Catheter-Based Transcoronary Myocardial Hypothermia Attenuates Arrhythmia and Myocardial Necrosis in Pigs With Acute Myocardial Infarction
| Autor: | Toru Ozawa, Ryohei Yoshikawa, Toshiro Shinke, Daisuke Ogasawara, Junya Shite, Mitsuhiro Yokoyama, Yusuke Tanino, Oscar Luis Paredes, Satoshi Watanabe, Daisuke Matsumoto, Hiromasa Otake |
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| Jazyk: | angličtina |
| Předmět: |
Male
medicine.medical_specialty Heart disease Swine Myocardial Infarction Lumen (anatomy) Myocardial Reperfusion Injury Sensitivity and Specificity Catheterization Necrosis Hypothermia Induced Internal medicine Coronary Circulation medicine Animals Myocardial infarction Probability Analysis of Variance business.industry Coronary flow reserve Arrhythmias Cardiac Hypothermia medicine.disease Catheter Disease Models Animal Coronary occlusion Anesthesia Circulatory system Cardiology Female medicine.symptom business Cardiology and Cardiovascular Medicine |
| Zdroj: | Journal of the American College of Cardiology. (2):250-260 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2006.06.080 |
| Popis: | ObjectivesThis study evaluated the efficacy of catheter-based transcoronary myocardial hypothermia (CTMH) in pigs with acute myocardial ischemia.BackgroundAlthough it has been suggested that hypothermia therapy can attenuate myocardial necrosis, few applications have been accepted for clinical use.MethodsThis study comprises 2 substudies. In both studies, pigs underwent 60 min of coronary occlusion and 180 min of reperfusion. In study 1, after 15 min of coronary occlusion with an over-the-wire-type balloon (OTWB), pigs in the hypothermia group (H) (n = 13) were directly infused with 4°C saline into the coronary artery through the OTWB wire lumen (2.5 ml/min) for 60 min. Pigs in the normothermia group (N) (n = 15) received the same amount of 36.5°C saline. In study 2, pigs in the hypothermia-reperfusion group (HR) (n = 5) were infused with 4°C saline through the infusion catheter (8 ml/min) for 30 min with a later start (60 min after coronary occlusion), whereas simple reperfusion was used for the reperfusion group (R) (n = 6).ResultsCatheter-based transcoronary myocardial hypothermia was successful in both studies. In study 1, CTMH significantly decreased ventricular arrhythmia and the ratio of necrosis to ischemic risk area (H: 9 ± 2%; N: 36 ± 4%; p < 0.0001) with a significant reduction of enzyme leaks. In study 2, CTMH tended to reduce the ratio of necrosis (HR: 33 ± 2%; R: 45 ± 5%; p = 0.08). In both studies, CTMH significantly suppressed the increase of 8-iso-prostaglandin F2αwhile preserving the coronary flow reserve.ConclusionsCatheter-based transcoronary myocardial hypothermia reduced myocardial necrosis while preserving coronary flow reserve, due, in part, to attenuation of oxidative stress. |
| Databáze: | OpenAIRE |
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