Acute heart failure following myocardial infarction: complement activation correlates with the severity of heart failure in patients developing cardiogenic shock

Orrem, Hilde Lang; Nilsson, Per H.; Pischke, Søren Erik; Grindheim, Guro; Garred, Peter; Seljeflot, Ingebjørg; Husebye, Trygve; Aukrust, Pål; Yndestad, Arne; Andersen, Geir Øystein; Barratt‐Due, Andreas; Mollnes, Tom Eirik

doi:10.1002/ehf2.12266

Cited by 31 publications

(17 citation statements)

References 53 publications

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“…The complement pathway plays an important role in the inflammatory response after MI and is necessary for clearance of the infarcted tissue, but at the same time it may enhance cell death of still-viable cardiomyocytes, resulting in infarct expansion (15). The classical complement pathway is activated after MI in the human heart, and is sustained chronically (42,69). It has been proposed that inhibition of this pathway may be an effective treatment post-MI (15,69).…”

Section: Discussionmentioning

confidence: 99%

Differential gene responses 3 days following infarction in the fetal and adolescent sheep heart

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Tellam

Darby

et al. 2020

Physiological Genomics

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There are critical molecular mechanisms that can be activated to induce myocardial repair, and in humans this is most efficient during fetal development. The timing of heart development in relation to birth and the size/electrophysiology of the heart are similar in humans and sheep, providing a model to investigate the repair capacity of the mammalian heart and how this can be applied to adult heart repair. Myocardial infarction was induced by ligation of the left anterior descending coronary artery in fetal (105 days gestation when cardiomyocytes are proliferative) and adolescent sheep (6 mo of age when all cardiomyocytes have switched to an adult phenotype). An ovine gene microarray was used to compare gene expression in sham and infarcted (remote, border and infarct areas) cardiac tissue from fetal and adolescent hearts. The gene response to myocardial infarction was less pronounced in fetal compared with adolescent sheep hearts and there were unique gene responses at each age. There were also region-specific changes in gene expression between each age, in the infarct tissue, tissue bordering the infarct, and tissue remote from the infarction. In total, there were 880 genes that responded to MI uniquely in the adolescent samples compared with 170 genes in the fetal response, as well as 742 overlap genes that showed concordant direction of change responses to infarction at both ages. In response to myocardial infarction, there were specific changes in genes within pathways of mitochondrial oxidation, muscle contraction, and hematopoietic cell lineages, suggesting that the control of energy utilization and immune function are critical for effective heart repair. The more restricted gene response in the fetus may be an important factor in its enhanced capacity for cardiac repair.

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Section: Discussionmentioning

confidence: 99%

Differential gene responses 3 days following infarction in the fetal and adolescent sheep heart

Lock

Tellam

Darby

et al. 2020

Physiological Genomics

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“…In line with this are findings that the degree of complement activation correlates with the severity of heart failure in patients developing cardiogenic shock after acute myocardial infarction. 19 Furthermore, blockade of C5 reduced infarct size and improved cardiac function in an experimental porcine model of severe myocardial infarction. 20 An important factor influencing the reperfusion injury and degree of neurological injury is the duration of hypoxia i.e., the time-to-ROSC.…”

Section: Complement Activationmentioning

confidence: 98%

Complement activation is associated with poor outcome after out-of-hospital cardiac arrest

et al. 2021

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Background: Cardiopulmonary resuscitation after cardiac arrest initiates a whole-body ischemia-reperfusion injury, which may activate the innate immune system, including the complement system. We hypothesized that complement activation and subsequent release of soluble endothelial activation markers were associated with cerebral outcome including death.Methods: Outcome was assessed at six months and defined by cerebral performance category scale (1À2; good outcome, 3À5; poor outcome including death) in 232 resuscitated out-of-hospital cardiac arrest patients. Plasma samples obtained at admission and day three were analysed for complement activation products C3bc, the soluble terminal complement complex (sC5b-9), and soluble CD14. Endothelial cell activation was measured by soluble markers syndecan-1, sE-selectin, thrombomodulin, and vascular cell adhesion molecule.Results: Forty-nine percent of the patients had good outcome. C3bc and sC5b-9 were significantly higher at admission compared to day three (p < 0.001 for both) and in patients with poor compared to good outcome (p = 0.03 and p < 0.001, respectively). Unadjusted, higher sC5b-9 at admission was associated with poor outcome (odds ratio 1.08 (95% CI 1.01À1.14), p = 0.024). Adjusted, sC5b-9 was still associated with outcome, but the association became non-significant when time to return-of-spontaneous-circulation above 25 min was included as a covariate. Endothelial cell activation markers increased from admission to day three, but only sE-selectin and thrombomodulin were significantly higher in patients with poor versus good outcome (p = 0.004 and p = 0.03, respectively) and correlated to sCD14 and sC5b-9/C3bc, respectively.

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“…The coronary revascularization outcome questionnaire for determination of quality (CROQ-PTCA-Post) was used to assess the changes in the QoL of participants before and 6 months after intervention (9). The CROQ-PTCA-Post includes 5 dimensions: symptoms, physical function, cognitive function, psychosocial function, and satisfaction, all of which are scored on a 100-point scale, with a higher the score indicating a higher quality of the corresponding dimension.…”

Section: Qolmentioning

confidence: 99%

Effect analysis of kinetic energy progressive exercise in patients with acute myocardial infarction after percutaneous coronary intervention: a randomized trial

Jiang¹,

Mei²,

Zhang³

et al. 2021

Ann Palliat Med

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Background: Acute myocardial infarction (AMI) is the most common critical illness clinically.Percutaneous coronary intervention (PCI) can help patients with AMI by reopening their blocked blood vessels and improving clinical symptoms. Clinical practice has confirmed that rehabilitation training after PCI could significantly promote the recovery of patients' heart function, reduce cardiovascular events, and have a positive significance for prognosis. This study aimed to explore the effect of kinetic energy progressive exercise (PEKE) applied to patients with AMI after PCI.Methods: From April 2019 to April 2020, a total of 98 patients with AMI after PCI in our hospital were randomly allocated to PEKE group and routine intervention (RI) group. The RI group adopted routine intervention, while the PEKE group introduced PEKE intervention on the basis of the RI group. The incidence of adverse events (AEs), motor function, cardiac function, and quality of life (QoL) before and after intervention were compared between the two groups.Results: Compared with the RI group, the incidence of AEs in the PEKE group was significantly reduced (χ 2 =4.404, P=0.036). After 6 months of intervention, the maximum exercise load and metabolic equivalent of the PEKE group were greater than those of the RI group (t=7.114, 4.565; P=0.000, 0.000). After 6 months of intervention, the left ventricular ejection fraction (LVEF) of the PEKE group was greater than that of the RI group (t=6.826, P=0.000), and there were no significant differences in left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) compared with the RI group (t=1.253, 1.147; P=0.213, 0.254). After 6 months of intervention, the PEKE group's symptoms, physical function, cognitive function, psychosocial function, and satisfaction scores were greater than those in the RI group (t=5.991,

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Acute heart failure following myocardial infarction: complement activation correlates with the severity of heart failure in patients developing cardiogenic shock

Cited by 31 publications

References 53 publications

Differential gene responses 3 days following infarction in the fetal and adolescent sheep heart

Differential gene responses 3 days following infarction in the fetal and adolescent sheep heart

Complement activation is associated with poor outcome after out-of-hospital cardiac arrest

Effect analysis of kinetic energy progressive exercise in patients with acute myocardial infarction after percutaneous coronary intervention: a randomized trial

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