| Objective:To observe the clinical effect of Xiao Qing Long Tang(XQLT)on Heart Failure with Preserved Ejection Fraction(HFpEF)of harmful fluid retention.And experimentally was used to explore the mechanism of XQLT on HFpEF,in order to provide a theoretical basis for the XQLT on the treatment of HFEF.Methods:(1)Clinical observations:68 patients with HFpEF of harmful fluid retention were randomly divided into control group and treatment group,each with 34 cases.The control group and treatment group were all treated with conventional Western medicine guidelines,the treatment group was also treated with XQLT.Observe the effects of XQLT on left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),E/A peak ratio,N-terminal B-type brain natriuretic peptide precursor(NT-proBNP),and TCM symptom score.(2)Experimental study:Eighteen 6-weeks-old SPF grade salt-sensitive hypertensive rats(DS)were selected,after one week of adaptive feeding,they were randomly divided into normal control group(NS group,n=6)and model control group(HS group,n=6)and XQLT(XQLT,n=6).The NS group was given a low-salt diet(0.3%Nacl),and the remaining two groups were given a high-salt diet(8%NaCl).From the 7th week to the 11th week of the high-salt diet,the XQLT group was given a drug intervention.Rat feces were collected before sacrifice and stored at-80℃.Fifteen 6-weeks-old SPF grade salt-sensitive hypertensive rats(DS)were selected,and after one week of adaptive feeding,they were randomly divided into fecal microbiota transplant from NS group(FMT NS group,n=5),fecal microbiota transplant from HS group(FMT HS group,n=5)and fecal microbiota transplant from XQLT group(FMT XQLT,n=5),all of three group were given a high-salt diet(8%NaCl).From 7th week to 11th week of the high-salt diet,the FMT NS,FMT HS,and FMT XQLT groups received fecal microbiota from the normal control group,model control group,and XQLT group.Echocardiography and NT-proBNP were used to observe the effect of fecal microbiota on heart function.Hematoxylin-eosin staining(HE)and Masson staining(Masson)analysis of myocardial and intestinal morphological changes;principal component analysis(PCA),principal coordinate analysis(PCoA)and non-metric multidimensional scale analysis(NMDS)were used to analysis the composition of gut microbiota.Western blot was used to detect inflammation and fibrosis markers(Collagen 1,Collagen 3,MCP-1,TNF-α and IL-6),and analyze the effect of XQLT and fecal microbiota from XQLT groupResults:(1)Clinical observation:The treatment group and the control group can effectively improve the cardiac function and TCM symptom scores of patients with HFpEF of harmful fluid retention,and the treatment group performed better than that in control group(P<0.05).The addition the XQLT can significantly improve the LVEF,LVDd,NT-proBNP and TCM symptom scores of patients with HFpEF of harmful fluid retention Studies have shown that XQLT can effectively improve the clinical symptoms and cardiac function of the syndrome patients with HFpEF of harmful fluid retention.(2)Experimental study:Compared with the NS group,the high-salt diet led to a decrease in LVEF in the HS group(P<0.05).After treatment with XQLT,the LVEF improved significantly(P<0.01).Compared with the HS group,XQLT significantly reduced the LVDd,NT-proBNP,and improved myocardial tissue morphology.XQLT inhibits the expression of collagen I.collagen Ⅲ,MCP-1,TNFα,IL-6,indicates that XQLT can significantly inhibited the myocardial inflammation and fibrosis.Analysis of PCA,PCoA and NMDs showed that XQLT significantly regulated the composition of intestinal flora.Fecal microbiota transplantation experiments show that the gut microbiota from XQLT group performed beneficial effect on LVEF,LVDd and NT-proBNP.The fecal microbiota from XQLT group can effectively influence the expression of collagen Ⅰ,collagen Ⅲ,MCP-1,TNFα,and IL-6 in left ventricle,indicates that the fecal microbiota from XQLT group significantly inhibited myocardial inflammation and fibrosis.The analysis of PCA,PCoA and NMDs showed that the composition of gut microbiota was significant influenced by XQLT.It indicates that XQLT may prevent myocardial inflammation and fibrosis by regulating gut microbiota,and delay the progress of HFpEFConclusion:XQLT performed beneficial effect on HFpEF of harmful fluid retention,and the treatment group showed better clinical symptoms.The experiment indicates that XQLT prevents cardiomyocyte hypertrophy,fibrosis,and the development of HFpEF in Rats by modulating the composition of the gut microbiota. |
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