The Effects Of Wenyangzhenshuai Granule Allying Exercise Training On Energy Metabolism In A Rat Model Of Chronic Heart Failure

1. ObjectiveThe experiment was to observe the protective effect of wenyangzhenshuai granule allying exercise training for heart structure and function of rat model with CHF,that induced by adriamycin,study it’s influence on energy metabolism of rat model with CHF,and to explore the therapeutic mechanism. 2. MethodMaking experimental adriamycin-induced chronic heart failure animal model. They were divided into control group,experimental control group, wenyangzhenshuai group, wenyangzhenshuai allying exercise training group, exercise training group,L-carnitine group. At 5 weeks after the first injection of adriamycin, rabbits in wenyangzhenshuai group, wenyangzhenshuai allying exercise training group, exercise training group, were orally with wenyangzhenshuai granules and(or) exercise training,9(10) experimental rats in each group were sacrificed respectively at the end of the 4th and 12 th week to investigate the effects of wenyangzhenshuai granule allying exercise training on ultrasound cardiogram,serum NT-pro BNP, Na+-K+ATP enzyme, Ca2+-Mg2+ ATP enzyme, P-AMPK、AMPK、PPARα、CPT-1 protein and gene exression, myocardial apoptosis and myocardial ultrastructure. 3.Result(1)The LVEF, LVFS and E/A of experimental groups had a statistically significant difference to the control group at the end of 4th weeks(P<0.05), at the end of 12 th weeks,the level of LVEF, LVFS and E/A decreased,which had a statistically significant difference to the control group(P<0.05), the other experimental groups decreased slower than experimental control groups(P<0.05).(2)At the end of 4th weeks,the LVDd、LVDs、LVS、LVPW of experimental groups had a statistically significant difference to the control group(P<0.05). The LVDd、LVDs、LVS、LVPW of experimental groups had a statistically significant difference to the control group(P<0.05) at the end of 12 th weeks.The IVS and LVPW levels of experimental groups had a statistically significant difference to the experimental control group(P<0.05).The LVDd and LVDs levels of L-carnitine group were not significantly different to the experimental control group(P>0. 05),and the LVDd and LVDs levels of other groups were significantly different to the experimental control group(P<0.05).(3)At the end of 4th weeks,comparison of serum NT-pro BNP and in each groups, the experimental groups were higher than the control group(P<0.05),the level of serum NT-pro BNP increased at the end of 12 th weeks, the wenyangzhenshuai group, wenyangzhenshuai allying exercise training group, exercise training group,L-carnitine group increased slower than other groups(P<0.05).(4)At the end of 4th weeks,comparison of serum Na+-K+ATP enzyme, Ca2+-Mg2 ATP enzyme in each groups, the experimental groups were lower than the control group(P<0.05),the level of serum NT-pro BNP were still lower than the control group at the end of 12 th weeks(P〈0.05);the wenyangzhenshuai group, wenyangzhenshuai allying exercise training group, exercise training group,L-carnitine group increased than experimental control group(P<0.01).(5)At the end of 12 th weeks,comparison of the myocardial P-AMPK、AMPK、PPARα、CPT-1 and AMPKm RNA、PPARαm RNA、CPT-1m RNA levels were different than the normal control group(P<0.05);the levels of the wenyangzhenshuai group, wenyangzhenshuai allying exercise training group, exercise training group,L-carnitine group were higher than the experimental control group(P<0.05),of which, P-AMPK、AMPK、PPARα、CPT-1 expressions in the wenyangzhenshuai allying exercise training group were most significant.(6)Results of electron microscopy:the myocardial structure of experimental groups were irregular, which had myocardial sarcomere structure fuzzy,disord of myocardial sarcomere and filament,mitochondria edema and vacuolization, and with inflammatory cells infiltration.The myocardial pathological changes in wenyangzhenshuai group and wenyangzhenshuai allying exercise training group were better than the other groups. 4. Conclusion(1) Wenyangzhenshuai granule allying exercise training can effectively decrease the serum NT pro-BNP level in chronic heart failure rat model.(2)Wenyangzhenshuai granule allying exercise training can effectively improve reduce the heart function, delay the cardiac structure changes and improve the ultrastructure of myocardial tissue in heart failure rat model;(3)Wenyangzhenshuai granule allying exercise training can regulate metabolic pathways of glycolipid through p-AMPK/PPARa path,increases the expression of CPT-l, improve fatty acid oxidation and partly inhibit metabolism remodeling.(4)Wenyangzhenshuai granule allying exercise training can improve metabolism remodeling,which is partly better than traditional Chinese medicine group, exercise training group and western medicine group. It indicates the synergistic effect of wenyangzhenshuai granule and exercise training on improving metabolism remodeling.For patients with chronic heart failure, cardiac rehabilitation should be based on drug therapy,combined with exercise training.