Intracoronary Application of Super-Saturated Oxygen to Reduce Infarct Size Following Myocardial Infarction

Schäfer, Andreas; Akin, Muharrem; Diekmann, Johanna; König, Tobias

doi:10.3390/jcm11061509

Cited by 6 publications

(4 citation statements)

References 49 publications

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“…The 2019 IC-HOT trial demonstrated the feasibility and safety of transfusion of SSO via the left main coronary artery [ 110 ]. Starting in 2021, the TherOx ® device has been routinely used as an adjunctive therapy for myocardial infarction at the Hannover Medical School [ 111 ]. In the same year, the ISO-SHOCK trial, which evaluated the administration of SSO 2 into the coronary arteries of patients with acute myocardial infarction and cardiogenic shock, was initiated with an anticipated completion date of 2025.…”

Section: Cardiac Protection Strategiesmentioning

confidence: 99%

Cardioprotective Strategies After Ischemia–Reperfusion Injury

Zhang,

Hu,

Zhai

et al. 2023

Am J Cardiovasc Drugs

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Acute myocardial infarction (AMI) is associated with high morbidity and mortality worldwide. Although early reperfusion is the most effective strategy to salvage ischemic myocardium, reperfusion injury can develop with the restoration of blood flow. Therefore, it is important to identify protection mechanisms and strategies for the heart after myocardial infarction. Recent studies have shown that multiple intracellular molecules and signaling pathways are involved in cardioprotection. Meanwhile, device-based cardioprotective modalities such as cardiac left ventricular unloading, hypothermia, coronary sinus intervention, supersaturated oxygen (SSO 2 ), and remote ischemic conditioning (RIC) have become important areas of research. Herein, we review the molecular mechanisms of cardioprotection and cardioprotective modalities after ischemia–reperfusion injury (IRI) to identify potential approaches to reduce mortality and improve prognosis in patients with AMI.

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Section: Cardiac Protection Strategiesmentioning

confidence: 99%

Cardioprotective Strategies After Ischemia–Reperfusion Injury

Zhang,

Hu,

Zhai

et al. 2023

Am J Cardiovasc Drugs

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“…One of the major advantages of SSO 2 over other methods for reducing infarct size during acute STEMI treatment in the cath-lab is that it can be started after successful revascularization, without delaying primary PCI. This is in contrast to other methods such as LV unloading by Impella or therapeutic hypothermia, which may require additional steps or procedures that could delay the primary treatment ( Table 1 ) [ 61 ].…”

Section: Cardioprotective Devices That Unload the Heartmentioning

confidence: 99%

The Use of Cardioprotective Devices and Strategies in Patients Undergoing Percutaneous Procedures and Cardiac Surgery

et al. 2023

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In the United States, about one million people are seen to visit the operating theater for cardiac surgery annually. However, nearly half of these visits result in complications such as renal, neurological, and cardiac injury of varying degrees. Historically, many mechanisms and approaches have been explored in attempts to reduce injuries associated with cardiac surgery and percutaneous procedures. Devices such as cardioplegia, mechanical circulatory support, and other methods have shown promising results in managing and preventing life-threatening cardiac-surgery-related outcomes such as heart failure and cardiogenic shock. Comparably, cardioprotective devices such as TandemHeart, Impella family devices, and venoarterial extracorporeal membrane oxygenation (VA-ECMO) have also been proven to show significant cardioprotection through mechanical support. However, their use as interventional agents in the prevention of hemodynamic changes due to cardiac surgery or percutaneous interventions has been correlated with adverse effects. This can lead to a rebound increased risk of mortality in high-risk patients who undergo cardiac surgery. Further research is necessary to delineate and stratify patients into appropriate cardioprotective device groups. Furthermore, the use of one device over another in terms of efficacy remains controversial and further research is necessary to assess device potential in different settings. Clinical research is also needed regarding novel strategies and targets, such as transcutaneous vagus stimulation and supersaturated oxygen therapy, aimed at reducing mortality among high-risk cardiac surgery patients. This review explores the recent advances regarding the use of cardioprotective devices in patients undergoing percutaneous procedures and cardiac surgery.

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“…This may enhance its cardioprotective effects. These therapies are also discussed in this special issue, Interventional Cardiology: Current Challenges in Acute Myocardial Infarction [40]. Studies on combinations of such therapies are necessary in order to clarify this position.…”

Section: The Future Of Therapeutic Hypothermia In Stemimentioning

confidence: 99%

Hypothermia for Cardioprotection in Patients with St-Elevation Myocardial Infarction: Do Not Give It the Cold Shoulder Yet!

Farissi

Mast

Kar

et al. 2022

JCM

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The timely revascularization of an occluded coronary artery is the cornerstone of treatment in patients with ST-elevation myocardial infarction (STEMI). As essential as this treatment is, it can also cause additional damage to cardiomyocytes that were still viable before reperfusion, increasing infarct size. This has been termed “myocardial reperfusion injury”. To date, there is still no effective treatment for myocardial reperfusion injury in patients with STEMI. While numerous attempts have been made to overcome this hurdle with various experimental therapies, the common denominator of these therapies is that, although they often work in the preclinical setting, they fail to demonstrate the same results in human trials. Hypothermia is an example of such a therapy. Although promising results were derived from experimental studies, multiple randomized controlled trials failed to do the same. This review includes a discussion of hypothermia as a potential treatment for myocardial reperfusion injury, including lessons learned from previous (negative) trials, advanced techniques and materials in current hypothermic treatment, and the possible future of hypothermia for cardioprotection in patients with STEMI.

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Intracoronary Application of Super-Saturated Oxygen to Reduce Infarct Size Following Myocardial Infarction

Cited by 6 publications

References 49 publications

Cardioprotective Strategies After Ischemia–Reperfusion Injury

Cardioprotective Strategies After Ischemia–Reperfusion Injury

The Use of Cardioprotective Devices and Strategies in Patients Undergoing Percutaneous Procedures and Cardiac Surgery

Hypothermia for Cardioprotection in Patients with St-Elevation Myocardial Infarction: Do Not Give It the Cold Shoulder Yet!

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