Duan Sheng-fu

Effects of ligustrazine controlled release capsule in chronic pulmonary heart disease

Before and after oral administration of ligustrazine controlled release capsule, pulmonary hemodynamics, right cardiac function, arterial blood gas and TXB2/6-keto-PGF1 alpha were studied in 16 patients with advanced cor pulmonale. The decrease of pulmonary arterial pressure and pulmonary vascular resistance, increase of cardiac output, improvement of right cardiac function and arterial blood gas were demonstrated after one course of treatment. The mechanism of these effects may be related to improvement of imbalance of TXB2/6-keto-PGF1 alpha. These results were in agreement with those of intravenous administration of ligustrazine, but no adverse reactions were found.SummaryBefore and after oral administration of ligustrazine controlled release capsule, pulmonary hemodynamics, right cardiac function, arterial blood gas and TXB2/6-keto-PGF1α were studied in 16 patients with advanced cor pulmonale. The decrease of pulmonary arterial pressure and pulmonary vascular resistance, increase of cardiac output, improvement of right cardiac function and arterial blood gas were demonstrated after one course of treatment. The mechanism of these effects may be related to improvement of imbalance of TXB2/6-keto-PGF1α. These results were in agreement with those of intravenous administration of ligustrazine, but no adverse reactions were found.

The acute effects of Ligustrazini on hemodynamics and right cardiac function in pulmonary arterial hypertension secondary to chronic obstructive pulmonary disease

We studied 20 patients with pulmonary arterial hypertension secondary to chronic obstructive pulmonary disease (COPD) to investigate the acute effect of Ligustrazini on hemodynamics and right cardiac function. The results suggested that Ligustrazini had the effects of dilating pulmonary vessel, decreasing mean pulmonary arterial pressure and pulmonary vascular resistance, increasing cardiac output, and improving right cardiac function. The maximum effects of Ligustrazini occurred at 30 min after starting administration of the drug, but its effects disappeared 1 h after its withdrawal. From the above we are led to conclude that Ligustrazini as a vasodilator works rapidly, but its effects do not persist long.SummaryWe studied 20 patients with pulmonary arterial hypertension secondary to chronic obstructive pulmonary disease (COPD) to investigate the acute effect of Ligustrazini on hemodynamics and right cardiac function. The results suggested that Ligustrazini had the effects of dilating pulmonary vessel, decreasing mean pulmonary arterial pressure and pulmonary vascular resistance, increasing cardiac output, and improving right cardiac function. The maximum effects of Ligustrazini occurred at 30 min after starting administration, of the drug, but its effects disappeared 1 h after its withdrawal. From the above we are led to conclude that Ligustrazini as a vasodilator works rapidly, but its effects do not persist long.

Attenuation of nitric oxide synthase gene expression in rat lung induced by hypoxia

SummaryIn order to investigate the role of nitric oxide (NO) in pathogenesis of hypoxic pulmonary hypertension (HPH), the mean pulmonary arterial pressure (mPAP), mRNA expression of NO synthase (NOS) in lung tissues, cGMP levels, and their relationships were studied in rats exposed to hypoxia from 8 h to 28 days. The results showed that mPAP began to increase in animals exposed to 10 % O2 for 8 h. Moreover, the longer the exposure, the higher the mPAP. Northern blot analysis and dot blot hybridization indicated that mRNA expression of NO in lung tissues of hypoxic rats tended to decrease with exposure days, but that of β-actin which acted as a control did not alter. The cGMP levels of plasma and lung tissues in hypoxic rats also inclined to be lower with exposure days. A marked negative correlations between the changes of cGMP levels and those of mPAP were found. It was suggested that mRNA expression of NOS gene was attenuated in hypoxic lung tissues, which may be one of important pathogenetic mechanisms of HPH.

Effects of sustained Ligustrazine on hemorrheology in patients with chronic pulmonary heart disease

SummaryBefore and after oral administration of sustained Ligustrazine, changes of hemorrheology and TXA2/PGI2 were evaluated in 16 patients with advanced chronic pulmonary heart disease. A decrease in whole blood and plasma viscosity, and reductions in hematocrit and fibrinogen were found after one course of treatment with sustained Ligustrazine. The mechanism of these effects may be related to improved modulation of imbalance of TXA2/PGI2 in patients with advanced chronic pulmonary heart disease.Before and after oral administration of sustained Ligustrazine, changes of hemorrheology and TXA2/PGI2 were evaluated in 16 patients with advanced chronic pulmonary heart disease. A decrease in whole blood and plasma viscosity, and reductions in hematocrit and fibrinogen were found after one course of treatment with sustained Ligustrazine. The mechanism of these effects may be related to improved modulation of imbalance of TXA2/PGI2 in patients with advanced chronic pulmonary heart disease.

Hemorrheologic changes in COPD patients with or without cor pulmonale.

SummaryIn 34 patients with chronic obstructive pulmonary disease (COPD), some hemorrheologic parameters were measured and pulmonary arterial mean pressure (PAMP) was examined simultaneously. The results suggested that the whole Wood viscosity (high shear rate) and hematocrit were significantly higher in group with cor pulmonale than in group without cor pulmonale; the whole blood viscosity (low and high shear rate) and hematocrit were higher in group with pulmonary hypertension than in group without pulmonary hypertension. In addition, a significant correlation was detected between PAMP and whole blood viscosity (r = 0.4786;P<0.01). As the correlation coefficient was moderate, we suggest that blood viscosity only plays a secondary role in development of pulmonary hypertension in patients with COPD.

Assessment of the clinical value of impedance pulmonary rheogram in the early diagnosis of cor pulmonale

SummaryThe impedance pulmonary rheogram (IPR) and its first derivation of 83 patients with chronic cor pulmonale (CCP) and 50 healthy persons were measured and analyzed. The results indicated that the following parameters are valuable in the diagnosis of CCP: 1. Q-b interval ≥ 0.15 sec; 2.RVET ≤ 0.28 sec; 3. Q-b/RVET ratio ≥ 0.46; 4. Q-b index ≥ 0.17; 5. Q-C interval ≥ 0.20 sec; 6. wave amplitude ≤ 0.15 ohm. When any three of the above-mentioned six indices are positive, the patient may be diagnosed as CCP. According to this standard the rate of early diagnosis of CCP was 73.6%.

A comparative study of the influences of pulmonary arterial pressure and pulmonary capillary wedge pressure on impedance rheopneumogram in patients with three different diseases

SummaryIn the present study right heart catheterization and impedance rheopneumogram examinations were performed simultaneously on 21 patients suffering from congenital cardiovascular diseases with atrial or ventricular septal defect accompanied by the left to right shunt (CCD) and 17 patients suffering from rheumatic valvular disease with mitral stenosis (MS) in order to investigate the differences in the impedance rheopneumogram parameters between CCD patients and patients with chronic obstructive pulmonary disease (COPD) as well as between MS and COPD patients. The results showed that when patients with different diseases had the same level of pulmonary arterial pressure, CCD patients had significantly higher Hs than COPD patients, while MS patients had significantly higher Hd/Hs ratio than COPD patients and CCD patients. The linear regressional equation between Hd/Hs ratio and pulmonary capillary wedge pressure (PCWP) was as follows: PCWP(kPa) = 0.17+0.98 × Hd/Hs (n = 155,Y = 0.422,P< 0.001). These results suggest that, (1) impedance rheopneumographic regressional equations with Hs as one of the major variables suitable for predicting secondary pulmonary hypertension in COPD patients are not suitable for use on CCD patients, (2) Hd/Hs ratio is useful in clinical work as an index for differential diagnosis between MS and Cor Pulmonale, and (3) PCWP can be roughly and noninvasively measured based on the measurement of impedance rheopneumogram parameter Hd/Hs.

Noninvasive quantitative diagnosis of pulmonary artery hypertension with impedance rheopneumogram in patients with chronic obstructive pulmonary disease

SummaryIn order to evaluate the value of impedance rheopneumogram (IRP) in predicting pulmonary arterial pressure (PAP) and pulmonary arterial hypertension (PAH) noninvasively and quantitatively, 150 patients with chronic obstructive pulmonary disease (COPD) were examined by IRP and right heart catheterization simultaneously. It was found that some parameters derived from IRP correlated well with PAP, the strongest correlation being demonstrated by Q-B/B-Y ratio (γ = 0.74,P<0.001) and Hs (γ = −0.56,P<0.001). We made a multi-stepwise regressional analysis and, obtained an equation to predict PAP from IRP parameters: PAP (kPa) = [−2.26−5.05xlnHs+27.02 × (Q-B/B-Y)] × 0.133 (γ = 0.78,P<0.001) Other 30 COPD patients were selected to assess the effectiveness of the equation, We found that the sensitivity and specificity of the equation in identifying PAH were 83% and 93% respectively.

Investigation on the relation of impedance rheopneumogram with pulmonary hemodynamics and right ventricular function in patients with chronic obstructive pulmonary disease.

SummaryIn order to investigate the relation of impedance rheopneumogram with pulmonary hemodynamics and right ventricular function in patients with chronic obstructive pulmonary disease (COPD), we measured impedance rheopneumogram and performed right heart catheterization on 150 COPD patients simultaneously both at rest and during exercise test. The results showed that impedance rheopneumogram was mainly influenced by right ventricular after-load while the influences of right ventricular pre-load, right ventricular contractivity, right ventricular work index and cardiac output were rather slight. These results also suggest that in COPD patients impedance rheopneumogram is of great value when used to predict pulmonary arterial pressure but of little value when used to measure the right ventricular function.

Studies on some parameters of tricuspid valve echocardiogram in the early diagnosis of chronic cor pulmonale

SummaryUsing tricuspid valve echocardiogram, the right ventricular time intervals and relevant parameters of the normal persons were studied and compared with those of the patients with chronic cor pulmonale. Six parameters related to time intervals in a cardiac cycle for the early diagnosis of cor pulmonale were proposed, i.e., RIRT≥37 ms, RIRT/C-D≥0.076, RIRT/REML≥0.613, REML≤53 ms, RSTI≤420 ms and RMST≤356 ms. The use of these parameters for the early diagnosis of cor polmonale is more significant than conventional criteria. A combined use of these parameters with the conventional criteria may improve further the use of echocardiogram for the early diagnosis of cor pulmonale.