Pathological links between stroke and cardiac arrest

Ghanekar, Shaila; Corey, Sydney; Lippert, Trenton; Borlongan, Cesar V.

doi:10.1186/s41016-016-0056-1

Cited by 8 publications

(4 citation statements)

References 29 publications

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“…In general, there is a strong association and comorbidity between stroke and cardiac arrest, with 88% of patients having some form of cardiovascular complication within 4 weeks of an ischemic stroke. 62 Likewise, cardiac interventions, such as transcatheter aortic valve implantation, can cause cerebrovascular complications. 63 We previously used a rat model of ischemic stroke to show that a single dose of Hi1a (2 ng/kg intracerebroventricular) dramatically reduced infarct size and improved neurologic and motor performance even when administered up to 8 hours after stroke onset.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Inhibition of Acid-Sensing Ion Channel 1a Recovers Heart Function After Ischemia–Reperfusion Injury

et al. 2021

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Background: Ischemia-reperfusion injury (IRI) is one of the major risk factors implicated in morbidity and mortality associated with cardiovascular disease. During cardiac ischemia, the build-up of acidic metabolites results in decreased intracellular and extracellular pH that can reach as low as 6.0-6.5. The resulting tissue acidosis exacerbates ischemic injury and significantly impacts cardiac function. Methods: We used genetic and pharmacological methods to investigate the role of acid sensing ion channel 1a (ASIC1a) in cardiac IRI at the cellular and whole organ level. Human induced pluripotent stem cell derived cardiomyocytes (hiPSC-CMs) as well as ex vivo and in vivo models of IRI were used to test the efficacy of ASIC1a inhibitors as pre- and post-conditioning therapeutic agents. Results: Analysis of human complex trait genetics indicate that variants in the ASIC1 genetic locus are significantly associated with cardiac and cerebrovascular ischemic injuries. Using hiPSC-CMs in vitro and murine ex vivo heart models, we demonstrate that genetic ablation of ASIC1a improves cardiomyocyte viability after acute IRI. Therapeutic blockade of ASIC1a using specific and potent pharmacological inhibitors recapitulates this cardioprotective effect. We used an in vivo model of myocardial infarction (MI) and two models of ex vivo donor heart procurement and storage as clinical models to show that ASIC1a inhibition improves post-IRI cardiac viability. Use of ASIC1a inhibitors as pre- or post-conditioning agents provided equivalent cardioprotection to benchmark drugs, including the sodium-hydrogen exchange inhibitor zoniporide. At the cellular and whole organ level, we show that acute exposure to ASIC1a inhibitors has no impact on cardiac ion channels regulating baseline electromechanical coupling and physiological performance. Conclusions: Collectively, our data provide compelling evidence for a novel pharmacological strategy involving ASIC1a blockade as a cardioprotective therapy to improve the viability of hearts subjected to IRI.

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Section: Discussionmentioning

confidence: 99%

Therapeutic Inhibition of Acid-Sensing Ion Channel 1a Recovers Heart Function After Ischemia–Reperfusion Injury

et al. 2021

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“…22 A biological cross-talk involving the brain and the heart is suggested by evidence demonstrating cardiac arrests result in a stroke-like brain pathology in adults. 25 This study offers the possibility of a relationship between cardiac arrest and clinical outcomes in AIS children undergoing cardiac procedure. Hemorrhagic conversion was positively associated with unfavorable outcomes.…”

Section: Discussionmentioning

confidence: 99%

Arterial ischemic stroke in children with congenital heart diseases

Yeh

Kim

et al. 2022

Pediatrics International

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Background: We describe the prevalence, thromboembolic risk factors, and neurologic outcomes in children with congenital heart disease (CHD) and arterial ischemic stroke (AIS). Methods: We retrospectively analyzed the clinical data of children with CHD and AIS from 2000 to 2016. Demographics, procedural and postprocedural data, neuroimaging findings, details of antithrombotic treatment, and neurological status at last follow up were evaluated. Results: Patients with cyanotic CHD accounted for 24 of 30 cases with AIS. The majority of AIS (70%) was procedure related, and the mean time from procedure to diagnosis of stroke was 9.7 (range, 1-30) days. At the time of AIS, 14 (46.7%) patients revealed coexistence of additional thromboembolic causes of AIS. Three patients (10.0%) experienced recurrent AIS and six patients (20.0%) were diagnosed with post-stroke epilepsy. The unfavorable outcomes were found in 13 patients (43.3%), including four deaths. The unfavorable outcome was significantly associated with the main branch involvement of middle cerebral artery (OR = 10.296, 95% CI = 1.335-79.439) and hemorrhagic transformation (OR = 16.264, 95% CI = 1. 359-194.690). Conclusions: Additional thromboembolic risk factors such as systemic or cardiac thrombus, arrhythmia, and surgical procedures for cyanotic CHD were found in patients with CHD and AIS. The main branch involvement of middle cerebral artery and hemorrhagic transformation were significant predictors of unfavorable outcomes. Further studies are required to identify the target for stroke prevention and develop better prophylactic strategies to minimize AIS in patients with CHD.

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“…A possible cause is the increased rate of infections in patients without COPD, including postoperative infections, that is known to increase the risk of strokes 39 . Another hypothesis might be the increased incidence of cardiac arrest in the group without COPD, that also tends to increase the risk of strokes 40 . The combination of these findings plus other factors that might play a role in strokes, may lead to an increased rate of stroke in patients without COPD.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the impact of chronic obstructive pulmonary disease on in‐hospital outcomes following left ventricular assist device implantation

et al. 2020

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Background: Chronic obstructive pulmonary disease (COPD) is a cause of ventricular dysfunction. However, in the setting of patients with heart failure undergoing left ventricular assist device (LVAD) implantation, there is a paucity of data on the association between COPD and in-hospital outcomes. Methods and Results: Retrospective cohort study based on the NIS including patients ≥18 years who underwent LVAD implantation from 2011 to 2017. Multivariate regression was used to evaluate the impact of COPD on in-hospital outcomes. A total of 25,503 patients underwent LVAD implantation, of which 13.8% also had COPD. COPD group was older (median 62 vs. 58 years), and more males (82% vs. 76.4%, p < .001 for both). COPD group had more hypertension, diabetes, atrial tachyarrhythmias, dyslipidemia, prior stroke, coronary artery diseases, pulmonary hypertension, and chronic kidney disease (p < .001 for all). No differences in strokes, infections, mechanical circulatory support, and LVAD thrombosis. There was a higher incident of inpatient acute kidney injury, major bleeding, cardiac complications, thromboembolism, and cardiac arrest in patients without COPD (p < .05 for all). Compared with no-COPD group, COPD group had a lower mortality (6.2% vs. 12.4%; odds ratio, 0.59; confidence interval, 0.512-0.685; p < .05). Conclusion: Patients with COPD undergoing LVAD implantation have more comorbidities, without an associated increase mortality.

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Pathological links between stroke and cardiac arrest

Cited by 8 publications

References 29 publications

Therapeutic Inhibition of Acid-Sensing Ion Channel 1a Recovers Heart Function After Ischemia–Reperfusion Injury

Therapeutic Inhibition of Acid-Sensing Ion Channel 1a Recovers Heart Function After Ischemia–Reperfusion Injury

Arterial ischemic stroke in children with congenital heart diseases

Evaluating the impact of chronic obstructive pulmonary disease on in‐hospital outcomes following left ventricular assist device implantation

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