Effect of ischemic postconditioning on microvascular obstruction in reperfused myocardial infarction. Results of a randomized study in patients and of an experimental model in swine

Bodı́, Vicente; Ruiz-Nodar, Juan M.; Feliu, Eloísa; Miñana, Gema; Núñez, Julio; Hüsser, Oliver; Martinez-Elvira, J.M.; Ruı́z, Amparo; Bonanad, Clara; Monmeneu, José V.; López‐Lereu, María P.; Forteza, María J.; Dios, Elena de; Hervas, Arantxa; Moratal, David; Gómez, Cristina; Mainar, Luis; Sanchís, Juan; Mainar, Vicente; Valencia, José; Díaz, Ana; Noguera, Inmaculada; Chaustre, Fabian; Chorro, Francisco J.

doi:10.1016/j.ijcard.2014.05.003

Cited by 33 publications

(27 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The early identification of post-reperfusion microvascular dysfunction and impaired myocardial deformation may help in tailoring appropriate pharmacological interventions in patients with reduced global strain, who would otherwise have low likelihood to retain contractile function and higher risk for congestive heart failure in the long run. Thus, the assessment of myocardial deformation may help to identify patients, who would benefit from rescue PCI after unsuccessful thrombolysis and from aggressive medical therapy including the early and high-dose administration of ACE-and aldosterone-inhibitors or future approaches aiming at reduction of infarct size and left ventricular remodeling [40,41].…”

Section: Discussionmentioning

confidence: 99%

Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement

Buss

Krautz

Hofmann

et al. 2015

International Journal of Cardiology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement

Buss

Krautz

Hofmann

et al. 2015

International Journal of Cardiology

View full text Add to dashboard Cite

“…Another group of domestic male pigs that had been treated with saline (10 mL/body) or pitavastatin-NP (PLGA containing 16 mg of pitavastatin in saline; 10 mL/body) were reperfused for 2 hours (S2C Fig), and 4% thioflavin S (Sigma-Aldrich) was injected into the left coronary artery via a 7-Fr catheter[27]. Then, the pigs were euthanized, and the hearts were excised.…”

Section: Methodsmentioning

confidence: 99%

A Translational Study of a New Therapeutic Approach for Acute Myocardial Infarction: Nanoparticle-Mediated Delivery of Pitavastatin into Reperfused Myocardium Reduces Ischemia-Reperfusion Injury in a Preclinical Porcine Model

et al. 2016

View full text Add to dashboard Cite

BackgroundThere is an unmet need to develop an innovative cardioprotective modality for acute myocardial infarction, for which interventional reperfusion therapy is hampered by ischemia-reperfusion (IR) injury. We recently reported that bioabsorbable poly(lactic acid/glycolic acid) (PLGA) nanoparticle-mediated treatment with pitavastatin (pitavastatin-NP) exerts a cardioprotective effect in a rat IR injury model by activating the PI3K-Akt pathway and inhibiting inflammation. To obtain preclinical proof-of-concept evidence, in this study, we examined the effect of pitavastatin-NP on myocardial IR injury in conscious and anesthetized pig models.Methods and ResultsEighty-four Bama mini-pigs were surgically implanted with a pneumatic cuff occluder at the left circumflex coronary artery (LCx) and telemetry transmitters to continuously monitor electrocardiogram as well as to monitor arterial blood pressure and heart rate. The LCx was occluded for 60 minutes, followed by 24 hours of reperfusion under conscious conditions. Intravenous administration of pitavastatin-NP containing ≥ 8 mg/body of pitavastatin 5 minutes before reperfusion significantly reduced infarct size; by contrast, pitavastatin alone (8 mg/body) showed no therapeutic effects. Pitavastatin-NP produced anti-apoptotic effects on cultured cardiomyocytes in vitro. Cardiac magnetic resonance imaging performed 4 weeks after IR injury revealed that pitavastatin-NP reduced the extent of left ventricle remodeling. Importantly, pitavastatin-NP exerted no significant effects on blood pressure, heart rate, or serum biochemistry. Exploratory examinations in anesthetized pigs showed pharmacokinetic analysis and the effects of pitavastatin-NP on no-reflow phenomenon.ConclusionsNP-mediated delivery of pitavastatin to IR-injured myocardium exerts cardioprotective effects on IR injury without apparent adverse side effects in a preclinical conscious pig model. Thus, pitavastatin-NP represents a novel therapeutic modality for IR injury in acute myocardial infarction.

show abstract

“…Neither the reduction of infarct size nor the reduction of no-reflow with ischemic postconditioning was confirmed in a rabbit model, 152 and noreflow reduction by ischemic postconditioning was also not confirmed in pigs. 153,154 In a mini-pig model of 3 hours of coronary occlusion/reperfusion, ischemic postconditioning with 6 cycles of 10-second reocclusion/10-second reperfusion reduced infarct size and area of no-reflow, but hypercholesterolemia abrogated the protection by ischemic postconditioning. 155 In patients with reperfused acute myocardial infarction, ischemic postconditioning protocols reduced infarct size, 47,[156][157][158][159][160][161][162][163][164] improved coronary blood flow 47,156,160,161,164 and coronary flow reserve, 159 and reduced edema and no-reflow.…”

Section: Coronary Vascular Protection By Ischemic Postconditioningmentioning

confidence: 99%

The Coronary Circulation as a Target of Cardioprotection

Heusch

2016

Circulation Research

209

160

View full text Add to dashboard Cite

Abstract:The atherosclerotic coronary vasculature is not only the culprit but also a victim of myocardial ischemia/ reperfusion injury. Manifestations of such injury are increased vascular permeability and edema, endothelial dysfunction and impaired vasomotion, microembolization of atherothrombotic debris, stasis with intravascular cell aggregates, and finally, in its most severe form, capillary destruction with hemorrhage. In animal experiments, local and remote ischemic pre-and postconditioning not only reduce infarct size but also these manifestations of coronary vascular injury, as do drugs which recruit signal transduction steps of conditioning. Clinically, no-reflow is frequently seen after interventional reperfusion, and it carries an adverse prognosis. The translation of cardioprotective interventions to clinical practice has been difficult to date. Only 4 drugs (brain natriuretic peptide, exenatide, metoprolol, and esmolol) stand unchallenged to date in reducing infarct size in patients with reperfused acute myocardial infarction; unfortunately, for these drugs, no information on their impact on the ischemic/reperfused coronary circulation is available. (Circ Res.

show abstract

Effect of ischemic postconditioning on microvascular obstruction in reperfused myocardial infarction. Results of a randomized study in patients and of an experimental model in swine

Cited by 33 publications

References 24 publications

Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement

Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement

A Translational Study of a New Therapeutic Approach for Acute Myocardial Infarction: Nanoparticle-Mediated Delivery of Pitavastatin into Reperfused Myocardium Reduces Ischemia-Reperfusion Injury in a Preclinical Porcine Model

The Coronary Circulation as a Target of Cardioprotection

Contact Info

Product

Resources

About