Microscopic Pathological Features Of Heart Collateral Stasis In Traditional Chinese Medicine

Objective To summarize the theory and clinical application of collateral stasis in heart collateral disease.To explore the micro-pathological features of collateral stasis in heart.Methods On the basis of studying information about collateral in《Huangdi Neijing》and others classical clauses with reviewing the modem related medical literature,summarized the theory of heart collateral stasis from theory to clinical application.75 male Sprague-Dawley rats were randomly divided into sham group,immediate group after modeling,1 hour group after modeling,3 hours group after modeling and 6 hours group after modeling.After establishment of the rat models,the histomorphological changes of myocardial and microvascular endothelial cells were observed in chronological order.TheTXB2,6-Keto-PGF1α,NO,ANGII,Fibrinogen,ICAM-1,VCAM-1,VE-cadherin,ANGPTL4,NRG-1 and PECAM-1 were measured.Results The ST segment in ECG of rats was continuously elevated from 1 hour to 6 hours after the establishment of the model.Disordered arrangement of myocardial cells,necrosis,dissolution and myocardial morphological destruction appeared in myocardial tissue with HE staining.Observaed by electron microscopy,microvascular lumen erythrocyte,plasma retention and lumen stenosis appeared in microvascular.Disordered arrangement and focal dissolution of myocardial fibers,myocardial membrane ruptured and mitochondrial structure destroyed.③ The degree of endothelial cells swelling aggravated,endothelial cell nuclear lesions increased,even endothelial cell necrosis and apoptosis.The tension of blood vessels increases,and the blood is in a hypercoagulable state after the establishment of the model.The TXBZ level was higher of the lh,3h and 6h group than the TXB2 level of the shaml group(P<0.05),and the highest was in the 6h group(428.49±36.45pmol/l).The level of 6-Keto-PGF1α in each group was lower than the level of 6-Keto-PGF1α of the sham group(P<0.05),and the lowest was the immediate group(0.14±0.03pmol/1).The level of NO in the immediate group(0.31±0.08 μ mol/1)and the lh group(0.81±0.16 μ mol/1)was lower than in the sham group(P<0.05).The level of ANGII in thelh,3h and 6h group was higher than in the sham group(P<0.05),and the highest was the 6h group(16.33±2.41ng/ml).Fibrinogen levels were significantly higher in each group than sham group(P<0.05),the highest is 6h group(35.50±5.69 ug/ml).Vascular endothelial function impaired after the establishment of the model.The expression of ICAM-1 mRNA increased unsteadily within 6 hours after modeling,the highest is 3h group(1.46±0.13),which was higher than that of the sham group(P<0.05).The expression of VCAM-lmRNA in each group was significantly decreased,the lowest was lh group(0.34±0.05).The expression of VE-Cadherin in the immediate group(1.22±0.28)and the 3h group(1.04±0.21)was higher than the sham group(P<0.05),while the expression of VE-Cadherin in the lh and 6h group fell back to normal level.The expression of PEC AM-1 in each group was higher than the sham group,the highest was the immediate group(1254.13±254.78).The expression of endotiiehal cell protective factor,myocardial injury protective factor at gene level were also promoted.The expressions of ANGPTL4 and NRG-1of each group were higher than those of the sham group(P<0.05).The highest expression of ANGPTL4 and NRG-1 was found in the 6h group(2.34±0.28)and the immediate group(1.63 ± 0.19).Conclusion The "Collateral stasis" in the theory of "heart collateral disease"is highly correlated with the CMD caused by microvascular disease in theory of modem mediime.Its main pathogenic characteristics are "blood clotting",and“blood does not supply nourishment".The main pathological manifestations of heart collateral stasis are blood retention in microvessels,stenosis of lumen,and even obstruction of lumen,which accords with the characteristics of "blood clotting " in the theory of Traditional Chinese Medicine.Heart collateral stasis causes structural damage of vascular endothelial cells,even necrosis and apoptosis;resulting in necrosis and dissolution of myocardial fibers,structural damage of mitochondria,seriously affecting the function of blood vessels and myocardium,which is consistent with the performance of "blood does not supply nourishment".Microscopic pathological features of heart collateral stasis also include increased vascular tension,hypercoagulability of blood and impaired microvascular endothelial barrier ftunction.In addition,the expression of microvascular endothelial cell protective factor and myocardial protective factor at gene level is also an integral part of the microscopic pathological features of heart collateral stasis.