The Effect Of Musk Tongxin Dropping Pills On Myocardial Remodeling And Microcirculation Dysfunction In Diabetic Cardiomyopathy

Objective:To explore the effect of Musk Tongxin Dropping Pills(MTDP)on myocardial remodeling and microcirculation dysfunction in diabetic cardiomyopathy(DCM).Methods:Forty male SD rats were randomly divided into blank control group(Control group,n=10),DCM model group(DCM group,n=10),DCM model+Pioglitazone group(DCM+PLZ group,n=10),DCM model+MTDP group(DCM+MTDP group,n=10).An intraperitoneal single injection of 65mg/kg streptozotocin(STZ)was used to establish rat model of DCM,the rats in Control group were treated with the same dose of sodium citrate buffer solution.DCM+PLZ group was treated with 3 mg/kg/d PLZ by ig after modeling,DCM+MTDP group was treated with 22mg/kg/d MTDP by ig,and DCM group was treated with 2ml/kg/d sodium carboxymethyl cellulose(CMC-Na)by ig.The general condition of rats was continuously observed.After intervening for 3 weeks,the random blood glucose of rats was detected by tail vein.Echocardiography examination was performed.Blood specimens were collected from the abdominal aorta,the levels of serum nitric oxide(NO)and endothelin-1(ET-1)were detected to observe the changes of endothelial function indexes,the levels of tumor necrosis factor?(TNF-?),Interleukin 6(IL-6),IL-1?,malondialdehyde(MDA)and superoxide dismutase(SOD)were detected to observe the changes of inflammation and oxidative stress indexes.The heart mass index(HMI)was calculated through the ratio of heart mass(HM)to the corresponding body mass(BM).Myocardial pathological tissue stainings of hematoxylin-eosin(HE),Masson and Carstairs staining were performed.Results:Compared with Control group,blood glucose in other three groups was higher,left ventricular end systolic diameter(LVSD)and left ventricular end diastolic diameter(LVDD)in DCM group increased significantly,while left ventricular ejection fraction(LVEF)and heart rate(HR)in this group decreased obviously(P<0.01).BM and HM in DCM group significantly reduced,and HM/BMx10~3 apparently increased(P<0.01).The levels of serum NO and SOD distinctly down-regulated(P<0.01),and the levels of ET-1,MDA,TNF-?,IL-1?,and IL-6 remarkably up-regulated(P<0.01).Compared with DCM group,LVSD and LVDD in DCM+MTDP group significantly decreased,LVEF and HR obviously increased(P<0.05).BM and HM increased apparently,HM/BMx10~3reduced distinctly(P<0.01).The levels of serum NO and SOD markedly up-regulated(P<0.05),and the levels of ET-1,MDA,TNF-?,IL-1?,and IL-6 down-regulated significantly(P<0.05).HE staining showed that myocardial cells arranged neatly in Control group but not in DCM group,intercellular space between myocardial cells in DCM group increased,accompanied by damaged myocardial fibers and infiltration of inflammatory cells.Masson staining showed that interstitial collagen fibers increased in DCM group.Carstairs staining showed that microembolization occurred in the myocardium in DCM group,while in DCM+MTDP and DCM+PLZ groups,the corresponding myocardial pathological changes were significantly improved.Conclusions:MTDP showed a positive effect on myocardial remodeling and microcirculation dysfunction in DCM rats.The potential mechanism of this effect of MTDP might be related to reduced LVEF and HMI,improved endothelial function and oxidative stress,alleviated inflammatory reaction,and finally ameliorated myocardial fibrosis and microembolization.