Intracoronary insulin administered at reperfusion in a porcine model of acute coronary syndrome
| Autor: | Pirjo-Riitta Salminen, Geir Olav Dahle, Christian Arvei Moen, Ketil Grong, Anne K. Jonassen, Rune Haaverstad, Knut Matre |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Cardiac function curve Acute coronary syndrome medicine.medical_specialty Swine medicine.medical_treatment Myocardial Infarction Ischemia Apoptosis Myocardial Reperfusion Myocardial Reperfusion Injury Anterior Descending Coronary Artery Critical Care and Intensive Care Medicine Random Allocation Reperfusion therapy Internal medicine medicine Animals Insulin Acute Coronary Syndrome Cardioprotection Caspase 3 business.industry Coronary Stenosis General Medicine medicine.disease Disease Models Animal medicine.anatomical_structure Cardiology Female Phosphatidylinositol 3-Kinase Cardiology and Cardiovascular Medicine business Proto-Oncogene Proteins c-akt Artery |
| Zdroj: | European Heart Journal: Acute Cardiovascular Care. 4:230-240 |
| ISSN: | 2048-8734 2048-8726 |
| DOI: | 10.1177/2048872614547689 |
| Popis: | Experimental studies have demonstrated that insulin elicits cardioprotection in coronary occlusion-reperfusion models. We studied the effects of intracoronary insulin on regional cardiac function in a porcine model with reperfusion after a critical coronary artery stenosis.In 20 anaesthetized pigs with an extracorporeal shunt from the brachiocephalic to the left anterior descending coronary artery, a fixed stenosis was applied, obtaining 50% reduction of shunt flow for 60 min. Intracoronary insulin 1 1U [DOSAGE ERROR CORRECTED] or 0.9% saline was infused for 15 min, starting 5 min prior to initiation of 180 min of reperfusion. Microsphere injections confirmed ischaemia and reperfusion. Epicardial echocardiographic multilayer radial tissue Doppler strain and strain rate and one-layer speckle-tracking strain evaluated myocardial function. Apoptosis was evaluated by cleaved caspase-3 activity. Area at risk and infarct size were determined with Evans Blue and triphenyltetrazolium chloride staining.In both groups, the area at risk constituted approximately 26% of the left ventricular mass. Minor areas of infarction were predominantly seen subendocardially, where tissue blood flow rate was severely reduced during stenosis. After 180 min of reperfusion, recovery of speckle-tracking circumferential strain averaged 57.5 ± 11.4% of baseline values in insulin treated animals compared to 22.3 ± 8.7% in controls (p = 0.025). Multilayer radial strain and strain rate did not differ between groups. Cleaved caspase-3 activity was most prominent in the subepicardial layer in the saline-treated group.Intracoronary insulin at the onset of reperfusion alleviated regional myocardial dysfunction in acute ischaemia-reperfusion and was associated with a reduction of apoptosis. |
| Databáze: | OpenAIRE |
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