QiShenYiQi Pills® prevents cardiac ischemia–reperfusion injury via energy modulation

Background QiShenYiQi Pills® (QSYQ) is a compound Chinese medicine used in China for alleviating cardiac function. The present study was designed to explore the effect and mechanism of QSYQ on ischemia–reperfusion (I/R)-induced disorders in myocardial structure and function, with particularly focusing on the regulation of energy metabolism. Methods Sprague–Dawley rats, with or without QSYQ pretreatment, were subjected to 30 min occlusion of the left anterior descending coronary artery and followed by 90 min or 24 h reperfusion. Myocardial blood flow (MBF) and cardiac function were evaluated at baseline, immediately after ischemia and 30, 60, 90 min, and 24 h after reperfusion. Myocardial infarction, myocardial histology and ultrastructure were assessed. Double staining of alpha-cardiac actinin and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling was conducted to assess myocardial apoptosis. ATP, ADP and AMP content was determined by Enzyme-Linked Immunosorbent Assay, F-actin in myocardial cells determined by immunofluorescence microscopy and expression of ATP synthase α, ATP5D, and phosphorylated-Myosin Light Chain (P-MLC) determined by western blotting. Results Pre-treatment with QSYQ protected against I/R-induced MBF decrease, myocardial infarction and apoptosis at 90 min and 24 h after reperfusion. Moreover, I/R 90 min caused an impairment on cardiac function, a decrease in the ratio of ADP/ATP and AMP/ATP, accompanying with reduction of ATP 5D expression and increase in the expression of P-MLC, meanwhile, myocardium to exhibit myocardial fiber rupture, interstitial edema, and mitochondria swelling, all of which were significantly ameliorated by pre-treatment with QSYQ. Conclusions The results of the present study suggest an involvement of regulation of energy metabolism in the action of QSYQ to protect against myocardial I/R injury.