The Mechanism of Qiangxin Decoction Intervening Myocardial Cell Apoptosis in Rats with Chronic Heart Failure

MAO Meiling; LU Jianqi; CHEN Jiayong; ZHANG Yunli; LU Wei; CHEN Lidan; ZHANG Yibo; LIN Hao

doi:10.12102/j.issn.1672-1349.2025.11.007

Abstract：Objective:To explore the possible mechanism of Qiangxin Decoction in improving cardiomyocyte apoptosis by inhibiting pro-apoptotic proteins Bcl-2 homologous antagonist factor 1(bak1)and Kruber-like factor(klf)3 in rats with chronic heart failure(CHF).Methods:Forty-eight specific pathogen-free(SPF)grade SD rats were randomly divided into the control group,model group,low-dose Qiangxin Decoction group,medium-dose Qiangxin Decoction group,high-dose Qiangxin Decoction group,and the sacubitril/valsartan group,with 8 rats in each group.Except for the control group,the CHF model was established by ligation of the left anterior descending coronary artery in the remaining groups of rats.Starting from the second day after the successful modeling,the low-dose Qiangxin Decoction group,the medium-dose Qiangxin Decoction group,and the high-dose Qiangxin Decoction group were respectively given 6.125,12.250,and 24.500 g/(kg·d)Qiangxin Decoction by gavage.The sacubitril/valsartan group was given 10.38 g/(kg·d)of sacubitril/valsartan dissolved in normal saline water by gavage.Control group and model group normal saline water was administered by gavage for 28 days.After the intervention,cardiac function indicators of rats in each group[including left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and left ventricular ejection fraction(LVEF)]were detected by echocardiography.Hematoxylin-eosin(HE)staining was used to observe the histopathological changes of the left ventricle in rats.The apoptosis of cardiomyocytes was observed by deoxyribonucleotide terminal transferase-mediated notch end labeling(TUNEL)staining.The expression of bak1 and klf3 proteins in the left ventricular tissues of rats were detected by Western Blot.Results:The results of HE staining and Tunnel detection indicated that,compared with the control group,the normal myocardial tissue structure of rats in the model group changed,the myocardial transverse stripes blurred,the arrangement of myocardial cells disordered,degeneration and necrosis occurred,and cell apoptosis increased,with a significant increase in brownish necrotic granular matter.The myocardial structure of rats in each administration group was intact,the cells neatly arranged,the necrotic particulate matter decreased,and the apoptosis of myocardial cells significantly improved.Compared with the control group,the LVEDD and LVESD of rats in the model group increased,LVEF decreased,and the expression levels of pro-apoptotic proteins bak1 and klf3 significantly increased(P＜0.05).Compared with the model group,the LVEDD and LVESD of rats in each administration group decreased,the LVEF increased,and the expression levels of pro-apoptotic proteins bak1 and klf3 significantly decreased(P＜0.05).Compared with the low-dose Qiangxin Decoction group,the improvement effects of each index in the medium-dose Qiangxin Decoction group,the high-dose Qiangxin Decoction group,and the sacubitril/valsartan group were better(P＜0.05).Compared with the medium-dose group of Qiangxin Decoction,there was no statistically significant difference between the sacubitril/valsartan group and the high-dose group of Qiangxin Decoction(P＞0.05).Conclusion:Qiangxin Decoction reduces the expression of pro-apoptotic proteins bak1 and klf3 in myocardial tissue,improves the abnormal apoptosis of myocardial cells,thereby alleviating the pathological damage of myocardial tissue and achieving the therapeutic effect of CHF.