Therapeutic Hypothermia for Cardioprotection in Acute Myocardial Infarction

Kang, In Sook; Ikeno, Fumiaki; Pyun, Wook Bum

doi:10.3349/ymj.2016.57.2.291

Cited by 11 publications

(11 citation statements)

References 61 publications

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“…Improvement of neurological outcome, even delayed hypothermia after return of successful resuscitation is beneficial (5). In contrast, delayed target temperature hypothermia at the time of reperfusion failed to reduce infarct size (IS) in models of myocardial ischemia (6). Additionally, the optimal target temperature after myocardial infarction (MI) is not clear.…”

Section: Introductionmentioning

confidence: 99%

Cardioprotection by very mild hypothermia in mice

Knoop

Naguib

Dannenberg

et al. 2019

Cardiovasc. Diagn. Ther

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Target temperature management is recommended in post-resuscitation care. Additionally, hypothermia is a promising option in adjunctive therapy of acute myocardial infarction (MI). However, first in men data are contradicting. There are still many open questions to identify the optimal regimen and target temperature. In this study, we aimed to investigate the effect of very mild hypothermia on infarct size (IS) in mice. Mice underwent cardiac ischemia by temporary occlusion of the left anterior descending (LAD) artery under conditions of very mild hypothermia (34-36 ℃). Hypothermia was reached within the first 5 minutes of ischemia (temperature: 34.6±0.5 vs. 36.8±1.1 ℃, P=0.035). Very mild hypothermia reduced IS in mice undergoing 30 minutes ischemia [IS/area at risk (AAR): 45±12% vs. 22±4%, P=0.018] as well as mice undergoing 60 minutes ischemia [IS/AAR: 67±7% vs. 28±2%, P=0.0003]. Very mild hypothermia reduces IS. This new approach in adjunctive therapy of patients with acute MI should be investigated in clinical trials.

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Section: Introductionmentioning

confidence: 99%

Cardioprotection by very mild hypothermia in mice

Knoop

Naguib

Dannenberg

et al. 2019

Cardiovasc. Diagn. Ther

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“…15,18 In general, hypothermia causes peripheral vasoconstriction, an increase in blood viscosity and a reduced blood flow, which can ultimately lead to increased thrombogenic potential. 14,[19][20][21] Conversely, therapeutic hypothermia has been shown to reduce hypoxemia and ischemia in a wide range of different settings, such as acute myocardial infarction 22,23 or organ preservation, prior to transplantation. 24 In the context of free-tissue transfer, it remains unclear whether hypothermia results in decreased perfusion, vasospasm, and thrombosis, or exerts protective effects associated with higher rates of flap patency and survival.…”

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confidence: 99%

Impact of Intraoperative Hypothermia on Microsurgical Free Flap Reconstructions

Moellhoff

Broer

Heidekrueger

et al. 2020

J Reconstr Microsurg

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Background Patients requiring microsurgical defect reconstruction are highly susceptible to intraoperative hypothermia, given oftentimes long operative times and exposure of large skin surface areas. While the impact of hypothermia has been extensively studied across various surgical fields, its role in the setting of microsurgical free flap reconstruction remains elusive. This study evaluates the effects of hypothermia on outcomes of free flap reconstructions. Methods Within 7 years, 602 patients underwent 668 microvascular free flap reconstructions. The cases were divided into two groups regarding the minimal core body temperature during free flap surgery: hypothermia (HT; < 36.0°C) versus normothermia (NT; ≥36.0°C). The data were retrospectively screened for patients' demographics, perioperative details, flap survival, surgical complications, and outcomes. Results Our data revealed no significant difference with regard to the rate of major and minor surgical complications, or the rate of revision surgery between both groups (p > 0.05). However, patients in the HT group showed significantly higher rates of total flap loss (6.6% [HT] vs. 3.0% [NT], p < 0.05) and arterial thrombosis (4.6% [HT] vs. 1.9% [NT], p < 0.05). This translated into a significantly longer hospitalization of patients with reduced core body temperature (HT: mean 16.8 days vs. NT: mean 15.1 days; p < 0.05). Conclusion Hypothermia increases the risk for arterial thrombosis and total flap loss. While free flap transfer is feasible also in hypothermic patients, surgeons' awareness of core body temperature should increase. Taken together, we suggest that the mean intraoperative minimum temperature should range between 36 and 36.5°C during free flap surgery as a pragmatic guideline.

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“…Therapeutic hypothermia has been used as a cardioprotective approach in patients with AMI by reducing the infarct size and microvascular resistance. 4 Severe hypothermia may cause ST elevation and lead to misdiagnosis. 5 The hypothermia in the present case might have been a manifestation of hypoperfusion of the peripheral circulation or a pre-shock state caused by the right ventricular and inferior wall AMI, similar to the manifestation of hypovolemic shock.…”

Section: Discussionmentioning

confidence: 99%

Induced by infection? A case of acute myocardial infarction with hypothermia

2019

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A 52-year-old man was admitted to our hospital because of abdominal pain, nausea, and vomiting. On arrival, his body temperature was <35°C. Although his other vital signs and electrocardiographic findings were normal, his white blood cell count and C-reactive protein concentration were elevated. He was diagnosed with severe infectious disease and treated with intravenous antibiotics and rewarming therapy. Two hours later, his body temperature had increased to 38.4°C, but his abdominal pain persisted. A repeat electrocardiographic examination showed an elevated ST-segment in leads II, III, and aVF. He was then diagnosed with ST-elevation myocardial infarction. Coronary angiography showed occlusion of the right coronary artery, and he underwent implantation of two stents. His symptoms were relieved soon thereafter, and his body temperature returned to normal without antibiotics.

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Therapeutic Hypothermia for Cardioprotection in Acute Myocardial Infarction

Cited by 11 publications

References 61 publications

Cardioprotection by very mild hypothermia in mice

Cardioprotection by very mild hypothermia in mice

Impact of Intraoperative Hypothermia on Microsurgical Free Flap Reconstructions

Induced by infection? A case of acute myocardial infarction with hypothermia

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