Research About The Mechanism Of 'Guanxin ?' Regulates Cardiac Local Raas In Treating Ventricular Remodeling After Acute Myocardial Infarction And The Characteristics Of Coronary Artery Lesions In Different Types Of Physical Patients With Coronary Heart Di

Research Background"Guanxin V Mixture" is the hospital preparation of the third subsidiary of Nanjing university of traditional Chinese medicine.It can enrich qi,activating blood and removing blood stasis,to cure Coronary Heart Disease(CHD),and the curative effect is definite.The preliminary studies have shown that it can intervene ventricular remodeling;improve heart function,but its interventional ventricular remodeling part of the mechanism to be more in-depth study.Objective1.To observe the effect of Guanxin V on ventricular remodeling after acute myocardial infarction,and explore its possible mechanism.2.To explore correlation with degree of coronary artery stenosis on characteristics of Coronary Heart Disease(CHD)patients with Qi deficiency mass or Blood stasis mass.Methods1.Animal experiment:54 male adult Syrian hamsters,ligating left anterior descending coronary artery to establish acute myocardial infarction model,then randomly divided into seven groups:the blank group(No operation),the sham operation group(operation without ligation),the model group,the Guanxin ? group,ACEI group(Perindopril),ARB group(Valsartan).Intragastric administration continued for 28 days.The left ventricular end-diastolic inner diameter(LVEDd),left ventricular end-diastolic inner diameter(LVEDd),ejection fraction(EF),fractional shortening(FS),were detected with echocardiogram.Body weight and cardiac weight ratio were measured.HE staining was used to observe the pathological changes of myocardium.Measurement of infarct size.Ang ? elisa for determination of myocardial tissue Ang ? content.Enzymatic determination of ACE activity.Western blotting(WB)and enzyme-linked immunosorbent assay(ELISA)were used to detect the expression of chymase in myocardium2.100 patients with coronary heart disease were selected to investigate on Physical Fitness Questionnaire of Chinese Medicine,and their TCM constitutions were analyzed.The patients were divided into two groups:Qi deficiency/blood stasis group and other constitution group.By coronary angiography,Gensini score,SYNTAX score and number artery with disease compared between the two groups.Analyzed degree of coronary artery disease in Qi deficiency/blood stasis group.Result1.Compared with the model group(1)Guanxin ? can increase EF,FS,reduce LVEDd,LVEDs(P<0.05),and the clinical effect of 2 times the dose is more significant.(2)Guanxin V can reduce heart weight,increase body weight and improve heart weight index(P<0.05).(3)In Guanxin ? group,the cell degeneration and necrosis,inflammatory cell infiltration,as well as the degree of fibrosis were obviously superior.(4)In Guanxin ? group,the size of Miocardial infarction was decreased,the degree of infarction decreased(P<0.05).(5)The content of Angn ? in the myocardium decreased,the activity of ACE decreased(P<0.05).(6)The Guanxin V can inhibit chymase expression.2.In coronary heart disease,patients with qi deficiency/blood stasis constitution accounting for 59%.Compared with other physical patients,qi deficiency,blood stasis type of patients with coronary artery disease to multiple lesions mainly coronary artery stenosis is more serious.(P<0.05).Conclusion1.Guanxin ? mixture can improve the structure and function of the heart after myocardial infarction,interfere with ventricular remodeling;inhibit ACE activity,reduce Ang ?production,inhibit chymase expression.Therefore,Guanxin ? can inhibit the activity of,ACE,reduce Ang ? production,inhibit chymase expression,and thus regulate cardiac local RAAS,which may be the intervention of myocardial infarction after ventricular remodelingone of the important mechanisms.2.In coronary heart disease,patients with qi deficiency/blood stasis constitution highly accounting for 59%,most of they multiple vessel disease,more severe degree of coronary artery diseas(P<0.05).