BACKGROUND： Coronary microembolization （CME） is a serious complication following percutaneous coronary intervention （PCI） in patients with acute coronary syndromes. The use of metoprolol before PCI can significan...BACKGROUND： Coronary microembolization （CME） is a serious complication following percutaneous coronary intervention （PCI） in patients with acute coronary syndromes. The use of metoprolol before PCI can significantly protect ischemic myocardium from myocardial damage, but the function of metoprolol in the treatment of CME is not entirely clear. This study was to explore the effect and significance of metoprolol on myocardial apoptosis and caspase-3 activation after CME in rats. METHODS： Thirty rats were randomly divided into three groups including sham-operation （control group）, CME plus saline （CME group）, CME plus metoprolol （metoprolol group）, 10 rats for each group. The CME group was induced by injecting 3 000 polyethylene microspheres （42 tJm） into the left ventricle during a 10-second occlusion of the ascending aorta; the control group was injected with physiological saline instead of microembolization ball; the metoprolol or saline group was given three intravenous bolus injections before CME. Echocardiography, TUNEL staining, and Western blotting were used to evaluate cardiac function, proportion of apoptotic cells and activation of caspase-3 respectively at 6 hours after operation. RESULTS： Echocardiographic parameters displayed that the metoprolol group improved cardiac function significantly compared with the CME group （P〈0.05）. The myocardial apoptotic rate of the CME group as well as the contents of activated caspase-3 increased significantly （P〈0.05）, both of which were ameliorated significantly by metoprolol treatment （P〈0.05）. CONCLUSIONS： This study demonstrates that metoprolol can protect the myocardium during CME in rats by inhibiting apoptosis and improving cardiac function. These results suggest that the inhibition of apoptosis can be a potential therapeutic strategy for the treatment of CME.展开更多
文摘目的评价美托洛尔和卡维地洛治疗扩张型心肌病心力衰竭的效果。方法检索中国生物医学文献数据库、中国知网、万方、维普、Pub Med、Cochrane图书馆、EMbase中关于美托洛尔和卡维地洛治疗扩张型心肌病心力衰竭的随机对照试验,同时筛检纳入文献的参考文献,并对文献质量进行严格评价和资料提取,对符合质量标准的研究使用Rev Man 5.1进行Meta分析。结果共纳入6篇文献,共438例患者。结果显示,与美托洛尔比较,卡维地洛治疗扩张型心肌病心力衰竭在临床有效率(OR=0.27,95%CI:0.15~0.48,P<0.000 01)、左心室射血分数(MD=-3.10,95%CI:-4.75^-1.44,P=0.0002)、左心室舒张末期内径(MD=2.3,95%CI:0.89~3.71,P=0.001)方面具有良好的疗效,差异有统计学意义。结论卡维地洛可以改善扩张型心肌病心力衰竭的左心室射血分数、左心室舒张末期内径,提高临床有效率,值得推广。
基金supported by a grant from the National Natural Science Foundation of China(30760262/C030313)
文摘BACKGROUND： Coronary microembolization （CME） is a serious complication following percutaneous coronary intervention （PCI） in patients with acute coronary syndromes. The use of metoprolol before PCI can significantly protect ischemic myocardium from myocardial damage, but the function of metoprolol in the treatment of CME is not entirely clear. This study was to explore the effect and significance of metoprolol on myocardial apoptosis and caspase-3 activation after CME in rats. METHODS： Thirty rats were randomly divided into three groups including sham-operation （control group）, CME plus saline （CME group）, CME plus metoprolol （metoprolol group）, 10 rats for each group. The CME group was induced by injecting 3 000 polyethylene microspheres （42 tJm） into the left ventricle during a 10-second occlusion of the ascending aorta; the control group was injected with physiological saline instead of microembolization ball; the metoprolol or saline group was given three intravenous bolus injections before CME. Echocardiography, TUNEL staining, and Western blotting were used to evaluate cardiac function, proportion of apoptotic cells and activation of caspase-3 respectively at 6 hours after operation. RESULTS： Echocardiographic parameters displayed that the metoprolol group improved cardiac function significantly compared with the CME group （P〈0.05）. The myocardial apoptotic rate of the CME group as well as the contents of activated caspase-3 increased significantly （P〈0.05）, both of which were ameliorated significantly by metoprolol treatment （P〈0.05）. CONCLUSIONS： This study demonstrates that metoprolol can protect the myocardium during CME in rats by inhibiting apoptosis and improving cardiac function. These results suggest that the inhibition of apoptosis can be a potential therapeutic strategy for the treatment of CME.
