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      Tongmai Yangxin intervening in myocardial remodeling after PCI for coronary heart disease: study protocol for a double-blind, randomized controlled trial

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          Abstract

          Background

          Coronary heart disease (CHD) has become a common cardiovascular disease that seriously threatens the health of people. As reperfusion in the early phase and drug therapy, especially percutaneous coronary intervention (PCI), have become widely used in the clinic, the mortality of acute myocardial infarction in the short term has been reduced significantly. In addition, in 40%–56% of patients who experience myocardial infarction, cardiac dysfunction occurs and about 25%–33% develop heart failure.

          Methods

          This study was designed as a multicenter, double-blind, randomized, placebo-controlled, parallel-group, superiority trial. Participants were randomly assigned in a 1:1 ratio through a centrally controlled, computer-generated, simple randomization schedule. The primary outcome was left ventricular end-diastolic volume index = left ventricular end-diastolic volume/body surface area. The combined secondary outcomes include traditional Chinese medicine syndrome score, echocardiogram results, 6-minute walk test results, Seattle Angina Questionnaire score, cardiac magnetic resonance imaging results, biological indicators, dynamic electrocardiogram results, and experiment event rate. Assessments will be performed at baseline and at 4, 8, and 12 weeks after randomization.

          Discussion

          This trial will demonstrate that the addition of a Tongmai Yangxin pill (TMYX) to conventional treatment will intervene in the development of cardiac remodeling and cardiac dysfunction.

          Trial registration

          This study was registered in the Chinese Clinical Trial Registry on 7 May 2019. The registration number is ChiCRT1900023023 ( http://www.chictr.org.cn/showproj.aspx?proj=12370).

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          Most cited references14

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          Cardiac Remodeling: Concepts, Clinical Impact, Pathophysiological Mechanisms and Pharmacologic Treatment

          Cardiac remodeling is defined as a group of molecular, cellular and interstitial changes that manifest clinically as changes in size, mass, geometry and function of the heart after injury. The process results in poor prognosis because of its association with ventricular dysfunction and malignant arrhythmias. Here, we discuss the concepts and clinical implications of cardiac remodeling, and the pathophysiological role of different factors, including cell death, energy metabolism, oxidative stress, inflammation, collagen, contractile proteins, calcium transport, geometry and neurohormonal activation. Finally, the article describes the pharmacological treatment of cardiac remodeling, which can be divided into three different stages of strategies: consolidated, promising and potential strategies.
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            The reverse remodeling response to sacubitril/valsartan therapy in heart failure with reduced ejection fraction

            Major classes of medical therapy for heart failure with reduced ejection fraction (HFrEF) induce reverse remodeling. The revere remodeling response to sacubitril/valsartan remains unstudied.
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              Heart failure after myocardial infarction: clinical implications and treatment.

              Heart failure is a frequent complication of myocardial infarction. Several factors, such as recurrent myocardial ischemia, infarct size, ventricular remodeling, stunned myocardium, mechanical complications, and hibernating myocardium influence the appearance of left ventricular systolic dysfunction after myocardial infarction. Importantly, its presence increases the risk of death by at least 3- to 4-fold. The knowledge of the mechanisms and clinical features are essential for the diagnosis and treatment of left ventricular dysfunction and heart failure after myocardial infarction. Therefore, this review will focus on the clinical implications and treatment of heart failure after myocardial infarction. © 2011 Wiley Periodicals, Inc. The authors have no funding, financial relationships, or conflicts of interest to disclose. © 2011 Wiley Periodicals, Inc.
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                Author and article information

                Contributors
                zhumingjun317@163.com
                Journal
                Trials
                Trials
                Trials
                BioMed Central (London )
                1745-6215
                20 March 2020
                20 March 2020
                2020
                : 21
                : 287
                Affiliations
                [1 ]GRID grid.460051.6, Center of Cardiology, , The First Affiliated Hospital of Henan University of TCM, ; 19 Renmin Road, Jinshui District, Zhengzhou, 450100 Henan Province China
                [2 ]GRID grid.460051.6, Graduate Division, , The First Affiliated Hospital of Henan University of TCM, ; 19 Renmin Road, Jinshui District, Zhengzhou, 450100 Henan Province China
                [3 ]GRID grid.256922.8, ISNI 0000 0000 9139 560X, Henan University of Chinese Medicine, ; 156 Jinshui East Road, Zhengdong New District, Zhengzhou, 450046 Henan Province China
                Author information
                http://orcid.org/0000-0001-7646-6577
                Article
                4208
                10.1186/s13063-020-4208-4
                7085139
                32197640
                7ed09b0e-bda1-458b-bd1a-6afdf24aec86
                © The Author(s). 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 19 December 2019
                : 25 February 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100007225, Ministry of Science and Technology;
                Award ID: 2018YFC1707402
                Award Recipient :
                Funded by: Ministry of Science and Technology (VN)
                Award ID: No. 2019YFC1710000
                Award Recipient :
                Funded by: Tianjin Zhongxin Pharmaceutical Group Co., Ltd.; Le Ren Tang Pharmaceutical Factory
                Award ID: No.2018YFC1707402
                Award Recipient :
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2020

                Medicine
                traditional chinese medicine,tongmai yangxin pill,myocardial remodeling,acute myocardial infarction

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