Mechano-chronotropic Unloading During the Acute Phase of Myocardial Infarction Markedly Reduces Infarct Size via the Suppression of Myocardial Oxygen Consumption

Sunagawa, Genya; Saku, Keita; Arimura, Takashi; Nishikawa, Takuya; Mikami, Hiroshi; Kamada, Kazuhiro; Abe, Kotaro; Kishi, Takuya; Tsutsui, Hiroyuki; Sunagawa, Kenji

doi:10.1007/s12265-018-9809-x

Cited by 16 publications

(10 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among 2048 articles initially screened, 11 studies were selected and pooled in the meta-analysis ( Figure S1 ) [ 5 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. Overall, 142 animals were enrolled, 79 (56%) being adult swine.…”

Section: Resultsmentioning

confidence: 99%

Mechanical Unloading of the Left Ventricle before Coronary Reperfusion in Preclinical Models of Myocardial Infarction without Cardiogenic Shock: A Meta-Analysis

Benenati

Macchione

Giachero

et al. 2022

JCM

View full text Add to dashboard Cite

Aim: to compare a conventional primary reperfusion strategy with a primary unloading approach before reperfusion in preclinical studies. Methods: we performed a meta-analysis of preclinical studies. The primary endpoint was infarct size (IS). Secondary endpoints were left ventricle end-diastolic pressure (LVEDP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO). We calculated mean differences (MDs) and associated 95% confidence intervals (CIs). Sensitivity and subgroup analyses on the primary and secondary endpoints, as well as a meta-regression on the primary endpoint using the year of publication as a covariate, were also conducted. Results: 11 studies (n = 142) were selected and entered in the meta-analysis. Primary unloading reduced IS (MD −28.82, 95% CI −35.78 to −21.86, I2 96%, p < 0.01) and LVEDP (MD −3.88, 95% CI −5.33 to −2.44, I2 56%, p = 0.02) and increased MAP (MD 7.26, 95% CI 1.40 to 13.12, I2 43%, p < 0.01) and HR (MD 5.26, 95% CI 1.97 to 8.55, I2 1%, p < 0.01), while being neutral on CO (MD −0.11, 95% CI −0.95 to 0.72, I2 88%, p = 0.79). Sensitivity and subgroup analyses showed, overall, consistent results. The meta-regression on the primary endpoint demonstrated a significant influence of the year of publication on effect estimate. Conclusions: in animal models of myocardial infarction, a primary unloading significantly reduces IS and exerts beneficial hemodynamic effects compared to a primary reperfusion.

show abstract

Section: Resultsmentioning

confidence: 99%

Mechanical Unloading of the Left Ventricle before Coronary Reperfusion in Preclinical Models of Myocardial Infarction without Cardiogenic Shock: A Meta-Analysis

Benenati

Macchione

Giachero

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…These 26 studies evaluated a total of 488 animals, including 265 subjects assisted with either surgical or percutaneous LVAD. Types of LVAD included trans-valvular pumps in 13 studies (Impella in nine studies [10,[16][17][18][19][20][21][22][23]; Hemopump in four studies [24][25][26][27]); LV-distal arterial bypass in four studies (2 LV-femoral artery [28,29]; 1 LV-carotid artery [30]; and 1 LV-descending aorta [31]), left atrial-femoral artery bypass in five studies [29,[32][33][34] (including one TandemHeart study [35]), left atrial-ascending aorta bypass in one study [36], and right atrial-femoral/subclavian artery bypass in six studies [17,32,37] (3 studies with LV vent [38][39][40]) (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Left Ventricular Assist Devices for Acute Myocardial Infarct Size Reduction: Meta-analysis

Miyashita

Kariya

Yamada

et al. 2020

J. of Cardiovasc. Trans. Res.

View full text Add to dashboard Cite

We conducted a meta-analysis of preclinical studies that tested left ventricular assist device (LVAD) therapy for reducing myocardial infarct size in experimental acute myocardial infarction (AMI). Twenty-six articles were included with a total of 488 experimental animal subjects. The meta-analysis showed that infarct size was significantly decreased by LVAD support compared to control animals (SDM, − 2.19; 95% CI, − 2.70 to − 1.69; P < 0.001). The meta-regression analysis demonstrated a high degree of heterogeneity associated with time from coronary artery occlusion to LVAD support, which correlated positively with infarct size. Subgroup analysis suggested smaller infarct size in LVAD therapies that withdrew blood from left heart than those from right heart. The proportion of left ventricular support relative to total cardiac output was positively correlated with infarct size reduction in Impella studies. Thus, early initiation of LVAD after ischemia and effective left ventricular venting may be important factors to reduce infarct size in AMI.

show abstract

“…Ischemia is the deprivation of blood supply; hence, tissues and the body parts are deprived of oxygen and nutrients ( Hunt et al, 1985 ; Mansfield et al, 1997 ; Madarame et al, 2013 ; Matsubara et al, 2015 ), and ischemia is typically caused by the narrowing or blockage of blood vessels or arteries. Reperfusion is the only intervention that can reliably reduce the infarct size in animals and humans ( Hale et al, 2013 ; Wei et al, 2016 ; Borges and Verdoorn, 2017 ; Misir et al, 2017 ; Sunagawa et al, 2018 ). Several preclinical cell culture and animal testing models are currently available to identify, assess, and prioritize the day-to-day new preventive and therapeutic inventions against I/R injury.…”

Section: Discussionmentioning

confidence: 99%

Chick Embryo: A Preclinical Model for Understanding Ischemia-Reperfusion Mechanism

et al. 2018

View full text Add to dashboard Cite

Ischemia-reperfusion (I/R)-related disorders, such as stroke, myocardial infarction, and peripheral vascular disease, are among the most frequent causes of disease and death. Tissue injury or death may result from the initial ischemic insult, primarily determined by the magnitude and duration of the interruption in blood supply and then by the subsequent reperfusion-induced damage. Various in vitro and in vivo models are currently available to study I/R mechanism in the brain and other tissues. However, thus far, no in ovo I/R model has been reported for understanding the I/R mechanisms and for faster drug screening. Here, we developed an in ovo Hook model of I/R by occluding and releasing the right vitelline artery of a chick embryo at 72 h of development. To validate the model and elucidate various underlying survival and death mechanisms, we employed imaging (Doppler blood flow imaging), biochemical, and blotting techniques and evaluated the cell death mechanism: autophagy and inflammation caused by I/R. In conclusion, the present model is useful in parallel with established in vitro and in vivo I/R models to understand the mechanisms of I/R development and its treatment.

show abstract

Mechano-chronotropic Unloading During the Acute Phase of Myocardial Infarction Markedly Reduces Infarct Size via the Suppression of Myocardial Oxygen Consumption

Cited by 16 publications

References 29 publications

Mechanical Unloading of the Left Ventricle before Coronary Reperfusion in Preclinical Models of Myocardial Infarction without Cardiogenic Shock: A Meta-Analysis

Mechanical Unloading of the Left Ventricle before Coronary Reperfusion in Preclinical Models of Myocardial Infarction without Cardiogenic Shock: A Meta-Analysis

Left Ventricular Assist Devices for Acute Myocardial Infarct Size Reduction: Meta-analysis

Chick Embryo: A Preclinical Model for Understanding Ischemia-Reperfusion Mechanism

Contact Info

Product

Resources

About