aspartate(2 mmol/L)(test group). All hearts underwent modified reperfusion with blood cardioplegic solution followed by conversion to a left-sided working model with perfusion from a support pig. And then, we measured stroke work index(SWI), high-energy phosphate stores, and myocardial water content of the hearts. SWI was calculated at left ventricular end-diastolic pressures of 3, 6, 9, and 12 mmHg after 60 and 120 minutes reperfusion, respectively, Result: At 60 minutes and 120 minutes after reperfusion, SWI was higher in the test group than in the control group significantly. The levels of AMP, ADP, ATP of the test group were also higher. But, the creatine phosphate level and myocardial water content were similar in the two groups. Conclusion: From these results, we could Prove that pyruvate and aspartate enhance cardiac contractility and high-energy phosphate stores after ischemia.

Effects of vitamin C as antioxidant on recovery of left ventricular function after ischemia and reperfusion in isolated rat heart (항산화제로서 비타민 C가 적출된 쥐심장에서 허혈 및 재관류후 좌심실 기능회복에 미치는 영향)

  • 류한영;이철주
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.593-598
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    • 1996
  • The large number of past investigation on extended myocardial protection clearly indicates that cold potassium cardioplegia and topical cooling have limited capabilities. Accordingly, more recent experimen- tal approaches have focused on the modalities of reperfusion and their implication on postischemic myo- cardial recovery. Oxygen may play a crucial role in the development of ischemic and reperfusion injury. Reactive oxygen radicals may be produced during ischemia or reperfusion after incomplete reduction of molecular oxygen or from other pathway and then induce fatal injury of the heart. The important obser- vation of oxygen-induced myocardial damage during reperfusion has led to the concept of applying oxy- gen free radical scavengers. So, this study is on dietary vitamin C supplementation as antioxidant in rats to determine whether or not they have a higher tolerance against cardiac ischemia-reperf'usion injury under Langendorff system. Male or female Sprague-Dawley rats (190-33Og) were randomly separated into two groups. Group A was not treated(n=10). Group B received vitamin C supplement (n=10). Experiment was performed 24 hours after vitamin C 200mg fed orally as injectable ascorbic acid. There were significant differences in contractile parameters between control and vitamin C-treated group. The RLVP (r te of post/preischemic left ventricular pressure) and Rdp/dt (rate of post/preischemic dp/dt) were significant statistically between two groups (p<0.05). But, RHR (rate of post/preischemic heart rate), time to first beat and sta'utilization were not significant. In conclusion, pretreatment with the antioxidant, ascorbic acid, was found to preserve left ventricular contractile function. But the precise mechanism of action of ascorbic acid has not as yet been determined, so further study will be required.

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