| Background and Objective:Acute myocardial infarction(AMI) is hazardous to human health, and is main cause of human death.Nowadays,with the fast step of our life,the incidence of acute myocardial infarction is more and more increasing and the onset ages become younger and younger.It attacted the great interests of the whole world.Qidan Tongmai tablet(QDTMT), a kind of Traditional Chinese Medicine,was established on the theory of Qixue and on the years of clinical experience. Recent studies show that QDTMT plays an important part in raising the activity of Ca2+-ATPase, Mg2+-ATPase,inhibiting the Ca2+ inflow,degrading the amount of Ca2+ in the myocardial cells and mitochondria, lightening the calcium overload, increasing the activity of super oxide dismutase (SOD),glutathione peroxidase (GSH-Px) in myocardial mitochondria,and decreasing the content of malondialdehyde (MDA) in mitochondria. And thus QDTMT could reduce the size of myocardial infarction induced by ischemia and ischemia reperfusion, elevate the power ofanti-oxidation and improve the function of the heart.Recent progresses have been made in the field of these drugs'action mechanism.Previous study showed that the drugs of promoting blood circulation by removing blood stasis are effective in treating myocardial ischemia and myocardial infarction.Qidan tongmai tablet is a compound preparation,that made of pure Chinese herbs which have the effect of supplementing qi,activiating blood circulation,relieving pain by removing obstruction in the channels.Clinical evidence proved that Qidan tongmai tablet showed preventive effects on ischemic heart disease,but the molecular mechanism was still unknown.So,the immunohistochemisty methods,the chemiluminescence method and the method of catch microparticle were employed to reveal its mechanism,and increased the application of Qidan tongmai tablet in clinic.To investigate the Tablet's protection on the ventricular remodeling of infarction myocardium,and it's effect on the expression level of BNP and cTnI,the following studies were carried out.Subjects and Methods:Thirty-six healthy rabbits were randomly divided into six groups:normal group,sham operation group,model group (AMI group, A model of AMI which reproduced by ligation of left circumflex branch of the coronary artery),control group (diltiazem hydrochloride group),Qidan tongmai tablet high dose group and Qidan tongmai tablet low dose group. Saline were given to normal group (blank control group),sham operation group, and model group at 10ml/kg·d weight; Suspension of Qidan tongmai tablet were given to Qidan tongmai tablet high dose group and Qidan tongmai tablet low dose group at dose of 1.48g/kg·d weight and 0.44g/kg·d weight. After 14-day administration of Qidan tongmai tablet, ligation of left circumflex branch of the coronary artery to cause Acute myocardial infarction.Electrocardiography was used to monitor Acute myocardial infarction. (1)Duplicating rabbit model of acute myocardial ischemia by means of ligating left circumflex branch(LCB) of coronary artery, observing and measuring dynamic characteristics of cardiac mechanical function, indexes such as±LVdp/dtmax,LVSP,HR are included. (2) Removing the rabbit heart, making myocardium section preparation, HE staining was employed to analyze the pathological damage in acute myocardial infarction of heart apex and the method of catch microparticle to detect the expression of BNP and cTnI in the acute myocardial infarction. Compared with the electrocardiography before ligation of left circumflex branch of the coronary artery the ST segment was changed clinically in all groups,which proved that the animal model was successfully copied.Main Results:1,Effects of QDTMT on myocardium pathological injury in rabbit:(1),Light microscope:No ischemia damage was found in blank control group. Necrosis was found in Qidan tongmai tablet max rabbits. The model group have appeared the obvious myocardial infarction,The myocardial infarction of Qidan tongmai tablet groups compared to the modle group,its pathological changes degree have significantly reduced;the myocardial infarction area was shrinked(P<0.01).(2),Electricity mirror:It is thus clear that Qidan tongmai tablet can significantly reduce myocardial pathology injury in rabbit,improve the ultramicrostructure of cell.2,Effects of QDTMT on the size of infarctic myocardium in Rabbit:After admistration of Qidan tongmai tablet for 14 days,QDTMT groups and diltiazem hydrochloride group had obvious effect of ameliorate the size of myocardial infarction,which have obvious difference with the model group (P<0.01).3,Effects of QDTMT on brain natriuretic peptide and cardiac troponin I of acute myocardial infarction in Rabbit:After admistration of Qidan tongmai tablet for 14 days, the rabbits were killed and blood were draw out and serum were seperated by centrifugation. Little expression of BNP and cTnI was detected in blank control group.However BNP and cTnI were detected expressed in all acute myocardial infarction groups.After AMI the content of cTnI and BNP have significantly increased,but in Qidan tongmai tablet groups and diltiazem hydrochloride group,the content of cTnI and BNP have significantly reduced, which have obvious difference with the model group (P<0.05orP<0.01).The contents of BNP and cTnI in diltiazem hydrochloride group is between Qidan tongmai tablet groups.However,two of them compared had no significant by LSD statistic analysis (P>0.05).4,Effect of QDTMT on hemorheological of acute myocardial infarction in Rabbit:The hemorrheological indexes such as the whole blood high-shear,the low-shear viscosity and fibrinogen were reduced significantly in Qidan tongmai tablet groups,the red cell deformability was strengthened clearly and erythrocyte aggregation was receded markedly(P<0.05或P<0.01).5,Effect of QDTMT on hemodynamics of acute myocardial infarction in Rabbit: In QDTMT high and low dose groups,the rates of heart accelerated,the left ventricular systolic pressures and the differentiate of pressures increased obviously,which were significantly different with the model group(P<0.05 or P<0.01). Conclusions and Suggestions:1,Qidan tongmai tablet could ameliorate the size of myocardial infarction, improved the systolic and diastolic function of the infarctic myocardium and has obvious protective effects on AMI rabbit modle which is reproduced by liagation of coronary.It suggested that Qidan tongmai tablet is valuable on prevention and treatment of AMI.2,Qidan tongmai tablet could decrease the expression of BNP and cTnI,and could decrease the occurrence of ventricular remodeling so as to improve the heart function,which was indicated that were the possible mechanism of prevention and treatment of AMI.
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