Exploring The Intervention Of Exercise Training On Chronic Heart Failure And Its Effect On Mitochondrial Energy Metabolism Based On The Theory Of "Move To The Yang"

Objective:Based on the theory of "Move to the Yang" in NeiJing,reviewing the application of traditional Chinese medicine classic theory in traditional Chinese medicine rehabilitation,observing the cardiac function and myocardial mitochondrial structure of rats with chronic heart failure induced by intraperitoneal injection of doxorubicin hydrochloride by observing exercise training,The effects of function,study the role of exercise training in improving myocardial cell mitochondrial energy metabolism and its mechanism,and explore the intervention mechanism of TCM rehabilitation theory in chronic heart failure.Methods:The model of Chronic heart failure was established by intraperitoneal injection of doxorubicin hydrochloride in small doses.The experimental animals were randomly divided intosham operation group(Sham group)and Chronic heart failure model group(CHF group).After 6 weeks of modeling,the rats in the Chronic heart failure model group were treated.They were randomly divided into Model control group(heart failure model group),Active control group(trimetazidine group),Exercise group(heart failure exercise group),and Exercise+AMPK inhibitor group.At the 7th week,the Active control group was given the intervention of trimetazidine hydrochloride,and the Exercise group and the Exercise+AMPK inhibitor group were given moderate-intensity exercise intervention for 8 weeks.At the end of the 6th week,echocardiography(LVFS,LVEF)was performed in each group of rats.At the end of the 14th week,the serum of each group was tested by enzyme-linked immunosorbent assay(ELISA)for detection of NT-proBNP and mitochondrial respiratory chain The activity of complex ?-?.The myocardial energy(ATP,ADP,AMP content)was detected by high performance liquid chromatography(HPLC).The morphological changes of myocardial cells and the ultrastructure of myocardial mitochondria were observed by light microscopy.Results:1.At the end of 6th weeks,the cardiac function(LVEF,LVFS)of the CHF group was lower than that of the Sham group(P<0.01).2.At the end of 14 weeks,compared with the Normal control group,the expression of NT-proBNP was increased in the Model control group,the Active control group,the Exercise group,and the Exercise+AMPK inhibitor group,There was significant statistical significance.among which the Normal control group and the Model control group,the Exercise group,and the Exercise+AMPK group(P<0.01),and there was statistical significance between the Active control group(P<0.05).Compared with the Model control group,the Expression of NT-proBNP decreased in each group(P<0.01).Compared with the Active control group,the expression of NT-proBNP was increased in the Exercise group and Exercise+AMPK inhibitor group(P<0.01).3.At the end of the 14th week,compared with the Normal control group,the myocardial mitochondrial respiratory chain complex ?,?,?,?(complex ?,?,?,?)in the Model control group,the Active control group,the Exercise group,and the Exercise+AMPK inhibitor group.The activities were significantly decreased(P<0.01).Compared with the Model control group,the activities of Complex ?,?,?and ? in the Active control group,Exercise group and Exercise+AMPK inhibitor group were significantly increased(P<0.01);Compared with the Active control group,the activity of Complex ?,?,? and ? in the Exercise group was increased(P<0.01),and the activities of ?,?,? and ? in the Exercise+AMPK inhibitor group were decreased(P<0.01).4.At the 14th week,compared with the Normal control group,the difference between the ATP,ADP,and AMP in the Exercise group and the Exercise+AMPK inhibitor group was statistically significant.The difference between the ATP and ADP groups in the Model control group was statistically significant.Significance,the Active control group had a statistically significant difference between the ATP and AMP levels.Compared with the Model control group,the ATP,ADP,and AMP levels in the Exercise group and the Active control group were statistically significant.The Exercise+AMPK inhibitor group The difference between ATP and AMP levels was statistically significant.Compared with the Active control group,the difference of ADP content between the Exercise group was statistically significant.The difference of ATP,ADP and AMP between the Exercise+AMPK inhibitor group was statistically significant.There were no statistically significant differences between the other groups.5.At the end of the 14th week,compared with the Normal control group,the results of HE staining showed that the Model group,the Active control group,the Exercise group,and the Exercise+AMPK inhibitor group showed that the structure of rat cardiomyocytes was changed to different degrees,the structure was fuzzy,the nucleus became large,the arrangement was irregular,and the myocardial cells were partially hypertrophied and edematous,and inflammatory cells were observed.The structure of myocardial cells in the Exercise group was restored,the morphology was basically normal,and the arrangement was more ordered than the Model control group,and there was no focal necrosis.The myocardial tissue morphology recovery in the Exercise+AMPK inhibitor group was lighter than that in the heart failure group.6.At the end of the 14th week,compared with the Normal control group,transmission electron microscopy showed that myocardial mitochondrial damage,mitochondria showed swelling,vacuolar-like changes,structure,each group structure Incomplete,some mitochondrial ambiguous changes.The Active control group,Exercise group,Exercise+AMPK inhibitor group were lighter than the Model control group,and the mitochondrial structure of the Exercise group and Exercise+AMPK inhibitor group improved significantly.Conclusion:1.There is a certain correspondence between the heart(Yangqi and energy),both play an important role in the occurrence and development of heart failure.Exercise training may improve myocardial energy metabolism by enhancing heart and Yangqi.2.Exercise training can reduce the level of serum NT-proBNP in the model group of chronic heart failure,enhance the cardiac function of rats with chronic heart failure,improve the ultrastructure of myocardial tissue and participate in the steady regulation of mitochondrial energy metabolism.3.Exercise training can improve myocardial energy metabolism by participating in the regulation of myocardial mitochondrial respiratory chain complexes(Complex?,?,?,?)and myocardial tissue ATP,ADP,and AMP.