Qiliqiangxin Capsules Optimize Cardiac Metabolism Flexibility in Rats With Heart Failure After Myocardial Infarction

Abstract

Metabolic modulation is a promising therapy for ischemic heart disease and heart failure. This study aimed to clarify the regional modulatory effect of Qiliqiangxin capsules (QLQX), a traditional Chinese medicine, on cardiac metabolic phenotypes. Sprague-Dawley rats underwent left anterior descending coronary artery ligation and were treated with QLQX and enalapril. Striking global left ventricular dysfunction and left ventricular remodeling were significantly improved by QLQX. In addition to the posterior wall, QLQX also had a unique beneficial effect on the anterior wall subject to a severe oxygen deficit. Cardiac tissues in the border and remote areas were separated for detection. QLQX enhanced the cardiac 18 F-fluorodeoxyglucose uptake and the levels and translocation of glucose transport 4 (GLUT4) in the border area. Meanwhile, it also suppressed glucose transport 1 (GLUT1) in both areas, indicating that QLQX encouraged border myocytes to use more glucose in a GLUT4-dependent manner. It was inferred that QLQX promoted a shift from glucose oxidation to anaerobic glycolysis in the border area by the augmentation of phosphorylated pyruvate dehydrogenase, pyruvate dehydrogenase kinases 4, and lactic dehydrogenase A. QLQX also upregulated the protein expression of fatty acid translocase and carnitine palmitoyl transferase-1 in the remote area to possibly normalize fatty acid (FA) uptake and oxidation similar to that in healthy hearts. QLQX protected global viable cardiomyocytes and promoted metabolic flexibility by modulating metabolic proteins regionally, indicating its potential for driving the border myocardium into an anaerobic glycolytic pathway against hypoxia injuries and urging the remote myocardium to oxidize FA to maximize energy production.

Qili Qiangxin Capsule Combined With Sacubitril/Valsartan for HFrEF: A Systematic Review and Meta-Analysis

“…In addition, astragaloside IV can also increase the energy supply of fatty acid β -oxidation in cardiomyocytes by activating PPAR α ( Dong et al, 2017 ) to maintain cell metabolism under hypoxia and low glucose conditions. On the contrary, for cardiomyocytes with better perfusion, the glucose oxidation pathway is uninhibited, which helps reduce the accumulation of metabolites and lactic acid produced by glycolysis ( Cheng et al, 2020 ). Finally, QQC has outstanding performance in enhancing myocardial contractility and reducing ventricular remodeling.…”

Integrating Evidence of the Traditional Chinese Medicine Collateral Disease Theory in Prevention and Treatment of Cardiovascular Continuum

“…Regarding these overlapped key nodes of the cardiovascular continuum, there are TCM set prescriptions based on collateral disease that could offer intervention targets at various continuum stages ( Figure 1 ). For example, Jinlida granules (JLDG) for metabolic syndrome, Tongxinluo (TXL) for atherosclerotic plaque and myocardial protection, Shensongyangxin (SSYX) capsules for anti-arrhythmias via metabolic reconstruction, and Qiliqiangxin (QLQX) capsules for cardiac remodeling and heart failure have been recognized under the guidance of translational medicine ( Table 1 ) ( Bai et al, 2013 ; Wang et al, 2014 ; Zaki et al, 2014 ; Luan et al, 2015 ; Wang et al, 2015 ; Zhang et al, 2016 ; Fan et al, 2017 ; Shen et al, 2017 ; Zhao et al, 2017 ; Chen H. et al, 2018 ; Chen Y. et al, 2018 ; Gao et al, 2018 ; Wang et al, 2018 ; Zhang et al, 2018 ; Lyu et al, 2019 ; Tung et al, 2019 ; Zhou et al, 2019 ; Cheng W. et al, 2020 ; Li et al, 2020 ; Yang et al, 2020 ; Zhao et al, 2020 ; Jiang et al, 2021 ; Hao et al, 2022 ). These set prescriptions have been approved for by the Chinese National Medical Products Administration (NMPA), and broadly used in clinical practice in the Chinese community.…”

Mesenchymal Stem Cell Exosomes in the Treatment of Myocardial Infarction: a Systematic Review of Preclinical In Vivo Studies

“…Briefly, animals were anesthetized, connected to a ventilator with an orotracheal tube, and left thoracotomy was performed between the 3 rd and 4 th intercostal space under sterile conditions. The heart was exposed and the LAD was then permanently ligated with a suture [46,47].…”