1
|
Guo F, Han X, You Y, Xu SJ, Zhang YH, Chen YY, Xin GJ, Liu ZX, Ren JG, Cao C, Li LM, Fu JH. Hydroxysafflor Yellow A Inhibits Pyroptosis and Protecting HUVECs from OGD/R via NLRP3/Caspase-1/GSDMD Pathway. Chin J Integr Med 2024:10.1007/s11655-023-3716-y. [PMID: 38319525 DOI: 10.1007/s11655-023-3716-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To observe the protective effect and mechanism of hydroxyl safflower yellow A (HSYA) from myocardial ischemia-reperfusion injury on human umbilical vein endothelial cells (HUVECs). METHODS HUVECs were treated with oxygen-glucose deprivation reperfusion (OGD/R) to simulate the ischemia reperfusion model, and cell counting kit-8 was used to detect the protective effect of different concentrations (1.25-160 µ mol/L) of HSYA on HUVECs after OGD/R. HSYA 80 µ mol/L was used for follow-up experiments. The contents of inflammatory cytokines interleukin (IL)-18, IL-1 β, monocyte chemotactic protein 1 (MCP-1), tumor necrosis factor α (TNF-α) and IL-6 before and after administration were measured by enzyme-linked immunosorbent assay. The protein expressions of toll-like receptor, NOD-like receptor containing pyrin domain 3 (NLRP3), gasdermin D (GSDMD) and GSDMD-N-terminal domain (GSDMD-N) before and after administration were detected by Western blot. NLRP3 inflammasome inhibitor cytokine release inhibitory drug 3 sodium salt (CRID3 sodium salt, also known as MCC950) and agonist were added, and the changes of NLRP3, cysteine-aspartic acid protease 1 (Caspase-1), GSDMD and GSDMD-N protein expressions were detected by Western blot. RESULTS HSYA inhibited OGD/R-induced inflammation and significantly decreased the contents of inflammatory cytokines IL-18, IL-1 β, MCP-1, TNF-α and IL-6 (P<0.01 or P<0.05). At the same time, by inhibiting NLRP3/Caspase-1/GSDMD pathway, HSYA can reduce the occurrence of pyroptosis after OGD/R and reduce the expression of NLRP3, Caspase-1, GSDMD and GSDMD-N proteins (P<0.01). CONCLUSIONS The protective effect of HSYA on HUVECs after OGD/R is related to down-regulating the expression of NLRP3 inflammasome and inhibiting pyroptosis.
Collapse
Affiliation(s)
- Fan Guo
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Xiao Han
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Yue You
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Shu-Juan Xu
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Ye-Hao Zhang
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Yuan-Yuan Chen
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Gao-Jie Xin
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Zi-Xin Liu
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Jun-Guo Ren
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Ce Cao
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| | - Ling-Mei Li
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China.
- Department of Central Laboratory, Kunshan Hospital of Chinese Medicine, Kunshan, Jiangsu Province, 215300, China.
| | - Jian-Hua Fu
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Chinese Materia Pharmacology, Beijing, 100091, China
| |
Collapse
|
2
|
SUN Q, CHENG K, DAI X, YANG Z, WU X, XU C, QIU X, GAO X, LIU D, YANG Q. Effect of electroacupuncture at Neiguan (PC6) at different time points on myocardial ischemia reperfusion arrhythmia in rats. J TRADIT CHIN MED 2024; 44:113-121. [PMID: 38213246 PMCID: PMC10774726 DOI: 10.19852/j.cnki.jtcm.20231110.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/17/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE To observe the effects of electroacupuncture at Neiguan (PC6) at different time points on reperfusion arrhythmia (RA) after myocardial ischemia and reperfusion in rats, and to investigate the correlation of this protective effect with nerve growth factor (NGF), tyrosine kinase A (TrkA), tyrosine hydroxylase (TH), and norepinephrine (NE). METHODS:A total of 72 Sprague-Dawley male rats were randomly divided into six groups (n = 12 rats/group): normal group (Norm), sham operation group (Sham), ischemia reperfusion group (I/R), pre-ischemic electroacupuncture group (EAI), pre-reperfusion electroacupuncture group (EAII), post-reperfusion electroacupuncture group (EAIII). The myocardial ischemia-reperfusion injury (MIRI) model was induced by occlusion of left anterior descending coronary artery for 20 min followed by reperfusion for 40 min in rats. With no intervention in the Norm group and only threading without ligation in the Sham group. Electroacupuncture pre-treatment at 20 min/d for 7 d before ligation in the EAⅠ group, 20 min of electroacupuncture before reperfusion in the EAII group and 20 min of electroacupuncture after reperfusion in the EAIII group. The electrocardiogram (ECG) of each group was recorded throughout the whole process, and the success of the MIRI model was determined based on the changs of J-point and T-wave in the ECG. The arrhythmia score was used to record premature ventricular contractions, ventricular tachycardia and ventricular fibrillation during the reperfusion period to assess the reperfusion induced arrhythmias. The expression levels of NGF, TrkA, TH protein were measured by Western blot. Moreover, the expression levels of plasma and myocardial NE levels were detected by enzyme linked immunosorbent assay. RESULTS The differences between Norm group and Sham group were not statistically significant in all indexes. Arrhythmia score, myocardial NGF, TrkA, TH, and NE expression were significantly higher in the I/R group compared with the Sham group. Arrhythmia score, myocardial NGF, TrkA, TH, and NE expression were significantly lower in each EA group compared with the I/R group. CONCLUSION Electroacupuncture at Neiguan (PC6) at different time points can reduce the incidence and severity of reperfusion arrhythmias in rats. This protective effect is related to electroacupuncture regulating NGF, TrkA, TH, NE expression and reducing sympathetic hyperactivation.
Collapse
Affiliation(s)
- Qianhui SUN
- 1 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Kai CHENG
- 2 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xingye DAI
- 1 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Zhiwen YANG
- 1 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xiaoling WU
- 1 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Chang XU
- 1 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xinghua QIU
- 1 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xiaofeng GAO
- 3 Beijing MedEx Technology Co., Ltd., Beijing 100029, China
| | - Daonan LIU
- 1 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Qirui YANG
- 1 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| |
Collapse
|
3
|
Pan SS, Wang F, Hui YP, Chen KY, Zhou L, Gao WL, Wu HK, Zhang DS, Yang SY, Hu XY, Liang GY. Insulin reduces pyroptosis-induced inflammation by PDHA1 dephosphorylation-mediated NLRP3 activation during myocardial ischemia-reperfusion injury. Perfusion 2023; 38:1277-1287. [PMID: 35506656 DOI: 10.1177/02676591221099807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous studies proved that pyrin domain-containing protein 3 (NLRP3)-induced pyroptosis plays an important role in Myocardial ischemia-reperfusion injury (MIRI). Insulin can inhibit the activation of NLRP3 inflammasome, although the exact mechanism remains unclear. The aim of this study was to determine whether insulin reduces NLRP3-induced pyroptosis by regulating pyruvate dehydrogenase E1alpha subunit (PDHA1) dephosphorylation during MIRI. METHODS Rat hearts were subject to 30 min global ischemia followed by 60 min reperfusion, with or without 0.5 IU/L insulin. Myocardial ischemia-reperfusion injury was evaluated by measuring myocardial enzymes release, Cardiac hemodynamics, pathological changes, infarct size, and apoptosis rate. Cardiac aerobic glycolysis was evaluated by measuring ATP, lactic acid content, and pyruvate dehydrogenase complex (PDHc) activity in myocardial tissue. Recombinant adenoviral vectors for PDHA1 knockdown were constructed. Pyroptosis-related proteins were measured by Western blotting analysis, immunohistochemistry staining, and ELISA assay, respectively. RESULTS It was found that insulin significantly reduced the area of myocardial infarction, apoptosis rate, and improved cardiac hemodynamics, pathological changes, energy metabolism. Insulin inhibits pyroptosis-induced inflammation during MIRI. Subsequently, Adeno-associated virus was used to knock down cardiac PDHA1 expression. Knockdown PDHA1 not only promoted the expression of NLRP3 but also blocked the inhibitory effect of insulin on NLRP3-mediated pyroptosis in MIRI. CONCLUSIONS Results suggest that insulin protects against MIRI by regulating PDHA1 dephosphorylation, its mechanism is not only to improve myocardial energy metabolism but also to reduce the NLRP3-induced pyroptosis.
Collapse
Affiliation(s)
- Si-Si Pan
- Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
- Translational Medicine Research Center, Guizhou Medical University, Guizhou, China
| | - Feng Wang
- Translational Medicine Research Center, Guizhou Medical University, Guizhou, China
| | - Yong-Peng Hui
- Translational Medicine Research Center, Guizhou Medical University, Guizhou, China
| | - Kai-Yuan Chen
- Translational Medicine Research Center, Guizhou Medical University, Guizhou, China
| | - Liu Zhou
- Translational Medicine Research Center, Guizhou Medical University, Guizhou, China
| | - Wei-Long Gao
- Translational Medicine Research Center, Guizhou Medical University, Guizhou, China
| | - Hong-Kun Wu
- Translational Medicine Research Center, Guizhou Medical University, Guizhou, China
| | - Deng-Sheng Zhang
- Cardiovascular Surgery, The Affiliated Hospital of Zunyi Medical University, Guizhou, China
| | - Si-Yuang Yang
- Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Xuan-Yi Hu
- Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Gui-You Liang
- Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
- Translational Medicine Research Center, Guizhou Medical University, Guizhou, China
| |
Collapse
|
4
|
Wang T, Liu J, Hu C, Wei X, Han L, Zhu A, Wang R, Chen Z, Xia Z, Yao S, Mao W. Downregulation of cardiac PIASy inhibits Cx43 SUMOylation and ameliorates ventricular arrhythmias in a rat model of myocardial ischemia/reperfusion injury. Chin Med J (Engl) 2023; 136:1349-1357. [PMID: 37014755 PMCID: PMC10309519 DOI: 10.1097/cm9.0000000000002618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Dysfunction of the gap junction channel protein connexin 43 (Cx43) contributes to myocardial ischemia/reperfusion (I/R)-induced ventricular arrhythmias. Cx43 can be regulated by small ubiquitin-like modifier (SUMO) modification. Protein inhibitor of activated STAT Y (PIASy) is an E3 SUMO ligase for its target proteins. However, whether Cx43 is a target protein of PIASy and whether Cx43 SUMOylation plays a role in I/R-induced arrhythmias are largely unknown. METHODS Male Sprague-Dawley rats were infected with PIASy short hairpin ribonucleic acid (shRNA) using recombinant adeno-associated virus subtype 9 (rAAV9). Two weeks later, the rats were subjected to 45 min of left coronary artery occlusion followed by 2 h reperfusion. Electrocardiogram was recorded to assess arrhythmias. Rat ventricular tissues were collected for molecular biological measurements. RESULTS Following 45 min of ischemia, QRS duration and QTc intervals statistically significantly increased, but these values decreased after transfecting PIASy shRNA. PIASy downregulation ameliorated ventricular arrhythmias induced by myocardial I/R, as evidenced by the decreased incidence of ventricular tachycardia and ventricular fibrillation, and reduced arrythmia score. In addition, myocardial I/R statistically significantly induced PIASy expression and Cx43 SUMOylation, accompanied by reduced Cx43 phosphorylation and plakophilin 2 (PKP2) expression. Moreover, PIASy downregulation remarkably reduced Cx43 SUMOylation, accompanied by increased Cx43 phosphorylation and PKP2 expression after I/R. CONCLUSION PIASy downregulation inhibited Cx43 SUMOylation and increased PKP2 expression, thereby improving ventricular arrhythmias in ischemic/reperfused rats heart.
Collapse
Affiliation(s)
- Tingting Wang
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Jinmin Liu
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Department of Anesthesiology, Wuhan No. 1 Hospital, Wuhan, Hubei 430022, China
| | - Chenchen Hu
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Xin Wei
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Linlin Han
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Afang Zhu
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Rong Wang
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Zhijun Chen
- Department of Anesthesiology, Wuhan No. 1 Hospital, Wuhan, Hubei 430022, China
| | - Zhengyuan Xia
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Shanglong Yao
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Weike Mao
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| |
Collapse
|
5
|
Liu G, Liu Q, Wan N, Shen X, Cui H, Dong C, Zhang X, Yin H, Wang J, Funk CD, Yu Y. Cardioprotection by Peroxidase Activity of Prostaglandin H Synthases in Ischemia/Reperfusion Injury. Circulation 2023; 147:1467-1470. [PMID: 37155589 DOI: 10.1161/circulationaha.122.061145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- Guizhu Liu
- Department of Pharmacology, Tianjin Key Laboratory of Inflammatory Biology, Center for Cardiovascular Diseases, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, School of Basic Medical Sciences, Tianjin Medical University, China (G.L., Q.L., X.Z., Y.Y.)
- Wuxi School of Medicine, Jiangnan University, Jiangsu, China (G.L.)
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (G.L., J.W.)
| | - Qian Liu
- Department of Pharmacology, Tianjin Key Laboratory of Inflammatory Biology, Center for Cardiovascular Diseases, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, School of Basic Medical Sciences, Tianjin Medical University, China (G.L., Q.L., X.Z., Y.Y.)
| | | | - Xia Shen
- School of Life Science and Technology, Shanghai Tech University, China (X.S., H.C., H.Y.)
| | - Hui Cui
- School of Life Science and Technology, Shanghai Tech University, China (X.S., H.C., H.Y.)
| | - Cheng Dong
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Tianjin Medical University, China (C.D.)
| | - Xu Zhang
- Department of Pharmacology, Tianjin Key Laboratory of Inflammatory Biology, Center for Cardiovascular Diseases, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, School of Basic Medical Sciences, Tianjin Medical University, China (G.L., Q.L., X.Z., Y.Y.)
| | - Huiyong Yin
- School of Life Science and Technology, Shanghai Tech University, China (X.S., H.C., H.Y.)
- Chinese Academy of Sciences Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, Innovation Center for Intervention of Chronic Disease and Promotion of Health, Chinese Academy of Sciences, China (H.Y.)
- Department of Biomedical Sciences, City University of Hong Kong, China (H.Y.)
| | - Jian Wang
- Department of Vascular and Cardiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, China (N.W.)
| | - Colin D Funk
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada (C.D.F.)
| | - Ying Yu
- Department of Pharmacology, Tianjin Key Laboratory of Inflammatory Biology, Center for Cardiovascular Diseases, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, School of Basic Medical Sciences, Tianjin Medical University, China (G.L., Q.L., X.Z., Y.Y.)
| |
Collapse
|
6
|
Ilyas M, Noor M, Khan HS, Haroon S, Farhat K, Ali S. Cardio protective effect of nicorandil in reperfusion injury among patients undergoing primary percutaneous coronary intervention. Pak J Med Sci 2023; 39:177-181. [PMID: 36694786 PMCID: PMC9842976 DOI: 10.12669/pjms.39.1.6034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 10/05/2022] [Accepted: 10/26/2022] [Indexed: 11/14/2022] Open
Abstract
Objectives To evaluate the effect of nicorandil in prevention of reperfusion injury during primary percutaneous coronary intervention by thrombolysis in myocardial infarction flow grade scoring. Methods A total of 140 patients from Rawalpindi Institute of Cardiology were enrolled in this study conducted from 7th September to 10th of October 2021. These participants were allocated into two major groups. Control group received conventional acute coronary syndrome protocol regimen only whereas experimental group was given nicorandil along with conventional acute coronary syndrome protocol. During primary percutaneous coronary intervention, thrombolysis in myocardial infarction flow grade scoring was analyzed and compared. Results Majority of participants in nicorandil group achieved thrombolysis in myocardial infarction Grade-3 scoring which indicated reduced rate of no reflow phenomenon as compared to control group. A statistically significant difference was noted in score of both groups (p value = 0.001) signifying prophylactic use of nicorandil before primary percutaneous coronary intervention along with conventional acute coronary syndrome protocol is superior to only conventional acute coronary syndrome protocol regimen to cases in the control group. Conclusion Use of nicorandil in ST elevated myocardial infarction patients before primary percutaneous coronary intervention prevents reperfusion injury thus decreasing the risk of post percutaneous coronary intervention complications and reducing mortality rate in cardiac patients suggesting its significant cardio protective role.
Collapse
Affiliation(s)
- Maria Ilyas
- Dr. Maria Ilyas, MBBS., Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Mudassar Noor
- Dr. Mudassar Noor, Associate Professor of Pharmacology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Hamid Sharif Khan
- Dr. Hamid Sharif Khan, Assistant Professor of Cardiology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan
| | - Sauleha Haroon
- Dr. Sauleha Haroon, Senior Registrar of Cardiology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan
| | - Kulsoom Farhat
- Dr. Kulsoom Farhat, Professor of Pharmacology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Shabana Ali
- Dr. Shabana Ali, Assistant Professor of Pharmacology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| |
Collapse
|
7
|
Maadani M, Sarraf NS, Alilou S, Aeinfar K, Sadeghipour P, Zahedmehr A, Fathollahi MS, Hashemi Ghadi SI, Zavarehee A, Zolfaghari M, Zolfaghari R. Relationship Between Preprocedural Lipid Levels and Periprocedural Myocardial Injury in Patients Undergoing Elective Percutaneous Coronary Intervention. Tex Heart Inst J 2022; 49:488444. [PMID: 36515930 PMCID: PMC9809085 DOI: 10.14503/thij-20-7384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Periprocedural myocardial injury is a predictor of cardiovascular morbidity and mortality after percutaneous coronary intervention. METHODS The authors examined the effects of preprocedural lipid levels (low-density lipoprotein, high-density lipoprotein, and triglycerides) in 977 patients with coronary artery disease who underwent elective percutaneous coronary intervention. RESULTS Elevated cardiac troponin I level (≥5× the upper limit of normal) was used to indicate periprocedural myocardial injury. Serum lipid samples were collected 12 hours preprocedurally. Cardiac troponin I was collected 1, 6, and 12 hours postprocedurally. Correlations between preprocedural lipid levels and postprocedural cardiac troponin I were studied. Low-density lipoprotein levels were less than 70 mg/dL in 70% of patients and greater than 100 mg/dL in only 7.4% of patients; 13% had triglyceride levels greater than or equal to 150 mg/dL, and 96% had high-density lipoprotein levels less than 40 mg/dL. Patients with elevated cardiac troponin I had significantly lower left ventricular ejection fraction than did those with cardiac troponin I levels less than 5× the upper limit of normal (P = .01). Double-and triple-vessel disease were more common in patients with elevated cardiac troponin I (P < .002). Multivariable logistic and linear regression analyses revealed no statistically significant associations between lipid levels and postprocedural cardiac troponin I elevation, possibly because such large proportions of included patients had low levels of low-density lipoprotein (70%) and a history of statin intake (86%). CONCLUSION The authors found no association between lipid profile and periprocedural myocardial injury.
Collapse
Affiliation(s)
- Mohsen Maadani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Sari Sarraf
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sanam Alilou
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Kamran Aeinfar
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmood Sheikh Fathollahi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyyed Isa Hashemi Ghadi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Zavarehee
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Zolfaghari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Zolfaghari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
WEI X, LI L, ZHANG Y, SHU Q, WANG S, CHEN P, HU L, YU Q, CAI R. Electroacupuncture preconditioning alleviates myocardial ischemia-reperfusion injury through the hypothalamic paraventricular nucleus- interposed nucleus nerve pathway. J TRADIT CHIN MED 2022; 42:379-388. [PMID: 35610007 PMCID: PMC9924790 DOI: 10.19852/j.cnki.jtcm.2022.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
OBJECTIVE To explore whether the paraventricular nucleus (PVN) participates in regulation of the anti-myocardial ischemia-reperfusion injury (MIRI) effect of electroacupuncture (EA) and whether this is achieved through the PVN-interposed nucleus (IN) neural pathway. METHODS The modeling method of myocardial ischemia reperfusion injury was achieved by ligating the left anterior descending coronary artery in Sprague-Dawley rats. We used the Powerlab multi-channel physiological recorder system to record electro-cardiograms and analyze the changes in ST segment displacement; 2,3,5-Triphenyltetrazolium chloride staining was used to observe the percentage of myocardial infarction areas. Detecting cardiac troponin I (cTnI), lactate dehydrogenase (LDH) in serum was done with an enzyme-linked immunosorbent assay kit. Morphological changes in the myocardium were detected in each group with hematoxylin-eosin staining of paraffin sections. Detection of c-fos protein expression in the PVN of the hypothalamus was done with the immune-ofluorescence method. The Plexon multi-channel acquisition system recorded PVN neuron discharges and local field potentials in each group of rats. Offline Sorter software was used for cluster analysis. Neuro Explorer software was used to perform autocorrelation, raster and frequency characteristics and spectral energy analysis of neuron signals in each group. RESULTS Compared with the MIRI model group, the areas of myocardial infarction in the EA group were significantly reduced; the expression of cTnI, LDH in serum was decreased significantly. The firing frequency of pyramidal cells in the PVN was significantly increased and the spectrum energy map showed energy was reduced, c-fos expression in PVN was reduced, this indicated that neuronal activity in the PVN participates in the effect of EA improving myocardial injury. In addition, we used the kainic acid method to lesion the IN and observed that the effect of EA was weakened. For example, the area of myocardial infarction of lesion IN + EA group in rats was significantly increased compared with that resulting from EA group, the expression of cTnI, LDH in serum was significantly increased, the firing frequency of pyramidal cells in the PVN was significantly reduced. A spectral energy diagram shows that the energy after damage was higher than that of EA group. At the same time, the expression of c-fos in the PVN increased again. CONCLUSION Our results indicated that the PVN-IN nerve pathway may participate as an effective pathway of EA to improve the effect of myocardial injury.
Collapse
Affiliation(s)
- Xiaotong WEI
- 1 Graduate School of Anhui University of Chinese Medicine, Hefei 230012, China
| | - Liaoyuan LI
- 1 Graduate School of Anhui University of Chinese Medicine, Hefei 230012, China
| | - Yating ZHANG
- 1 Graduate School of Anhui University of Chinese Medicine, Hefei 230012, China
| | - Qi SHU
- 1 Graduate School of Anhui University of Chinese Medicine, Hefei 230012, China
| | - Shuaiya WANG
- 1 Graduate School of Anhui University of Chinese Medicine, Hefei 230012, China
| | - Pianpian CHEN
- 1 Graduate School of Anhui University of Chinese Medicine, Hefei 230012, China
| | - Ling HU
- 2 Institute of Acupuncture and Meridian, Anhui University of Chinese Medicine, Hefei 230012, China
- 3 Key Laboratory of Acupuncture and Moxibustion Fundamentals and Techniques of Anhui Province, Anhui University of Chinese Medicine, Hefei 230038, China
| | - Qing YU
- 2 Institute of Acupuncture and Meridian, Anhui University of Chinese Medicine, Hefei 230012, China
- 3 Key Laboratory of Acupuncture and Moxibustion Fundamentals and Techniques of Anhui Province, Anhui University of Chinese Medicine, Hefei 230038, China
- Prof. CAI Ronglin, Institute of Acupuncture and Meridian, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Ronglin CAI
- 2 Institute of Acupuncture and Meridian, Anhui University of Chinese Medicine, Hefei 230012, China
- 3 Key Laboratory of Acupuncture and Moxibustion Fundamentals and Techniques of Anhui Province, Anhui University of Chinese Medicine, Hefei 230038, China
- Prof. CAI Ronglin, Institute of Acupuncture and Meridian, Anhui University of Chinese Medicine, Hefei 230012, China.
| |
Collapse
|
9
|
El Farissi M, Buscone S, Bax NAM, van Rijswijk JW, Veenendaal T, Keulards DCJ, Zelis JM, van Tuijl S, Eerdekens R, Demandt J, Vervaat F, Zimmermann FM, Bouwmeester S, Rave Y, Zhu KS, Conrad C, van 't Veer M, Pijls NHJ, Klumperman J, Bouten CVC, Otterspoor LC. Ultrastructural Characteristics of Myocardial Reperfusion Injury and Effect of Selective Intracoronary Hypothermia: An Observational Study in Isolated Beating Porcine Hearts. Ther Hypothermia Temp Manag 2021; 12:129-137. [PMID: 34847796 DOI: 10.1089/ther.2021.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
In acute myocardial infarction (AMI), myocardial reperfusion injury may undo part of the recovery after revascularization of the occluded coronary artery. Selective intracoronary hypothermia is a novel method aimed at reducing myocardial reperfusion injury, but its presumed protective effects in AMI still await further elucidation. This proof-of-concept study assesses the potential protective effects of selective intracoronary hypothermia in an ex-vivo, isolated beating heart model of AMI. In four isolated Langendorff perfused beating pig hearts, an anterior wall myocardial infarction was created by inflating a balloon in the mid segment of the left anterior descending (LAD) artery. After one hour, two hearts were treated with selective intracoronary hypothermia followed by normal reperfusion (cooled hearts). In the other two hearts, the balloon was deflated after one hour, allowing normal reperfusion (control hearts). Biopsies for histologic and electron microscopic evaluation were taken from the myocardium at risk at different time points: before occlusion (t = BO); 5 minutes before reperfusion (t = BR); and 10 minutes after reperfusion (t = AR). Electron microscopic analysis was performed to evaluate the condition of the mitochondria. Histological analyses included evaluation of sarcomeric collapse and intramyocardial hematoma. Electron microscopic analysis revealed intact mitochondria in the hypothermia treated hearts compared to the control hearts where mitochondria were more frequently damaged. No differences in the prespecified histological parameters were observed between cooled and control hearts at t = AR. In the isolated beating porcine heart model of AMI, reperfusion was associated with additional myocardial injury beyond ischemic injury. Selective intracoronary hypothermia preserved mitochondrial integrity compared to nontreated controls.
Collapse
Affiliation(s)
- Mohamed El Farissi
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Serena Buscone
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Noortje A M Bax
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Center for Care & Cure Technology Eindhoven (C3Te), Eindhoven University, Eindhoven, The Netherlands
| | - Jan Willem van Rijswijk
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Tineke Veenendaal
- Section Cell Biology, Center for Molecular Medicine, University Medical Center, Utrecht, The Netherlands
| | | | - Jo M Zelis
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Rob Eerdekens
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Jesse Demandt
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Fabienne Vervaat
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Sjoerd Bouwmeester
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Yahav Rave
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Kwankwan S Zhu
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Cecile Conrad
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Marcel van 't Veer
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.,Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Nico H J Pijls
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.,Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Judith Klumperman
- Section Cell Biology, Center for Molecular Medicine, University Medical Center, Utrecht, The Netherlands
| | - Carlijn V C Bouten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Luuk C Otterspoor
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| |
Collapse
|
10
|
El Farissi M, Good R, Engstrøm T, Oldroyd KG, Karamasis GV, Vlaar PJ, Lønborg JT, Teeuwen K, Keeble TR, Mangion K, De Bruyne B, Fröbert O, De Vos A, Zwart B, Snijder RJR, Brueren GRG, Palmers PJ, Wijnbergen IF, Berry C, Tonino PAL, Otterspoor LC, Pijls NHJ. Safety of Selective Intracoronary Hypothermia During Primary Percutaneous Coronary Intervention in Patients With Anterior STEMI. JACC Cardiovasc Interv 2021; 14:2047-2055. [PMID: 34454860 DOI: 10.1016/j.jcin.2021.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/21/2021] [Accepted: 06/08/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aim of this study was to determine the safety of selective intracoronary hypothermia during primary percutaneous coronary intervention (PPCI) in patients with anterior ST-segment elevation myocardial infarction (STEMI). BACKGROUND Selective intracoronary hypothermia is a novel treatment designed to reduce myocardial reperfusion injury and is currently being investigated in the ongoing randomized controlled EURO-ICE (European Intracoronary Cooling Evaluation in Patients With ST-Elevation Myocardial Infarction) trial (NCT03447834). Data on the safety of such a procedure during PPCI are still limited. METHODS The first 50 patients with anterior STEMI treated with selective intracoronary hypothermia during PPCI were included in this analysis and compared for safety with the first 50 patients randomized to the control group undergoing standard PPCI. In-hospital mortality, occurrence of rhythm or conduction disturbances, stent thrombosis, onset of heart failure during the procedure, and subsequent hospital admission were assessed. RESULTS In-hospital mortality was 0%. One patient in both groups developed cardiogenic shock. Atrial fibrillation occurred in 0 and 3 patients (P = 0.24), and ventricular fibrillation occurred in 5 and 3 patients (P = 0.72) in the intracoronary hypothermia group and control group, respectively. Stent thrombosis occurred in 2 patients in the intracoronary hypothermia group; 1 instance was intraprocedural, and the other occurred following interruption of dual-antiplatelet therapy consequent to an intracranial hemorrhage 6 days after enrollment. No stent thrombosis was observed in the control group (P = 0.50). CONCLUSIONS Selective intracoronary hypothermia during PPCI in patients with anterior STEMI can be implemented within the routine of PPCI and seems to be safe. The final safety results will be reported at the end of the trial.
Collapse
Affiliation(s)
- Mohamed El Farissi
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Richard Good
- Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom
| | - Thomas Engstrøm
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Keith G Oldroyd
- Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom
| | - Grigoris V Karamasis
- Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; Anglia Ruskin School of Medicine, Chelmford, Essex, United Kingdom
| | - Pieter J Vlaar
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Jacob T Lønborg
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Koen Teeuwen
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Thomas R Keeble
- Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom; Anglia Ruskin School of Medicine, Chelmford, Essex, United Kingdom
| | - Kenneth Mangion
- Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom
| | | | - Ole Fröbert
- Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden
| | - Annemiek De Vos
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Bastiaan Zwart
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Roel J R Snijder
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Guus R G Brueren
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Pieter-Jan Palmers
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Inge F Wijnbergen
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Colin Berry
- Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom; British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Pim A L Tonino
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Luuk C Otterspoor
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Nico H J Pijls
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands.
| |
Collapse
|
11
|
Shi Y, Hou SA. Protective effects of metformin against myocardial ischemia‑reperfusion injury via AMPK‑dependent suppression of NOX4. Mol Med Rep 2021; 24:712. [PMID: 34396450 PMCID: PMC8383039 DOI: 10.3892/mmr.2021.12351] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/01/2020] [Indexed: 01/04/2023] Open
Abstract
Numerous studies have demonstrated that metformin can reduce the incidence of myocardial infarction and improve the prognosis of patients. However, its specific mechanism has not been determined. Using a rat model of myocardial ischemia-reperfusion injury (MIRI), it was observed that metformin significantly reduced infarct size, and decreased the levels of plasma lactate dehydrogenase and creatine kinase-MB form. A TTC-Evans blue staining was used to detect the infarct size and MTT assay was used to evaluate the cell viability. TUNEL assay was performed to evaluate apoptosis. Furthermore, 4-hydroxynonenal was detected by immunohistochemical staining. mRNA expression levels were detected by reverse transcription-quantitative PCR; protein expression levels were detected by immunoblotting. When treated with metformin, the number of TUNEL-positive cells was significantly decreased. Reduced 4HNE immunoreactivity was observed in metformin-treated rats as determined via immunohistochemistry. Furthermore, NADPH oxidase 4 (NOX4) was downregulated by metformin at both the mRNA and protein levels, and adenosine 5′-monophosphate-activated protein kinase (AMPK) phosphorylation was increased by metformin. In a primary myocardial hypoxia-reoxygenation cell model, metformin increased the viability of cardiomyocytes and reduced the content of malondialdehyde. It was also found that metformin upregulated the phosphorylation of AMPK and decreased the expression of NOX4. Furthermore, pre-treatment with AMPK inhibitor compound-C could block the effect of metformin, indicated by increased NOX4 compared with metformin treatment alone. These results suggested that metformin was capable of reducing the oxidative stress injury induced by MIRI. In conclusion, the present study indicated that metformin activated AMPK to inhibit the expression of NOX4, leading to a decrease in myocardial oxidative damage and apoptosis, thus alleviating reperfusion injury.
Collapse
Affiliation(s)
- Yan Shi
- Department of Critical Care Medicine, People's Hospital of Rizhao, Rizhao, Shandong 276800, P.R. China
| | - Shu-Ai Hou
- Department of Critical Care Medicine, People's Hospital of Rizhao, Rizhao, Shandong 276800, P.R. China
| |
Collapse
|
12
|
Li C, Liu Z, Shi R. A Bibliometric Analysis of 14,822 Researches on Myocardial Reperfusion Injury by Machine Learning. Int J Environ Res Public Health 2021; 18:ijerph18158231. [PMID: 34360526 PMCID: PMC8345983 DOI: 10.3390/ijerph18158231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 12/13/2022]
Abstract
Myocardial ischemia is the major cause of death worldwide, and reperfusion is the standard intervention for myocardial ischemia. However, reperfusion may cause additional damage, known as myocardial reperfusion injury, for which there is still no effective therapy. This study aims to analyze the landscape of researches concerning myocardial reperfusion injury over the past three decades by machine learning. PubMed was searched for publications from 1990 to 2020 indexed under the Medical Subject Headings (MeSH) term “myocardial reperfusion injury” on 13 April 2021. MeSH analysis and Latent Dirichlet allocation (LDA) analyses were applied to reveal research hotspots. In total, 14,822 publications were collected and analyzed in this study. MeSH analyses revealed that time factors and apoptosis were the leading terms of the pathogenesis and treatment of myocardial reperfusion injury, respectively. In LDA analyses, research topics were classified into three clusters. Complex correlations were observed between topics of different clusters, and the prognosis is the most concerned field of the researchers. In conclusion, the number of publications on myocardial reperfusion injury increases during the past three decades, which mainly focused on prognosis, mechanism, and treatment. Prognosis is the most concerned field, whereas studies on mechanism and treatment are relatively lacking.
Collapse
Affiliation(s)
- Chan Li
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha 410008, China;
| | - Zhaoya Liu
- Department of the Geriatrics, The Third Xiangya Hospital, Central South University, Changsha 410013, China;
| | - Ruizheng Shi
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha 410008, China;
- Correspondence: ; Tel.: +86-0731-888-36044
| |
Collapse
|
13
|
Song Y, Xu C, Liu J, Li Y, Wang H, Shan D, Wainer IW, Hu X, Zhang Y, Woo AYH, Xiao RP. Heterodimerization With 5-HT 2BR Is Indispensable for β 2AR-Mediated Cardioprotection. Circ Res 2021; 128:262-277. [PMID: 33208036 DOI: 10.1161/circresaha.120.317011] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
RATIONALE The β2-adrenoceptor (β2-AR), a prototypical GPCR (G protein-coupled receptor), couples to both Gs and Gi proteins. Stimulation of the β2-AR is beneficial to humans and animals with heart failure presumably because it activates the downstream Gi-PI3K-Akt cell survival pathway. Cardiac β2-AR signaling can be regulated by crosstalk or heterodimerization with other GPCRs, but the physiological and pathophysiological significance of this type of regulation has not been sufficiently demonstrated. OBJECTIVE Here, we aim to investigate the potential cardioprotective effect of β2-adrenergic stimulation with a subtype-selective agonist, (R,R')-4-methoxy-1-naphthylfenoterol (MNF), and to decipher the underlying mechanism with a particular emphasis on the role of heterodimerization of β2-ARs with another GPCR, 5-hydroxytryptamine receptors 2B (5-HT2BRs). METHODS AND RESULTS Using pharmacological, genetic and biophysical protein-protein interaction approaches, we studied the cardioprotective effect of the β2-agonist, MNF, and explored the underlying mechanism in both in vivo in mice and cultured rodent cardiomyocytes insulted with doxorubicin, hydrogen peroxide (H2O2) or ischemia/reperfusion. In doxorubicin (Dox)-treated mice, MNF reduced mortality and body weight loss, while improving cardiac function and cardiomyocyte viability. MNF also alleviated myocardial ischemia/reperfusion injury. In cultured rodent cardiomyocytes, MNF inhibited DNA damage and cell death caused by Dox, H2O2 or hypoxia/reoxygenation. Mechanistically, we found that MNF or another β2-agonist zinterol markedly promoted heterodimerization of β2-ARs with 5-HT2BRs. Upregulation of the heterodimerized 5-HT2BRs and β2-ARs enhanced β2-AR-stimulated Gi-Akt signaling and cardioprotection while knockdown or pharmacological inhibition of the 5-HT2BR attenuated β2-AR-stimulated Gi signaling and cardioprotection. CONCLUSIONS These data demonstrate that the β2-AR-stimulated cardioprotective Gi signaling depends on the heterodimerization of β2-ARs and 5-HT2BRs.
Collapse
MESH Headings
- Adrenergic beta-2 Receptor Agonists/pharmacology
- Animals
- Cardiomyopathies/chemically induced
- Cardiomyopathies/metabolism
- Cardiomyopathies/pathology
- Cardiomyopathies/prevention & control
- Cardiotoxicity
- Cell Death/drug effects
- Cells, Cultured
- Disease Models, Animal
- Doxorubicin
- Ethanolamines/pharmacology
- Fenoterol/analogs & derivatives
- Fenoterol/pharmacology
- Fibrosis
- Hydrogen Peroxide
- Male
- Mice, Inbred C57BL
- Mice, Knockout
- Myocardial Reperfusion Injury/metabolism
- Myocardial Reperfusion Injury/pathology
- Myocardial Reperfusion Injury/prevention & control
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Protein Multimerization
- Rats, Sprague-Dawley
- Receptor, Serotonin, 5-HT2B/genetics
- Receptor, Serotonin, 5-HT2B/metabolism
- Receptors, Adrenergic, beta-2/genetics
- Receptors, Adrenergic, beta-2/metabolism
- Signal Transduction
- Mice
- Rats
Collapse
Affiliation(s)
- Ying Song
- State Key Laboratory of Membrane Biology, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China (Y.S., D.S., X.H., Y.Z., A.Y.-H.W., R.-P.X.)
| | - Chanjuan Xu
- Cellular Signaling laboratory, International Research Center for Sensory Biology and Technology of MOST, Key Laboratory of Molecular Biophysics of MOE, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China (C.X., J.L.)
| | - Jianfeng Liu
- Cellular Signaling laboratory, International Research Center for Sensory Biology and Technology of MOST, Key Laboratory of Molecular Biophysics of MOE, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China (C.X., J.L.)
| | - Yulong Li
- State Key Laboratory of Membrane Biology, Peking University School of Life Sciences, Beijing, China (Y.L., H.W.)
- Peking-Tsinghua Center for Life Sciences, Beijing, China (Y.L., H.W., R.-P.X.)
- PKU-IDG/McGovern Institute for Brain Research, Beijing, China (Y.L., H.W.)
| | - Huan Wang
- State Key Laboratory of Membrane Biology, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China (Y.S., D.S., X.H., Y.Z., A.Y.-H.W., R.-P.X.)
| | - Dan Shan
- State Key Laboratory of Membrane Biology, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China (Y.S., D.S., X.H., Y.Z., A.Y.-H.W., R.-P.X.)
| | | | - Xinli Hu
- State Key Laboratory of Membrane Biology, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China (Y.S., D.S., X.H., Y.Z., A.Y.-H.W., R.-P.X.)
| | - Yan Zhang
- State Key Laboratory of Membrane Biology, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China (Y.S., D.S., X.H., Y.Z., A.Y.-H.W., R.-P.X.)
| | - Anthony Yiu-Ho Woo
- State Key Laboratory of Membrane Biology, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China (Y.S., D.S., X.H., Y.Z., A.Y.-H.W., R.-P.X.)
- Department of Pharmacology, Shenyang Pharmaceutical University, Shenyang, China (A.Y.-H.W.)
| | - Rui-Ping Xiao
- State Key Laboratory of Membrane Biology, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, China (Y.S., D.S., X.H., Y.Z., A.Y.-H.W., R.-P.X.)
- Peking-Tsinghua Center for Life Sciences, Beijing, China (Y.L., H.W., R.-P.X.)
- Beijing City Key Laboratory of Cardiometabolic Molecular Medicine, Peking University, China (R.-P.X.)
- PKU-Nanjing Institute of Translational Medicine, China (R.-P.X.)
| |
Collapse
|
14
|
Ekeuku SO, Pang KL, Chin KY. Palmatine as an Agent Against Metabolic Syndrome and Its Related Complications: A Review. Drug Des Devel Ther 2020; 14:4963-4974. [PMID: 33235437 PMCID: PMC7680161 DOI: 10.2147/dddt.s280520] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/29/2020] [Indexed: 12/20/2022] Open
Abstract
Palmatine is a naturally occurring isoquinoline alkaloid with various pharmacological properties. Given its antioxidant and anti-inflammatory properties, palmatine may be able to impede the effects of metabolic syndrome (MetS) and its related diseases triggered by inflammation and oxidative stress. This review summarises the existing literature about the effects of palmatine supplementation on MetS and its complications. The evidence shows that palmatine could protect against MetS, and cardiovascular diseases, osteoporosis and osteoarthritis, which might be associated with MetS. These protective effects are mediated by the antioxidant and anti-inflammatory properties of palmatine. Although preclinical experiments have demonstrated the efficacy of palmatine against MetS and its related diseases, no human clinical trials have been performed to validate these effects. This research gap should be bridged to validate the efficacy and safety of palmatine supplementation in protecting humans against MetS and its related diseases.
Collapse
Affiliation(s)
- Sophia Ogechi Ekeuku
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Kok-Lun Pang
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| |
Collapse
|
15
|
Chen Q, Zhang P, Xiao QX, Liu Q, Zhang Y. Protective effect of Shengmai injection on myocardial endothelial cell glycoprotein detachment after myocardial ischemia-reperfusion injury in isolated rat hearts. Perfusion 2020; 36:757-765. [PMID: 33070762 DOI: 10.1177/0267659120965921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate effects of Shengmai injection (SMI) postconditioning on myocardial ischemia-reperfusion injury (MIRI) in isolated rat hearts. MATERIALS AND METHODS A total of thirty isolated hearts were randomly divided into three groups: Sham group, I/R group and SMI group. Sham group was continuously perfused with K-H solution for 120 minutes. I/R group and SMI group were given balanced perfusion for 30 min followed by reperfusion for 60 min, with an interval of 30 min, and those in the SMI group were given postconditioning with 1% SMI during the first 10 min of reperfusion. The left ventricular function, markers of myocardial injury, endothelial cell injury and oxidative stress injury were measured at 30 minutes after equilibration (t0), 30 minutes after ischemia (t2) and 60 minutes after reperfusion (t3). RESULTS The results showed that there was no significant difference for all observation indexes at t0. Compared with the Sham group, real portfolio project and coronary arterial flow rate and the activity of superoxide dismutase were significantly decreased in the I/R group, whereas those in the SMI group were significantly higher. Left ventricular end-diastolic pressure, the concentrate of malondialdehyde, lactate dehydrogenase, cTn-I, hyaluronic acid, heparin sulphate, syndecan-1 in the I/R group were markedly higher than those in the Sham group, whereas those in the SMI group were significantly lower. CONCLUSION In summary, the present study indicated that 1% SMI postconditioning can alleviate the detachment of endothelial cell glycoprotein envelope induced by myocardial ischemia-reperfusion injury, and its mechanism is probably related to the inhibition of the oxidative stress injury.
Collapse
Affiliation(s)
- Qi Chen
- Department of Anesthesiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Ping Zhang
- Department of Anesthesiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Qiu-Xia Xiao
- Department of Anesthesiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Qing Liu
- Department of Anesthesiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Ying Zhang
- Department of Anesthesiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| |
Collapse
|
16
|
Xiao B, Huang X, Wang Q, Wu Y. Beta-Asarone Alleviates Myocardial Ischemia-Reperfusion Injury by Inhibiting Inflammatory Response and NLRP3 Inflammasome Mediated Pyroptosis. Biol Pharm Bull 2020; 43:1046-1051. [PMID: 32321872 DOI: 10.1248/bpb.b19-00926] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Beta-asarone (β-Asarone), the major component of Acorus tatarinowii Rhizoma, has been proved to be muti-pharmacological activities including anti-inflammation, and which is effective in protecting the central nervous system. However, the effect of β-Asarone on myocardial ischemia-reperfusion (I/R) injury is not yet clear. This study used a rat model with 45 min occlusion and 24 h releasing of proximal segment of left anterior descending coronary artery. The effects of β-Asarone on cardiac histopathology, myocardial infarction size, levels of cardiac troponin T (cTNT), myeloperoxidase (MPO) and interleukin-1β (IL-1β), protein expressions of apoptosis-associated speck-like protein containing a CARD (ASC), Nod-like receptor protein 3 (NLRP3), caspase-1 and Gasdermin D (GSDMSD), and left ventricular performance were studied respectively. Our results showed that administration of β-Asarone significantly improved the heart outcome after myocardial ischemia and reperfusion in terms of less infarction size and lower serum cTNT concentration. Further, β-Asarone treatment evidently inhibited inflammatory response with less granulocyte infiltration, mild tissue edema and lower tissue MPO content, it also suppressed NLRP3 signal pathway and cardiac cell's pyroptosis for less protein expressions of ASC and NLRP3, lower level cleavage activation of caspase-1 and GSDMSD, and lower serum IL-1β concentration. Finally, β-Asarone treatment well preserved the left ventricular performance with higher ejection fraction and fractional shortening. The experimental results suggested that β-Asarone was protective against myocardial ischemia-reperfusion injury, in which inhibition of inflammatory response and suppression of NLRP3 inflammasome mediated pyroptosis were supposed to play a vital role.
Collapse
Affiliation(s)
- Bin Xiao
- Department of Traditional Chinese Medicine, Xuanwu Hospital Capital Medical University
| | - Xiaobo Huang
- Department of Traditional Chinese Medicine, Xuanwu Hospital Capital Medical University
| | - Qian Wang
- Department of Traditional Chinese Medicine, Xuanwu Hospital Capital Medical University
| | - Yanchuan Wu
- Central laboratory of Xuanwu Hospital Capital Medical University
| |
Collapse
|
17
|
Zhu N, Li J, Li Y, Zhang Y, Du Q, Hao P, Li J, Cao X, Li L. Berberine Protects Against Simulated Ischemia/Reperfusion Injury-Induced H9C2 Cardiomyocytes Apoptosis In Vitro and Myocardial Ischemia/Reperfusion-Induced Apoptosis In Vivo by Regulating the Mitophagy-Mediated HIF-1α/BNIP3 Pathway. Front Pharmacol 2020; 11:367. [PMID: 32292345 PMCID: PMC7120539 DOI: 10.3389/fphar.2020.00367] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/10/2020] [Indexed: 12/28/2022] Open
Abstract
Berberine (BBR) has a variety of pharmacological activities and is widely used in Asian countries. However, the clinical application of BBR still lacks scientific basis, what protective mechanism of BBR against myocardial ischemia-reperfusion injury (MIRI). In vitro experiments, BBR pretreatment regulated autophagy-related protein expression, induced cell proliferation and autophagosome formation, and reduced the mitochondrial membrane potential (ΔΨm) increase in H9C2 cells. In vivo experiments, BBR reduced the myocardial infarct size, decreased cardiomyocyte apoptosis, and markedly decreased myocardial enzyme (CK-MB, LDH, and AST) activity-induced I/R. In addition, upon BNIP3 knockdown, the regulatory effects of BBR on the above indicators were weakened both in H9C2 cells and in vivo. Luciferase reporter and ChIP assays indicated that BBR mediated BNIP3 expression by enhancing the binding of HIF-1α to the BNIP3 promoter. BBR protects against myocardial I/R injury by inducing cardiomyocytes proliferation, inhibiting cardiomyocytes apoptosis, and inducing the mitophagy-mediated HIF-1α/BNIP3 pathway. Thus, BBR may serve as a novel therapeutic drug for myocardial I/R injury.
Collapse
Affiliation(s)
- Na Zhu
- Department of Health Management, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Jiang Li
- Henan Provincial Research Center of Natural Medicine Extraction and Medical Technology Application Engineering, Zhengzhou Railway Vocational Technical College, Zhengzhou, China
| | - Yongli Li
- Department of Health Management, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Yuwei Zhang
- Medical Genetic Institute of Henan Province, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Qiubo Du
- Department of Cardiology, Henan Provincial Key Lab for Control of Coronary Heart Disease, Henan Provincial People's Hospital, Central China Fuwai Hospital, Zhengzhou University People's Hospital, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Peiyuan Hao
- Department of Cardiology, Henan Provincial Key Lab for Control of Coronary Heart Disease, Henan Provincial People's Hospital, Central China Fuwai Hospital, Zhengzhou University People's Hospital, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Jinying Li
- Department of Health Management, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Xueming Cao
- Department of Cardiology, Henan Provincial Key Lab for Control of Coronary Heart Disease, Henan Provincial People's Hospital, Central China Fuwai Hospital, Zhengzhou University People's Hospital, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Li Li
- Department of Scientific Research and Discipline Construction, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, China
| |
Collapse
|
18
|
Bai Y, Li Z, Liu W, Gao D, Liu M, Zhang P. Biochanin A attenuates myocardial ischemia/reperfusion injury through the TLR4/NF-κB/NLRP3 signaling pathway. Acta Cir Bras 2019; 34:e201901104. [PMID: 31859817 PMCID: PMC6917477 DOI: 10.1590/s0102-865020190110000004] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/09/2019] [Accepted: 10/11/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Myocardial ischemia/reperfusion (Ml/R) injury is a leading cause of damage in cardiac tissues, with high rates of mortality and disability. Biochanin A (BCA) is a main constituent of Trifolium pratense L. This study was intended to explore the effect of BCA on Ml/R injury and explore the potential mechanism. METHODS In vivo MI/R injury was established by transient coronary ligation in Sprague-Dawley rats. Triphenyltetrazolium chloride staining (TTC) was used to measure myocardial infarct size. ELISA assay was employed to evaluate the levels of myocardial enzyme and inflammatory cytokines. Western blot assay was conducted to detect related protein levels in myocardial tissues. RESULTS BCA significantly ameliorated myocardial infarction area, reduced the release of myocardial enzyme levels including aspartate transaminase (AST), creatine kinase (CK-MB) and lactic dehydrogenase (LDH). It also decreased the production of inflammatory cytokines (IL-1β, IL-18, IL-6 and TNF-α) in serum of Ml/R rats. Further mechanism studies demonstrated that BCA inhibited inflammatory reaction through blocking TLR4/NF-kB/NLRP3 signaling pathway. CONCLUSION The present study is the first evidence demonstrating that BCA attenuated Ml/R injury through suppressing TLR4/NF-kB/NLRP3 signaling pathway-mediated anti-inflammation pathway.
Collapse
Affiliation(s)
- Yejun Bai
- Physician, First School of Clinical Medicine, Nanjing University of Chinese Medicine, and Department of Cardiovascular, Haimen Branch of Shanghai First People's Hospital Haimen Traditional Chinese Medicine Hospital, China. Conception and design of the study, manuscript writing
| | - Zhigang Li
- Physician, Department of Cardiovascular, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, China. Acquisition and analysis of data
| | - Weihao Liu
- Physician, First School of Clinical Medicine, Nanjing University of Chinese Medicine, and Department of Cardiovascular, Haimen Branch of Shanghai First People's Hospital Haimen Traditional Chinese Medicine Hospital, China. Conception and design of the study, manuscript writing
| | - Dong Gao
- Physician, First School of Clinical Medicine, Nanjing University of Chinese Medicine, and Department of Cardiovascular, Haimen Branch of Shanghai First People's Hospital Haimen Traditional Chinese Medicine Hospital, China. Conception and design of the study, manuscript writing
| | - Min Liu
- Chief physician, Department of Cardiovascular, Xuzhou City Hospital of TCM Affiliated to Nanjing University of Chinese Medicine, China. Technical procedures, acquisition of data
| | - Peiying Zhang
- Chief physician, Department of Cardiovascular, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, China. Design and supervised all phases of the study
| |
Collapse
|
19
|
Pranav Nayak B, Ganesha KR, Minaz N, Razdan R, Goswami SK. Phloroglucinol, a nutraceutical for IR-induced cardiac damage in diabetic rats. Animal Model Exp Med 2019; 2:210-216. [PMID: 31773097 PMCID: PMC6762217 DOI: 10.1002/ame2.12079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/28/2019] [Accepted: 07/29/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Myocardial injury due to ischemia-reperfusion (IR) is aggravated in diabetes which is associated with oxidative stress. Alleviating oxidative stress via use of antioxidants has been shown to be effective at minimizing myocardial cell death and improving cardiac function. The aim of the present study was to evaluate the cardioprotective effect of phloroglucinol against myocardial reperfusion injury (MRI) in diabetic rats. METHODS Diabetes was induced in female rats with streptozotocin (50 mg/kg). The diabetic rats were orally treated with phloroglucinol (100 and 200 mg/kg daily for 28 days). After treatment the hearts were isolated and mounted on a Langendorff apparatus. The hearts were subjected to 15 minutes of IR to induce myocardial damage. Cardiac functions including heart rate (HR), resting and developed tension, and rate of change of contraction (+dP/dt max) were recorded. Cardiac injury biomarkers lactate dehydrogenase (LDH) and creatine kinase (CK-MB) were measured in the heart perfusate. Levels of the antioxidant enzymes reduced glutathione (GSH) and malondialdehyde (MDA) were measured. Hematoxylin and eosin (H&E) staining was also performed. RESULTS After IR injury, a decrease in HR and +dP/dt max in hearts from diabetic rat was seen compared to healthy rat hearts, which was reversed by phloroglucinol treatment. Myocardial infarct size, measured by H&E staining, was increased in diabetic rats compared to healthy rats and an increase in the activity of LDH and CK-MB in the heart perfusate in diabetic rats was decreased by phloroglucinol treatment. An increase in MDA levels and a decrease in levels of antioxidant enzymes were observed in diabetic rats, which was reversed with phloroglucinol treatment. CONCLUSION Phloroglucinol treatment has potential therapeutic promise in the treatment of MRI in diabetes.
Collapse
Affiliation(s)
- B. Pranav Nayak
- Department of PharmacologyAl‐Ameen College of PharmacyBengaluruKarnatakaIndia
| | - K. R. Ganesha
- Department of PharmacologyAl‐Ameen College of PharmacyBengaluruKarnatakaIndia
| | - Nathani Minaz
- Department of PharmacologyAl‐Ameen College of PharmacyBengaluruKarnatakaIndia
| | - Rema Razdan
- Department of PharmacologyAl‐Ameen College of PharmacyBengaluruKarnatakaIndia
| | - Sumanta Kumar Goswami
- Department of PharmacologyAl‐Ameen College of PharmacyBengaluruKarnatakaIndia
- Department of Pharmaceutical sciencesNortheastern UniversityBostonMAUSA
| |
Collapse
|
20
|
Wu L, Fang J, Yuan X, Xiong C, Chen L. Adropin reduces hypoxia/reoxygenation-induced myocardial injury via the reperfusion injury salvage kinase pathway. Exp Ther Med 2019; 18:3307-3314. [PMID: 31602203 DOI: 10.3892/etm.2019.7937] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 05/10/2019] [Indexed: 02/05/2023] Open
Abstract
Adropin is a secreted polypeptide that has been demonstrated to serve an important role in protecting the vascular endothelium. Pharmacological activation of pro-survival kinases, such as PI3K-Akt and ERK1/2, are involved in the reperfusion injury salvage kinase (RISK) pathway. In the present study, the effects of adropin in cardiomyocyte injury induced by simulated ischemia/reperfusion (SI/R) were assessed. Additionally, the current study also assessed the mechanisms that govern SI/R in a H9c2 cardiomyoblast cell model. Cell viability was measured using an MTT assay. Cell injury was assessed using creatine kinase MB measurements. Apoptosis was assessed using flow cytometry and caspase-3 activity. The inflammatory response was measured using tumor necrosis factor α and interleukin-10 expression. Oxidative stress was assessed using malondialdehyde and superoxide dismutase. The expression levels of Akt, ERK1/2, glycogen synthase kinase 3β (GSK3β), Bcl-2 and Bax were determined using western blot analysis. The results of the current study revealed that moderate-dose adropin increased cell viability, reduced early apoptosis and caspase-3 activity, promoted Bcl-2 expression, inhibited Bax and increased the Bcl-2/Bax ratio. Adropin significantly increased the phosphorylation of Akt, ERK1/2 and GSK3β, whereas inhibitors of PI3K and ERK1/2, respectively, LY294002 and PD98059, abolished the cardioprotective role of adropin. Furthermore, no significant difference was observed in phosphorylated-STAT3/total-STAT3 expression between the adropin and SI/R groups and Janus kinase 2 inhibitor AG490 did not significantly inhibit the protective role of adropin. These results indicate that adropin exerts a protective effect against SI/R injury through the RISK pathway instead of the survivor activating factor enhancement pathway.
Collapse
Affiliation(s)
- Lingzhen Wu
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Jun Fang
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Xun Yuan
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Chang Xiong
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Lianglong Chen
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, P.R. China
| |
Collapse
|
21
|
Saadat N, Saadatagah S, Aghajani Nargesi A, Alidoosti M, Poorhosseini H, Amirzadegan A, Lashkari R, Mortazavi SH, Jalali A, Ghodsi S, Salarifar M. Short-term safety and long-term benefits of stent postdilation after primary percutaneous coronary intervention: Results of a cohort study. Catheter Cardiovasc Interv 2019; 95:1249-1256. [PMID: 31318488 DOI: 10.1002/ccd.28396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/25/2019] [Accepted: 07/02/2019] [Indexed: 11/07/2022]
Abstract
AIM Achieving the optimal apposition of coronary stents during percutaneous coronary intervention is not always feasible. The risks and benefits of stent postdilation in primary percutaneous coronary intervention (PPCI) in patients with ST-elevation myocardial infarction (STEMI) have remained controversial. We sought to evaluate the immediate angiographic and long-term outcomes in patients with and without stent postdilation. METHODS A cohort of patients (n = 1,224) with STEMI, treated with PPCI (n = 500 postdilated; n = 724 controls), were studied. The flow grade, the myocardial blush grade, and the frame count were considered angiographic outcomes. The clinical outcomes were major adverse cardiovascular events (MACE)-comprising cardiac death, nonfatal MI, and repeat revascularization-and the device-oriented composite endpoint (DOCE)-consisting of cardiac death, target lesion revascularization, and target vessel revascularization. RESULTS The flow and myocardial blush grades were not different between the two groups, and the frame count was significantly lower in the postdilation group (15.7 ± 8.4 vs. 17 ± 10.4; p < .05). The patients were followed up for 348 ± 399 days. DOCE (2.2% vs. 5.8%) and cardiac mortality (1.2% vs. 3.2%) were lower in the postdilation group. In the fully adjusted propensity score-matched analysis, postdilation was associated with decreased DOCE (HR = 0.40 [0.18-0.87], p = .021). CONCLUSIONS Selective postdilation improved some angiographic and clinical outcomes and could not be discouraged in PPCI on patients with STEMI.
Collapse
Affiliation(s)
- Nasser Saadat
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Arash Aghajani Nargesi
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Mohammad Alidoosti
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Reza Lashkari
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Salarifar
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
22
|
Qiao SG, Sun Y, Sun B, Wang A, Qiu J, Hong L, An JZ, Wang C, Zhang HL. Sevoflurane postconditioning protects against myocardial ischemia/reperfusion injury by restoring autophagic flux via an NO-dependent mechanism. Acta Pharmacol Sin 2019; 40:35-45. [PMID: 30002490 DOI: 10.1038/s41401-018-0066-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 06/05/2018] [Indexed: 12/14/2022] Open
Abstract
Volatile anesthetics improve postischemic cardiac function and reduce infarction even when administered for only a brief time at the onset of reperfusion. A recent study showed that sevoflurane postconditioning (SPC) attenuated myocardial reperfusion injury, but the underlying mechanisms remain unclear. In this study, we examined the effects of sevoflurane on nitric oxide (NO) release and autophagic flux during the myocardial ischemia/reperfusion (I/R) injury in rats in vivo and ex vivo. Male rats were subjected to 30 min ischemia and 2 h reperfusion in the presence or absence of sevoflurane (1.0 minimum alveolar concentration) during the first 15 min of reperfusion. We found that SPC significantly improved hemodynamic performance after reperfusion, alleviated postischemic myocardial infarction, reduced nicotinamide adenine dinucleotide content loss, and cytochrome c release in heart tissues. Furthermore, SPC significantly increased the phosphorylation of endothelial nitric oxide synthase (NOS) and neuronal nitric oxide synthase, and elevated myocardial NOS activity and NO production. All these effects were abolished by treatment with an NOS inhibitor NG-nitro-L-arginine methyl ester (L-NAME, 10 mg/kg, i.v.). We also observed myocardial I/R-induced accumulation of autophagosomes in heart tissues, as evidenced by increased ratios of microtubule-associated protein 1 light chain 3 II/I, up-regulation of Beclin 1 and P62, and reduced lysosome-associated membrane protein-2 expression. SPC significantly attenuated I/R-impaired autophagic flux, which were blocked by L-NAME. Moreover, pretreatment with the autophagic flux blocker chloroquine (10 mg/kg, i.p.) increased autophagosome accumulation in SPC-treated heart following I/R and blocked SPC-induced cardioprotection. The same results were also observed in a rat model of myocardial I/R injury ex vivo, suggesting that SPC protects rat hearts against myocardial reperfusion injury by restoring I/R-impaired autophagic flux via an NO-dependent mechanism.
Collapse
|
23
|
van der Weg K, Prinzen FW, Gorgels AP. Editor's Choice- Reperfusion cardiac arrhythmias and their relation to reperfusion-induced cell death. Eur Heart J Acute Cardiovasc Care 2018; 8:142-152. [PMID: 30421619 DOI: 10.1177/2048872618812148] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Reperfusion does not only salvage ischaemic myocardium but can also cause additional cell death which is called lethal reperfusion injury. The time of reperfusion is often accompanied by ventricular arrhythmias, i.e. reperfusion arrhythmias. While both conditions are seen as separate processes, recent research has shown that reperfusion arrhythmias are related to larger infarct size. The pathophysiology of fatal reperfusion injury revolves around intracellular calcium overload and reactive oxidative species inducing apoptosis by opening of the mitochondrial protein transition pore. The pathophysiological basis for reperfusion arrhythmias is the same intracellular calcium overload as that causing fatal reperfusion injury. Therefore both conditions should not be seen as separate entities but as one and the same process resulting in two different visible effects. Reperfusion arrhythmias could therefore be seen as a potential marker for fatal reperfusion injury.
Collapse
Affiliation(s)
- Kirian van der Weg
- 1 Department of Cardiology, Maastricht University Medical Center, The Netherlands
| | - Frits W Prinzen
- 2 Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, The Netherlands
| | - Anton Pm Gorgels
- 1 Department of Cardiology, Maastricht University Medical Center, The Netherlands.,2 Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, The Netherlands
| |
Collapse
|
24
|
Abstract
BACKGROUND/AIM:\ Rho kinase is a downstream effector of Rho GTPase that is known to regulate various pathological processes. The aim of this study was to evaluate the regulation of Rho kinase activity in leukocytes in patients with ischemia/reperfusion (I/R) injury. PATIENTS AND METHODS We investigated 38 patients with acute ST-segment elevation myocardial infarction (STEMI), 26 patients with atherosclerosis (AS) and 22 normal subjects. All patients underwent coronary angiography (CAG) and all STEMI patients received primary percutaneous coronary intervention (PPCI) of the left anterior descending artery (LAD) within 12 h after chest pain on-set. Blood samples for leukocyte Rho kinase activity were obtained before CAG and 3 and 24 hours after CAG/PCI. RESULTS Rho kinase activity increased in the I/R and AS groups. Compared with the AS group, Rho kinase activity was significantly higher in peripheral blood leukocytes in STEMI/PPCI. Furthermore, there was no correlation between changes in Rho kinase activity and changes in high-sensitivity troponin I (hs-TnI) and C-reactive protein (CRP). There was a negative correlation between Rho kinase activity and IL-6. CONCLUSION Rho kinase is involved in the pathogenesis of heart I/R injury in patients. Inhibition of Rho kinase may be an additional therapeutic intervention for the treatment of I/R.
Collapse
Affiliation(s)
- Juan Zhang
- 1 Department of Cardiology, The Second Hospital of Shandong University, Jinan, Shandong Province, China
| | - Fei Xu
- 1 Department of Cardiology, The Second Hospital of Shandong University, Jinan, Shandong Province, China
| | - Xiao-Bo Liu
- 2 Shandong Blood Center, Jinan, Shandong Province, China
| | - Shao-Jie Bi
- 1 Department of Cardiology, The Second Hospital of Shandong University, Jinan, Shandong Province, China
| | - Qing-Hua Lu
- 1 Department of Cardiology, The Second Hospital of Shandong University, Jinan, Shandong Province, China
| |
Collapse
|
25
|
Hwang IC, Kim JY, Kim JH, Lee JE, Seo JY, Lee JW, Park J, Yang HM, Kim SH, Cho HJ, Kim HS. Therapeutic Potential of a Novel Necrosis Inhibitor, 7-Amino-Indole, in Myocardial Ischemia-Reperfusion Injury. Hypertension 2018; 71:1143-1155. [PMID: 29661840 PMCID: PMC5959205 DOI: 10.1161/hypertensionaha.117.09405] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 04/04/2017] [Accepted: 03/08/2018] [Indexed: 12/20/2022]
Abstract
Supplemental Digital Content is available in the text. Opening of mitochondrial permeability transition pore and Ca2+ overload are main contributors to myocardial ischemia–reperfusion injury, which paradoxically causes a wide variety of myocardial damage. We investigated the protective role of a novel necrosis inhibitor (NecroX-7; NecX) against myocardial ischemia–reperfusion injury using in vitro and in vivo models. H9C2 rat cardiomyoblasts and neonatal cardiomyocytes were exposed to hypoxia–reoxygenation stress after pre-treatment with NecX, vitamin C, a combination of vitamin C and E, N-acetylcysteine, an apoptosis inhibitor (Z-VAD-fmk), or cyclosporine A. The main mechanism of cell death after hypoxia–reoxygenation stress was not apoptosis but necrosis, which was prevented by NecX. Protective effect of NecX was based on its potent reactive oxygen species scavenging activity, especially on mitochondrial reactive oxygen species. NecX preserved mitochondrial membrane potential through prevention of Ca2+ influx and inhibition of mitochondrial permeability transition pore opening, which was more potent than that by cyclosporine A. Using Sprague-Dawley rats exposed to myocardial ischemia for 45 minutes followed by reperfusion, we compared therapeutic efficacies of NecX with cyclosporine A, vitamin C, a combination of vitamin C and E, and 5% dextrose, each administered 5 minutes before reperfusion. NecX markedly inhibited myocardial necrosis and reduced fibrotic area to a greater extent than did cyclosporine A and other treated groups. In addition, NecX preserved systolic function and prevented pathological dilatory remodeling of left ventricle. The novel necrosis inhibitor has a significant protective effect against myocardial ischemia–reperfusion injury through inhibition of mitochondrial permeability transition pore opening, indicating that it is a promising candidate for cardioprotective adjunctive measure on top of reperfusion therapy.
Collapse
Affiliation(s)
- In-Chang Hwang
- From the Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-H.K., J.P., H.-M.Y., H.-J.C., H.-S.K.).,National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.).,Strategic Center of Cell and Bio Therapy for Heart, Diabetes, and Cancer, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-Y.K., J.-E.L., J.-W.L., H.-M.Y., H.-J.C., H.-S.K.)
| | - Ju-Young Kim
- From the Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-H.K., J.P., H.-M.Y., H.-J.C., H.-S.K.).,National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.).,Strategic Center of Cell and Bio Therapy for Heart, Diabetes, and Cancer, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-Y.K., J.-E.L., J.-W.L., H.-M.Y., H.-J.C., H.-S.K.)
| | - Ji-Hyun Kim
- National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.)
| | - Joo-Eun Lee
- National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.).,Strategic Center of Cell and Bio Therapy for Heart, Diabetes, and Cancer, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-Y.K., J.-E.L., J.-W.L., H.-M.Y., H.-J.C., H.-S.K.)
| | - Ji-Yun Seo
- National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.).,Strategic Center of Cell and Bio Therapy for Heart, Diabetes, and Cancer, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-Y.K., J.-E.L., J.-W.L., H.-M.Y., H.-J.C., H.-S.K.)
| | - Jae-Won Lee
- National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.)
| | - Jonghanne Park
- From the Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-H.K., J.P., H.-M.Y., H.-J.C., H.-S.K.).,National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.)
| | - Han-Mo Yang
- From the Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-H.K., J.P., H.-M.Y., H.-J.C., H.-S.K.).,National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.).,Strategic Center of Cell and Bio Therapy for Heart, Diabetes, and Cancer, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-Y.K., J.-E.L., J.-W.L., H.-M.Y., H.-J.C., H.-S.K.)
| | - Soon-Ha Kim
- R&D Campus, LG Chem/Ltd., Daejeon, Republic of Korea (S.-H.K.)
| | - Hyun-Jai Cho
- From the Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-H.K., J.P., H.-M.Y., H.-J.C., H.-S.K.).,National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.).,Strategic Center of Cell and Bio Therapy for Heart, Diabetes, and Cancer, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-Y.K., J.-E.L., J.-W.L., H.-M.Y., H.-J.C., H.-S.K.)
| | - Hyo-Soo Kim
- From the Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (I.-C.H., J.-H.K., J.P., H.-M.Y., H.-J.C., H.-S.K.) .,National Leading Laboratory for Cardiovascular Stem Cell, Seoul National University College of Medicine, Republic of Korea (I.-C.H., J.-Y.K., J.-H.K., J.-E.L., J.-Y.S., J.-W.L., J.P., H.-M.Y., H.-J.C., H.-S.K.).,and Department of Molecular Medicine and Biopharmaceutical Science, Seoul National University, Republic of Korea (H.-S.K.).,R&D Campus, LG Chem/Ltd., Daejeon, Republic of Korea (S.-H.K.)
| |
Collapse
|
26
|
He SF, Jin SY, Yang W, Pan YL, Huang J, Zhang SJ, Zhang L, Zhang Y. Cardiac μ-opioid receptor contributes to opioid-induced cardioprotection in chronic heart failure. Br J Anaesth 2018; 121:26-37. [PMID: 29935580 DOI: 10.1016/j.bja.2017.11.110] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 11/10/2017] [Accepted: 12/23/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND The therapeutic potential of cardiac μ-opioid receptors in ischaemia-reperfusion (I/R) injury during opioid-modulating diseases, such as heart failure, is unknown. We aimed to explore the changes of cardiac μ-opioid receptor expression during heart failure, and its role in opioid-induced cardioprotection. METHODS Rats received doxorubicin (DOX) or were subjected to coronary artery ligation to induce heart failure, or received normal saline (NS) as control. Hearts from NS or DOX rats were isolated and subjected to myocardial ischaemia and reperfusion in an in vitro perfusion system. The opioid [D-Ala,2N-MePhe,4 Gly-ol]-enkephalin (DAMGO), with a high μ-opioid receptor specificity, morphine, and remifentanil were administrated before I/R with or without opioid receptor antagonists, or an extracellular signal-regulated kinase (ERK) inhibitor. RESULTS Cardiac μ-opioid receptor mRNA concentrations were 3.2 times elevated in DOX-treated rats compared with NS rats, while cardiac μ-opioid receptor protein concentrations showed 6.1- and 3.5-fold increases in DOX-treated and post-infarcted rats, respectively. DAMGO reduced I/R-caused infarct size, expressed as the ratio of area at risk, from 0.50 (0.04) to 0.25 (0.03) in failing rat hearts, but had no effect on infarct size in control hearts. DAMGO promoted phosphorylation of ERK and glycogen synthase kinase (GSK)-3β only in failing hearts. DAMGO-mediated cardioprotection was blocked by an ERK inhibitor. The μ-opioid receptor antagonist D-Pen-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 (CTOP) prevented morphine- and remifentanil-induced cardioprotection and phosphorylation of ERK and GSK-3β in failing hearts. In contrast, δ- and κ-opioid receptor selective antagonists were less potent than CTOP in the failing hearts. CONCLUSIONS Cardiac μ-opioid receptors were substantially up-regulated during heart failure, which increased DAMGO-induced cardioprotection against I/R injury.
Collapse
Affiliation(s)
- S F He
- Department of Anaesthesiology, The Second Hospital of Anhui Medical University, Hefei, China
| | - S Y Jin
- Department of Anaesthesiology, The Second Hospital of Anhui Medical University, Hefei, China
| | - W Yang
- Department of Anaesthesiology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Y L Pan
- Department of Anaesthesiology, The Second Hospital of Anhui Medical University, Hefei, China
| | - J Huang
- Department of Anaesthesiology, The Second Hospital of Anhui Medical University, Hefei, China
| | - S J Zhang
- Department of Ultrasound, The Second Hospital of Anhui Medical University, Hefei, China
| | - L Zhang
- Laboratory for Integrative Neuroscience, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
| | - Y Zhang
- Department of Anaesthesiology, The Second Hospital of Anhui Medical University, Hefei, China.
| |
Collapse
|
27
|
胡 静, 谷 小, 孟 炎, 王 娅, 高 琴, 李 正, 李 晓, 程 向. [Effect of dexmedetomidine postconditioning on myocardial ischemia-reperfusion injury and inflammatory response in diabetic rats]. Nan Fang Yi Ke Da Xue Xue Bao 2017; 37:1506-1511. [PMID: 29180332 PMCID: PMC6779648 DOI: 10.3969/j.issn.1673-4254.2017.11.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the effect of dexmedetomidine postconditioning in alleviating myocardial ischemia-reperfusion (IR) injury and inflammation in diabetic mellitus rats. METHODS Thirty normal male Sprauge Dawley (SD) rats were randomly allocated into 3 groups (n=10), namely the sham-operated group, IR group, and dexmedetomidine postconditioning (DP) group. Similarly, another thirty diabetic SD rats were also randomly allocated into diabetic sham (DM-S) group, diabetic IR (DM-IR) group and diabetic dexmedetomidine postconditioning (DM-DP) group. The mean arterial pressure (MAP), heart rate (HR) and the rate pressure product (RPP) were recorded at baseline, after 30 min of ischemia, and at 30 and 120 min during reperfusion. Myocardial infarct size was analyzed by TTC double staining method, and plasma levels of CTnI, TNF-a, IL-6, IL-10 and IL-1β were measured at 120 min of reperfusion. RESULTS Compared with those in the sham-operated group, normal and diabetic rats in IR and DP groups showed significantly lowered MAP, HR, and RPP and increased levels of plasma CTnI, TNF-a, IL-6, IL-10 and IL-1β levels after 30 min of ischemia and at 30 min and 120 min of reperfusion (P<0.05). Compared with those in the IR group, the normal rats in DP group showed decreased MAP, HR, and RPP at 30 min of ischemia and at 30 min of reperfusion, which increased at 120 min of reperfusion (P<0.05); the infarct size and plasma CTnI, TNF-a, IL-6 and IL-1β levels were decreased while IL-10 was increased in DP group (P<0.05). Compared with those in DP group, the rats in DM-DP group showed similar MAP, HR and RPP (P>0.05) but significantly increased infarct size and plasma CTnI, TNF-a, IL-6 and IL-1β levels (P<0.05). CONCLUSION Dexmedetomidine postconditioning may produce a cardioprotective effect against myocardial IR injury in normal rats by alleviating inflammation, but can not reduce the release of inflammatory mediators in diabetic rats to improve myocardial infarction.
Collapse
Affiliation(s)
- 静 胡
- 蚌埠医学院第一附属医院麻醉科,安徽 蚌埠 233004Deparment of Anesthesiology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
- 蚌埠医学院生理教研室,安徽 蚌埠 233030Department of Physiology, Bengbu Medical College, Bengbu 233030, China
| | - 小雨 谷
- 蚌埠医学院第一附属医院麻醉科,安徽 蚌埠 233004Deparment of Anesthesiology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
- 蚌埠医学院生理教研室,安徽 蚌埠 233030Department of Physiology, Bengbu Medical College, Bengbu 233030, China
| | - 炎 孟
- 蚌埠医学院第一附属医院麻醉科,安徽 蚌埠 233004Deparment of Anesthesiology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
| | - 娅 王
- 蚌埠医学院生理教研室,安徽 蚌埠 233030Department of Physiology, Bengbu Medical College, Bengbu 233030, China
| | - 琴 高
- 蚌埠医学院生理教研室,安徽 蚌埠 233030Department of Physiology, Bengbu Medical College, Bengbu 233030, China
| | - 正红 李
- 蚌埠医学院生理教研室,安徽 蚌埠 233030Department of Physiology, Bengbu Medical College, Bengbu 233030, China
| | - 晓红 李
- 蚌埠医学院第一附属医院麻醉科,安徽 蚌埠 233004Deparment of Anesthesiology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
| | - 向阳 程
- 蚌埠医学院第一附属医院麻醉科,安徽 蚌埠 233004Deparment of Anesthesiology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
| |
Collapse
|
28
|
Chen GH, Xu CS, Zhang J, Li Q, Cui HH, Li XD, Chang LP, Tang RJ, Xu JY, Tian XQ, Huang PS, Xu J, Jin C, Yang YJ. Inhibition of miR-128-3p by Tongxinluo Protects Human Cardiomyocytes from Ischemia/reperfusion Injury via Upregulation of p70s6k1/p-p70s6k1. Front Pharmacol 2017; 8:775. [PMID: 29163161 PMCID: PMC5670141 DOI: 10.3389/fphar.2017.00775] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/13/2017] [Indexed: 12/11/2022] Open
Abstract
Background and Aims: Tongxinluo (TXL) is a multifunctional traditional Chinese medicine that has been widely used to treat cardiovascular and cerebrovascular diseases. However, no studies have explored whether TXL can protect human cardiomyocytes (HCMs) from ischemia/reperfusion (I/R) injury. Reperfusion Injury Salvage Kinase (RISK) pathway activation was previously demonstrated to protect the hearts against I/R injury and it is generally activated via Akt or (and) Erk 1/2, and their common downstream protein, ribosomal protein S6 kinase (p70s6k). In addition, prior studies proved that TXL treatment of cells promoted secretion of VEGF, which could be stimulated by the increased phosphorylation of one p70s6k subtype, p70s6k1. Consequently, we hypothesized TXL could protect HCMs from I/R injury by activating p70s6k1 and investigated the underlying mechanism. Methods and Results: HCMs were exposed to hypoxia (18 h) and reoxygenation (2 h) (H/R), with or without TXL pretreatment. H/R reduced mitochondrial membrane potential, increased bax/bcl-2 ratios and cytochrome C levels and induced HCM apoptosis. TXL preconditioning reversed these H/R-induced changes in a dose-dependent manner and was most effective at 400 μg/mL. The anti-apoptotic effect of TXL was abrogated by rapamycin, an inhibitor of p70s6k. However, inhibitors of Erk1/2 (U0126) or Akt (LY294002) failed to inhibit the protective effect of TXL. TXL increased p70s6k1 expression and, thus, enhanced its phosphorylation. Furthermore, transfection of cardiomyocytes with siRNA to p70s6k1 abolished the protective effects of TXL. Among the micro-RNAs (miR-145-5p, miR-128-3p and miR-497-5p) previously reported to target p70s6k1, TXL downregulated miR-128-3p in HCMs during H/R, but had no effects on miR-145-5p and miR-497-5p. An in vivo study confirmed the role of the p70s6k1 pathway in the infarct-sparing effect of TXL, demonstrating that TXL decreased miR-128-3p levels in the rat myocardium during I/R. Transfection of HCMs with a hsa-miR-128-3p mimic eliminated the protective effects of TXL. Conclusions: The miR-128-3p/p70s6k1 signaling pathway is involved in protection by TXL against HCM apoptosis during H/R. Overexpression of p70s6k1 is, therefore, a potential new strategy for alleviating myocardial reperfusion injury.
Collapse
Affiliation(s)
- Gui-Hao Chen
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chuan-Sheng Xu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Zhang
- Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Qing Li
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - He-He Cui
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiang-Dong Li
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li-Ping Chang
- National Key Laboratory of Collateral Disease Research and Innovative Chinese Medicine, Shijiazhuang, China
| | - Rui-Jie Tang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun-Yan Xu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xia-Qiu Tian
- Department of Surgical Intensive Care Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Pei-Sen Huang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Xu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chen Jin
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-Jin Yang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
29
|
Affiliation(s)
- Heerajnarain Bulluck
- From the The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., D.J.H.); The National Institute of Health Research, Biomedical Research Centre, University College London Hospitals, United Kingdom (H.B., D.J.H.); Papworth Hospital NHS Trust, Cambridge, United Kingdom (H.B.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (D.J.H.); National Heart Research Institute Singapore, National Heart Centre, Singapore (D.J.H.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and Yong Loo Lin School of Medicine, National University of Singapore (D.J.H.)
| | - Derek J Hausenloy
- From the The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., D.J.H.); The National Institute of Health Research, Biomedical Research Centre, University College London Hospitals, United Kingdom (H.B., D.J.H.); Papworth Hospital NHS Trust, Cambridge, United Kingdom (H.B.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (D.J.H.); National Heart Research Institute Singapore, National Heart Centre, Singapore (D.J.H.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and Yong Loo Lin School of Medicine, National University of Singapore (D.J.H.).
| |
Collapse
|
30
|
Pasupathy S, Tavella R, Grover S, Raman B, Procter NEK, Du YT, Mahadavan G, Stafford I, Heresztyn T, Holmes A, Zeitz C, Arstall M, Selvanayagam J, Horowitz JD, Beltrame JF. Early Use of N-acetylcysteine With Nitrate Therapy in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction Reduces Myocardial Infarct Size (the NACIAM Trial [N-acetylcysteine in Acute Myocardial Infarction]). Circulation 2017. [PMID: 28634219 DOI: 10.1161/circulationaha.117.027575] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Contemporary ST-segment-elevation myocardial infarction management involves primary percutaneous coronary intervention, with ongoing studies focusing on infarct size reduction using ancillary therapies. N-acetylcysteine (NAC) is an antioxidant with reactive oxygen species scavenging properties that also potentiates the effects of nitroglycerin and thus represents a potentially beneficial ancillary therapy in primary percutaneous coronary intervention. The NACIAM trial (N-acetylcysteine in Acute Myocardial Infarction) examined the effects of NAC on infarct size in patients with ST-segment-elevation myocardial infarction undergoing percutaneous coronary intervention. METHODS This randomized, double-blind, placebo-controlled, multicenter study evaluated the effects of intravenous high-dose NAC (29 g over 2 days) with background low-dose nitroglycerin (7.2 mg over 2 days) on early cardiac magnetic resonance imaging-assessed infarct size. Secondary end points included cardiac magnetic resonance-determined myocardial salvage and creatine kinase kinetics. RESULTS Of 112 randomized patients with ST-segment-elevation myocardial infarction, 75 (37 in NAC group, 38 in placebo group) underwent early cardiac magnetic resonance imaging. Median duration of ischemia pretreatment was 2.4 hours. With background nitroglycerin infusion administered to all patients, those randomized to NAC exhibited an absolute 5.5% reduction in cardiac magnetic resonance-assessed infarct size relative to placebo (median, 11.0%; [interquartile range 4.1, 16.3] versus 16.5%; [interquartile range 10.7, 24.2]; P=0.02). Myocardial salvage was approximately doubled in the NAC group (60%; interquartile range, 37-79) compared with placebo (27%; interquartile range, 14-42; P<0.01) and median creatine kinase areas under the curve were 22 000 and 38 000 IU·h in the NAC and placebo groups, respectively (P=0.08). CONCLUSIONS High-dose intravenous NAC administered with low-dose intravenous nitroglycerin is associated with reduced infarct size in patients with ST-segment-elevation myocardial infarction undergoing percutaneous coronary intervention. A larger study is required to assess the impact of this therapy on clinical cardiac outcomes. CLINICAL TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry. URL: http://www.anzctr.org.au/. Unique identifier: 12610000280000.
Collapse
Affiliation(s)
- Sivabaskari Pasupathy
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Rosanna Tavella
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Suchi Grover
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Betty Raman
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Nathan E K Procter
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Yang Timothy Du
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Gnanadevan Mahadavan
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Irene Stafford
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Tamila Heresztyn
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Andrew Holmes
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Christopher Zeitz
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Margaret Arstall
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Joseph Selvanayagam
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - John D Horowitz
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - John F Beltrame
- From Discipline of Medicine, University of Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., Y.T.D., G.M., C.Z., M.A., J.D.H., J.F.B); Basil Hetzel Institute for Translational Health Research, Adelaide, Australia (S.P., R.T., B.R., N.E.K.P., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Central Adelaide Local Health Network, Australia (S.P., R.T., B.R., N.E.K.P., Y.D., G.M., I.S., T.H., A.H., C.Z., J.D.H., J.F.B); Northern Adelaide Local Health Network, Australia (G.M., C.Z., M.A., J.F.B.); Southern Adelaide Local Health Network, Australia (S.G., J.S.); Discipline of Medicine, Flinders University, Adelaide, Australia (S.G., J.S.); and South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.).
| |
Collapse
|
31
|
Ramos C, Brito R, González-Montero J, Valls N, Gormaz JG, Prieto JC, Aguayo R, Puentes Á, Noriega V, Pereira G, Palavecino T, Rodrigo R. Effects of a novel ascorbate-based protocol on infarct size and ventricle function in acute myocardial infarction patients undergoing percutaneous coronary angioplasty. Arch Med Sci 2017; 13:558-567. [PMID: 28507569 PMCID: PMC5420620 DOI: 10.5114/aoms.2016.59713] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 03/15/2016] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION This study was designed to test the hypothesis that high-dose ascorbate prior to reperfusion followed by low chronic oral doses ameliorate myocardial reperfusion injury (MRI) in acute myocardial infarction patients subjected to primary percutaneous coronary angioplasty (PCA). MATERIAL AND METHODS A randomized double-blind placebo-controlled and multicenter clinical trial was performed on acute myocardial infarction (AMI) patients who underwent PCA. Sodium ascorbate (320 mmol/l, n = 53) or placebo (n = 46) was infused 30 min prior to PCA. Blood samples were drawn at enrolment (M1), after balloon deflation (M2), 6-8 h after M2 (M3) and at discharge (M4). Total antioxidant capacity of plasma (ferric reducing ability of plasma - FRAP), erythrocyte reduced glutathione (GSH) and plasma ascorbate levels were determined in blood samples. Cardiac magnetic resonance (CMR) was performed at 7-15 days and 2-3 months following PCA. Ninety-nine patients were enrolled. In 67 patients, the first CMR was performed, and 40 patients completed follow-up. RESULTS The ascorbate group showed significantly higher ascorbate and FRAP levels and a decrease in the GSH levels at M2 and M3 (p < 0.05). There were no significant differences in the infarct size, indexed end-systolic volume and ejection fraction at both CMRs. There was a significant amelioration in the decreased ejection fraction between the first and second CMR in the ascorbate group (p < 0.05). CONCLUSIONS Ascorbate given prior to reperfusion did not show a significant difference in infarct size or ejection fraction. However, it improved the change in ejection fraction determined between 7-15 days and 2-3 months. This result hints at a possible functional effect of ascorbate to ameliorate MRI.
Collapse
Affiliation(s)
| | - Roberto Brito
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Jaime González-Montero
- Faculty of Medicine, University of Chile, Santiago, Chile
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Nicolás Valls
- Faculty of Medicine, University of Chile, Santiago, Chile
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Juan G. Gormaz
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Juan C. Prieto
- Faculty of Medicine, University of Chile, Santiago, Chile
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | | | | | | | | | - Ramón Rodrigo
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| |
Collapse
|
32
|
van der Weg K, Kuijt WJ, Bekkers SC, Tijssen JG, Green CL, Lemmert ME, Krucoff MW, Gorgels AP. Reperfusion ventricular arrhythmia bursts identify larger infarct size in spite of optimal epicardial and microvascular reperfusion using cardiac magnetic resonance imaging. Eur Heart J Acute Cardiovasc Care 2017; 7:246-256. [PMID: 28345953 DOI: 10.1177/2048872617690887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Ventricular arrhythmia (VA) bursts following recanalisation in acute ST-elevation myocardial infarction (STEMI) are related to larger infarct size (IS). Inadequate microvascular reperfusion, as determined by microvascular obstruction (MVO) using cardiac magnetic resonance imaging (CMR), is also known to be associated with larger IS. This study aimed to test the hypothesis that VA bursts identify larger infarct size in spite of optimal microvascular reperfusion. METHODS All 65 STEMI patients from the Maastricht ST elevation (MAST) study with brisk epicardial flow (TIMI 3), complete ST recovery post-percutaneous coronary intervention and early CMR were included. Using 24-hour Holter registrations from the time of admission, VA bursts were identified against subject-specific Holter background VA rates using a statistical outlier method. MVO and final IS were determined using delayed enhancement CMR. RESULTS MVO was present in 37/65 (57%) of patients. IS was significantly smaller in the group without MVO (median 9.4% vs. 20.5%; p < 0.001). IS in the group with MVO did not differ depending on VA burst ( n = 28/37; median 20.8% vs. 19.7%; p = 0.64). However, in the group without MVO, VA burst was associated with significantly larger IS ( n = 17/28; median 10.5% vs. 4.1%; p = 0.037). In multivariable analyses, VA burst as well as anterior infarct location remained independent predictors of larger infarct size. CONCLUSION In the presence of suboptimal reperfusion with MVO by CMR, VA burst does not further define MI size. However, with optimal TIMI 3 reperfusion and optimal microvascular perfusion (i.e. no MVO), VA burst is associated with larger IS, indicating that VA burst is a marker of additional cell death.
Collapse
Affiliation(s)
- Kirian van der Weg
- 1 Maastricht University Medical Center, Maastricht, The Netherlands.,2 Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA
| | | | | | | | - Cynthia L Green
- 2 Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA
| | - Miguel E Lemmert
- 1 Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mitchell W Krucoff
- 2 Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA
| | - Anton Pm Gorgels
- 1 Maastricht University Medical Center, Maastricht, The Netherlands
| |
Collapse
|
33
|
Chen W, Chen G. Danshen (Salvia miltiorrhiza Bunge): A Prospective Healing Sage for Cardiovascular Diseases. Curr Pharm Des 2017; 23:5125-5135. [PMID: 28828985 DOI: 10.2174/1381612823666170822101112] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 07/01/2017] [Accepted: 07/24/2017] [Indexed: 02/07/2023]
Abstract
Danshen (Salvia miltiorrhiza Bunge) is a valued herbal plant in the Traditional Chinese Medicine. The dried root of this plant (Radix Salvia miltiorrhiza), either alone or in combination with other herbal ingredients, has been used for hundreds of years to treat numerous ailments, especially cardiovascular diseases. For the past several decades, many studies have tried to delineate the putative cardioprotective effects of this folk medicine through the lens of modern scientific research. In this review, we have summarized the current knowledge about the pharmacological potentials of danshen. The main focus is laid on the predominant bioactive compounds in danshen, which include phenolic acids and tanshinones. We discussed the absorption and metabolism of these compounds, and examine in detail the cardioprotective mechanisms during atherosclerosis, thrombosis, and myocardial infarction reperfusion.
Collapse
Affiliation(s)
- Wei Chen
- College of Biologic Big Data, Yunnan Agricultural University, Kunming 650201, China
- Yunnan Research Institute for Local Plateau Agriculture and Industry, Kunming 650201, China
- Division of Precision Nutrition, BGI-Agriculture, Shenzhen 518083, China
| | - Guoxun Chen
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, 37996, United States
| |
Collapse
|
34
|
Affiliation(s)
- Xavier Rossello
- From Hatter Cardiovascular Institute, University College London, London, UK (X.R., D.M.Y.); and NIHR UCLH Biomedical Research Centre, University College London Hospital, London, UK (D.M.Y.)
| | - Derek M Yellon
- From Hatter Cardiovascular Institute, University College London, London, UK (X.R., D.M.Y.); and NIHR UCLH Biomedical Research Centre, University College London Hospital, London, UK (D.M.Y.).
| |
Collapse
|
35
|
Lian ZX, Wang F, Fu JH, Chen ZY, Xin H, Yao RY. ATP-induced cardioprotection against myocardial ischemia/reperfusion injury is mediated through the RISK pathway. Exp Ther Med 2016; 12:2063-2068. [PMID: 27698693 PMCID: PMC5038560 DOI: 10.3892/etm.2016.3563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/25/2016] [Indexed: 12/11/2022] Open
Abstract
The aim of the present study was to examine the post-infarct acute effect of adenosine-5'-triphosphate (ATP) on myocardial infarction (MI) size as well as its precise molecular mechanism. Sixty New Zealand white male rabbits were exposed to 40 min of ischemia followed by 180 min of reperfusion. The rabbits were intravenously administered 3 mg/kg of ATP (ATP group) or saline (control group) immediately after reperfusion and maintained throughout the first 30 min. The wortmannin+ATP, PD-98059+ATP, and 5-hydroxydecanoic acid (5-HD) sodium salt+ATP groups were separately injected with wortmannin (0.6 mg/kg), PD-98059 (0.3 mg/kg), and 5-HD (5 mg/kg) 5 min prior to ATP administration. MI size was calculated as the percentage of the risk area in the left ventricle. Myocardial apoptosis was determined using a TUNEL assay. Western blot analysis was performed to examine the levels of protein kinase B (Akt)/p-Akt and extracellular signal-regulated kinase (ERK)/p-ERK in the ischemic myocardium, 180 min after reperfusion. The infarct size was significantly smaller in the ATP group than in the control group (p<0.05). The infarct size-reducing effect of ATP was completely blocked by wortmannin, PD-98059 and 5-HD. Compared with the control group, cardiomyocyte apoptosis was significantly reduced in the ATP group, while this did not occur in the wortmannin+ATP, PD-98059+ATP and 5-HD+ATP groups. Western blot analysis revealed a higher myocardial expression of p-Akt and p-ERK 180 min following reperfusion in the ATP versus the control group. In conclusion, cardioprotection by postischemic ATP administration is mediated through activation of the reperfusion injury salvage kinase (RISK) pathway and opening of the mitochondrial ATP-dependent potassium channels.
Collapse
Affiliation(s)
- Zhe-Xun Lian
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Fang Wang
- Department of Cardiology, The Third People's Hospital of Qingdao, Qingdao, Shandong 266000, P.R. China
| | - Jun-Hua Fu
- Department of Interventional Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Zuo-Yuan Chen
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Hui Xin
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Ru-Yong Yao
- Department of Central Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| |
Collapse
|
36
|
Schumer EM, Chaney JH, Trivedi JR, Linsky PL, Williams ML, Slaughter MS. Emergency Coronary Artery Bypass Grafting: Indications and Outcomes from 2003 through 2013. Tex Heart Inst J 2016; 43:214-9. [PMID: 27303236 DOI: 10.14503/thij-14-4978] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Emergency coronary artery bypass grafting (CABG) is associated with increased in-hospital mortality rates and adverse events. This study retrospectively evaluated indications and outcomes in patients who underwent emergency CABG. The Society of Thoracic Surgeons database for a single center (Jewish Hospital) was queried to identify patients undergoing isolated CABG. Univariate analysis was performed. From January 2003 through December 2013, 5,940 patients underwent CABG; 212 presented with emergency status. A high proportion of female patients (28.2%) underwent emergency surgery. Emergency CABG patients experienced high rates of intra-aortic balloon pump support, bleeding, dialysis, in-hospital death, and prolonged length of stay. The proportion of emergency coronary artery bypass grafting declined during years 2008-2013 compared with 2003-2007 (2.2% vs. 4.5%, P < 0.001), but the incidence of angiographic accident (5.3% vs. 29.2%) increased as an indication. Ongoing ischemia remains the most frequent indication for emergency CABG, yet the incidence of angiographic accident has greatly increased. In-hospital mortality rates and adverse events remain high. If we look specifically at emergency CABG cases arising from angiographic accident, we find that 14 (15%) of all 93 emergency CABG deaths occurred in that subset of patients. Efforts to improve outcomes should therefore be focused on this high-risk group.
Collapse
|
37
|
Abstract
Mild therapeutic hypothermia of 32-35°C improved neurologic outcomes in outside hospital cardiac arrest survivor. Furthermore, in experimental studies on infarcted model and pilot studies on conscious patients with acute myocardial infarction, therapeutic hypothermia successfully reduced infarct size and microvascular resistance. Therefore, mild therapeutic hypothermia has received an attention as a promising solution for reduction of infarction size after acute myocardial infarction which are not completely solved despite of optimal reperfusion therapy. Nevertheless, the results from randomized clinical trials failed to prove the cardioprotective effects of therapeutic hypothermia or showed beneficial effects only in limited subgroups. In this article, we reviewed rationale for therapeutic hypothermia and possible mechanisms from previous studies, effective methods for clinical application to the patients with acute myocardial infarction, lessons from current clinical trials and future directions.
Collapse
Affiliation(s)
- In Sook Kang
- Department of Internal Medicine, Green Hospital, Seoul, Korea
- Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ikeno Fumiaki
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - Wook Bum Pyun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
| |
Collapse
|
38
|
Pachel C, Mathes D, Arias-Loza AP, Heitzmann W, Nordbeck P, Deppermann C, Lorenz V, Hofmann U, Nieswandt B, Frantz S. Inhibition of Platelet GPVI Protects Against Myocardial Ischemia-Reperfusion Injury. Arterioscler Thromb Vasc Biol 2016; 36:629-35. [PMID: 26916731 DOI: 10.1161/atvbaha.115.305873] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 02/16/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the effects of platelet inhibition on myocardial ischemia-reperfusion (IR) injury. APPROACH AND RESULTS Timely restoration of coronary blood flow after myocardial infarction is indispensable but leads to additional damage to the heart (myocardial IR injury). Microvascular dysfunction contributes to myocardial IR injury. We hypothesized that platelet activation during IR determines microvascular perfusion and thereby the infarct size in the reperfused myocardium. The 3 phases of thrombus formation were analyzed by targeting individual key platelet-surface molecules with monoclonal antibody derivatives: (1) adhesion (anti-glycoprotein [GP]-Ib), (2) activation (anti-GPVI), and (3) aggregation (anti-GPIIbIIIa) in a murine in vivo model of left coronary artery ligation (30 minutes of ischemia followed by 24 hours of reperfusion). Infarct sizes were determined by Evans Blue/2,3,5-triphenyltetrazolium chloride staining, infiltrating neutrophils by immunohistology. Anti-GPVI treatment significantly reduced infarct size versus control, whereas anti-GPIb or anti-GPIIbIIIa antibody fragments showed no significant differences. Mechanistically, anti-GPVI antibody-mediated reduction of infarct size was not because of impaired Ca(2+) signaling or platelet degranulation because mice deficient in store-operated calcium channels (stromal interaction molecule 1, ORAI1), α-granules (Nbeal2(-/-)), and dense granule release (Unc13d(-/-)) had similar infarct sizes as control animals. Protective effects of anti-GPVI treatment were accompanied by improved microperfusion. Leukocyte infiltration was reduced in both anti-GPVI and anti-GPIb-treated IR mice. CONCLUSIONS Inhibition of platelet activation by an anti-GPVI antibody, but not inhibition of platelet adhesion or aggregation by an anti-GPIb or anti-GPIIbIIIa antibody significantly reduces infarct size. The reduction of the infarct size is primarily based on an improved microperfusion after anti-GPVI antibody treatment.
Collapse
Affiliation(s)
- Christina Pachel
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.)
| | - Denise Mathes
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.)
| | - Anahi-Paula Arias-Loza
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.)
| | - Wolfram Heitzmann
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.)
| | - Peter Nordbeck
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.)
| | - Carsten Deppermann
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.)
| | - Viola Lorenz
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.)
| | - Ulrich Hofmann
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.)
| | - Bernhard Nieswandt
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.)
| | - Stefan Frantz
- From the Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (C.P., D.M., A.-P.A.-L., W.H., P.N., U.H., S.F.); Hospital Pharmacy, Jena University Hospital, Jena, Germany (D.M.); Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany (U.H., S.F.); Rudolf Virchow Center, DFG Research Center for Experimental Biomedicine, Würzburg, Germany (C.D., V.L., B.N.); Division of Newborn Medicine, Boston Children's Hospital, Boston (V.L.); and Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Halle (Saale), Germany (U.H., S.F.).
| |
Collapse
|
39
|
Badalzadeh R, Mokhtari B, Yavari R. Contribution of apoptosis in myocardial reperfusion injury and loss of cardioprotection in diabetes mellitus. J Physiol Sci 2015; 65:201-15. [PMID: 25726180 PMCID: PMC10717803 DOI: 10.1007/s12576-015-0365-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 02/11/2015] [Indexed: 12/21/2022]
Abstract
Ischemic heart disease is one of the major causes of death worldwide. Ischemia is a condition in which blood flow of the myocardium declines, leading to cardiomyocyte death. However, reperfusion of ischemic regions decreases the rate of mortality, but it can also cause later complications. In a clinical setting, ischemic heart disease is always coincident with other co-morbidities such as diabetes. The risk of heart disease increases 2-3 times in diabetic patients. Apoptosis is considered to be one of the main pathophysiological mechanisms of myocardial ischemia-reperfusion injury. Diabetes can disrupt the anti-apoptotic intracellular signaling cascades involved in myocardial protection. Therefore, targeting these changes may be an effective cardioprotective approach in the diabetic myocardium against ischemia-reperfusion injury. In this article, we review the interaction of diabetes with the pathophysiology of myocardial ischemia-reperfusion injury, focusing on the contribution of apoptosis in this context, and then discuss the alterations of pro-apoptotic or anti-apoptotic pathways probably responsible for the loss of cardioprotection in diabetes.
Collapse
Affiliation(s)
- Reza Badalzadeh
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behnaz Mokhtari
- Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Raana Yavari
- Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
40
|
Crimi G, Pica S, Raineri C, Bramucci E, De Ferrari GM, Klersy C, Ferlini M, Marinoni B, Repetto A, Romeo M, Rosti V, Massa M, Raisaro A, Leonardi S, Rubartelli P, Oltrona Visconti L, Ferrario M. Remote ischemic post-conditioning of the lower limb during primary percutaneous coronary intervention safely reduces enzymatic infarct size in anterior myocardial infarction: a randomized controlled trial. JACC Cardiovasc Interv 2014; 6:1055-63. [PMID: 24156966 DOI: 10.1016/j.jcin.2013.05.011] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 05/14/2013] [Accepted: 05/17/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study sought to evaluate whether remote ischemic post-conditioning (RIPC) could reduce enzymatic infarct size in patients with anterior ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (pPCI). BACKGROUND Myocardial reperfusion injury may attenuate the benefit of pPCI. In animal models, RIPC mitigates myocardial reperfusion injury. METHODS One hundred patients with anterior ST-segment elevation myocardial infarction and occluded left anterior descending artery were randomized to pPCI + RIPC (n = 50) or conventional pPCI (n = 50). RIPC consisted of 3 cycles of 5 min/5 min ischemia/reperfusion by cuff inflation/deflation of the lower limb. The primary endpoint was infarct size assessed by the area under the curve of creatinine kinase-myocardial band release (CK-MB). Secondary endpoints included the following: infarct size assessed by cardiac magnetic resonance delayed enhancement volume; T2-weighted edema volume; ST-segment resolution >50%; TIMI (Thrombolysis In Myocardial Infarction) frame count; and myocardial blush grading. RESULTS Four patients (2 RIPC, 2 controls) were excluded due to missing samples of CK-MB. A total of 96 patients were analyzed; median area under the curve CK-MB was 8,814 (interquartile range [IQR]: 5,567 to 11,325) arbitrary units in the RIPC group and 10,065 (IQR: 7,465 to 14,004) arbitrary units in control subjects (relative reduction: 20%, 95% confidence interval: 0.2% to 28.7%; p = 0.043). Seventy-seven patients underwent a cardiac magnetic resonance scan 3 to 5 days after randomization, and 66 patients repeated a second scan after 4 months. T2-weighted edema volume was 37 ± 16 cc in RIPC patients and 47 ± 22 cc in control subjects (p = 0.049). ST-segment resolution >50% was 66% in RIPC and 37% in control subjects (p = 0.015). We observed no significant differences in TIMI frame count, myocardial blush grading, and delayed enhancement volume. CONCLUSIONS In patients with anterior ST-segment elevation myocardial infarction, RIPC at the time of pPCI reduced enzymatic infarct size and was also associated with an improvement of T2-weighted edema volume and ST-segment resolution >50%. (Remote Postconditioning in Patients With Acute Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention [PCI] [RemPostCon]; NCT00865722).
Collapse
Affiliation(s)
- Gabriele Crimi
- Struttura Complessa Cardiologia, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy; SC Cardiologia, Azienda Sanitaria Locale 3 Ospedale Villa Scassi, Genova, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Sobral MLP, dos Santos Júnior SF, de Sá JC, Terrazas ADS, Trompieri DFDM, de Sousa TAN, dos Santos GG, Stolf NAG. Improvement in cardioplegic perfusion technique in single aortic clamping - initial results. Braz J Cardiovasc Surg 2014; 29:229-35. [PMID: 25140473 PMCID: PMC4389463 DOI: 10.5935/1678-9741.20140026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 11/17/2013] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The most common method used for myocardial protection is administering cardioplegic solution in the coronary circulation. Nevertheless, protection may be achieved by intermittent perfusion of the coronary system with patient's own blood. The intermittent perfusion may be performed by multiple sequences of clamping and opening of the aortic clamp or due single clamping and accessory cannulation of the aortic root as in the improved technique proposed in this study, reperfusion without the need for multiple clamping of the aorta. OBJECTIVE To evaluate the clinical outcome and the occurrence of neurological events in in-hospital patients submitted to myocardial revascularization surgery with the "improved technique" of intermittent perfusion of the aortic root with single clamping. METHODS This is a prospective, cross-sectional, observational study that describes a myocardial management technique that consists of intermittent perfusion of the aortic root with single clamping in which 50 patients (mean age 58.5 ± 7.19 years old) have been submitted to the myocardial revasculrization surgery under the proposed technique. Clinical and laboratory variables, pre- and post-surgery, have been assessed. RESULTS The mean peak level of post-surgery CKMB was 51.64 ± 27.10 U/L in the second post-surgery and of troponin I was 3.35 ± 4.39 ng/ml in the fourth post-surgery, within normal limits. No deaths have occurred and one patient presented mild neurological disorder. Hemodynamic monitoring has not indicated any changes. CONCLUSION The myocardial revascularization surgery by perfusion with the improved technique with intermittent aortic root with single clamping proved to be safe, enabling satisfactory clinical results.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Gilmar Geraldo dos Santos
- Instituto do Coração da Faculdade de Medicina da Universidade de São
Paulo INCOR/FMUSP, São Paulo, SP, Brazil
| | - Noedir Antonio Groppo Stolf
- Instituto do Coração da Faculdade de Medicina da Universidade de São
Paulo (FMUSP), São Paulo, SP, Brazil. Real e Benemérita Associação Portuguesa de São
Paulo, São Paulo, SP, Brazil
| |
Collapse
|
42
|
Hausenloy DJ. Conditioning the heart to prevent myocardial reperfusion injury during PPCI. Eur Heart J Acute Cardiovasc Care 2013; 1:13-32. [PMID: 24062884 DOI: 10.1177/2048872612438805] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 01/22/2012] [Indexed: 11/15/2022]
Abstract
For patients presenting with a ST-segment elevation myocardial infarction (STEMI), early myocardial reperfusion by primary percutaneous coronary intervention (PPCI) remains the most effective treatment strategy for limiting myocardial infarct size, preserving left ventricular systolic function, and preventing the onset of heart failure. Recent advances in PCI technology to improve myocardial reperfusion and the introduction of novel anti-platelet and anti-thrombotic agents to maintain the patency of the infarct-related coronary artery continue to optimize PPCI procedure. However, despite these improvements, STEMI patients still experience significant major adverse cardiovascular events. One major contributing factor has been the inability to protect the heart against the lethal myocardial reperfusion injury, which accompanies PPCI. Past attempts to translate cardioprotective strategies, discovered in experimental studies to prevent lethal myocardial reperfusion injury, into the clinical setting of PPCI have been disappointing. However, a number of recent proof-of-concept clinical studies suggest that the heart can be 'conditioned' to protect itself against lethal myocardial reperfusion injury, as evidenced by a reduction in myocardial infarct size. This can be achieved using either mechanical (such as ischaemic postconditioning, remote ischaemic preconditioning, therapeutic hypothermia, or hyperoxaemia) or pharmacological (such as cyclosporin-A, natriuretic peptide, exenatide) 'conditioning' strategies as adjuncts to PPCI. Furthermore, recent developments in cardiac magnetic resonance (CMR) imaging can provide a non-invasive imaging strategy for assessing the efficacy of these novel adjunctive therapies to PPCI in terms of key surrogate clinical endpoints such as myocardial infarct size, myocardial salvage, left ventricular ejection fraction, and the presence of microvascular obstruction or intramyocardial haemorrhage. In this article, we review the therapeutic potential of 'conditioning' to protect the heart against lethal myocardial reperfusion injury in STEMI patients undergoing PPCI.
Collapse
|
43
|
Ren J, Zhang H, Huang L, Liu Y, Liu F, Dong Z. Protective effect of dexmedetomidine in coronary artery bypass grafting surgery. Exp Ther Med 2013; 6:497-502. [PMID: 24137215 PMCID: PMC3786847 DOI: 10.3892/etm.2013.1183] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 06/03/2013] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to observe the impact of dexmedetomidine on postoperative myocardial injury in patients undergoing off-pump coronary artery bypass (OPCAB) grafting. One hundred and sixty-two patients who were undergoing OPCAB surgery were randomly divided into control and dexmedetomidine groups (groups C and Dex, respectively). Following the first vascular anastomosis grafting, the patients in group Dex received a continuous intravenous infusion of 0.2–0.5 μg/kg/h dexmedetomidine, until they were transferred to the Cardiac Surgery intensive care unit (ICU) for 12 h. Patients in group C received physiological saline intraoperatively and an intravenous infusion of 2–4 mg/kg/h isopropylphenol for postoperative sedation. Invasive arterial pressure and heart rate were continuously monitored for 5 min subsequent to entry into the operating theatre (T0), immediately following surgery (T1), 12 h post-surgery (T2), 24 h post-surgery(T3), 48 h post-surgery(T4) and 72 h post-surgery (T5). Blood samples were taken to determine the plasma levels of cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) at each time point. At 72 h post-surgery, a dynamic electrocardiogram was monitored. The blood pressure, heart rate, levels of cTnI, CK-MB, norepinephrine and cortisol, and postoperative arrhythmic events in the patients in group Dex all decreased compared with those in group C. The duration of mechanical ventilation and ICU residence time were also shorter than those in the control group (P<0.05). Dexmedetomidine reduced post-surgical myocardial injury in patients who had undergone OPCAB surgery.
Collapse
Affiliation(s)
- Jianjun Ren
- Department of Anesthesiology, The Second Affiliated Hospital, Hebei Medical University, Shijiazhuang, Hebei 050000
| | | | | | | | | | | |
Collapse
|
44
|
Buja LM. The pathobiology of acute coronary syndromes: clinical implications and central role of the mitochondria. Tex Heart Inst J 2013; 40:221-228. [PMID: 23914009 PMCID: PMC3709209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Ongoing investigation has provided new insights into the pathobiology of myocardial ischemic injury. These include an improved understanding of the roles of the major modes of cell injury and death, including oncosis, apoptosis, and unregulated autophagy, as well as the central role of the mitochondria in the progression of myocardial ischemic injury, reperfusion injury, and myocardial conditioning. This understanding is providing insights for developing new pathophysiologic, pharmacologic, and cell-based therapies, alone or in combination with percutaneous coronary interventions, for better preservation of myocardium and reduction of morbidity and mortality rates from ischemic heart disease.
Collapse
Affiliation(s)
- L Maximilian Buja
- Cardiovascular Pathology Research Laboratory, Texas Heart Institute, Houston, Texas 77030, USA.
| |
Collapse
|
45
|
Traverse JH, Henry TD, Vaughan DE, Ellis SG, Pepine CJ, Willerson JT, Zhao DXM, Simpson LM, Penn MS, Byrne BJ, Perin EC, Gee AP, Hatzopoulos AK, McKenna DH, Forder JR, Taylor DA, Cogle CR, Baraniuk S, Olson RE, Jorgenson BC, Sayre SL, Vojvodic RW, Gordon DJ, Skarlatos SI, Moyè LA, Simari RD. LateTIME: a phase-II, randomized, double-blinded, placebo-controlled, pilot trial evaluating the safety and effect of administration of bone marrow mononuclear cells 2 to 3 weeks after acute myocardial infarction. Tex Heart Inst J 2010; 37:412-420. [PMID: 20844613 PMCID: PMC2929864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A realistic goal for cardiac cell therapy may be to attenuate left ventricular remodeling following acute myocardial infarction to prevent the development of congestive heart failure. Initial clinical trials of cell therapy have delivered cells 1 to 7 days after acute myocardial infarction. However, many patients at risk of developing congestive heart failure may not be ready for cell delivery at that time-point because of clinical instability or hospitalization at facilities without access to cell therapy. Experience with cell delivery 2 to 3 weeks after acute myocardial infarction has not to date been explored in a clinical trial. The objective of the LateTIME study is to evaluate by cardiac magnetic resonance the effect on global and regional left ventricular function, between baseline and 6 months, of a single intracoronary infusion of 150 × 106 autologous bone marrow mononuclear cells (compared with placebo) when that infusion is administered 2 to 3 weeks after moderate-to-large acute myocardial infarction. The 5 clinical sites of the Cardiovascular Cell Therapy Research Network (CCTRN) will enroll a total of 87 eligible patients in a 2:1 bone marrow mononuclear cells-to-placebo patient ratio; these 87 will have undergone successful percutaneous coronary intervention of a major coronary artery and have left ventricular ejection fractions ≤0.45 by echocardiography. When the results become available, this study should provide insight into the clinical feasibility and appropriate timing of autologous cell therapy in high-risk patients after acute myocardial infarction and percutaneous coronary intervention.
Collapse
Affiliation(s)
- Jay H Traverse
- Minneapolis Heart Institute at Abbott Northwestern Hospital, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Chen Z, Chua CC, Gao J, Chua KW, Ho YS, Hamdy RC, Chua BH. Prevention of ischemia/reperfusion-induced cardiac apoptosis and injury by melatonin is independent of glutathione peroxdiase 1. J Pineal Res 2009; 46:235-41. [PMID: 19141089 PMCID: PMC2752734 DOI: 10.1111/j.1600-079x.2008.00654.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Free-radical generation is one of the primary causes of myocardial ischemia/reperfusion (I/R) injury. Melatonin is an efficient free-radical scavenger and induces the expression of antioxidant enzymes. We have previously shown that melatonin can prevent free-radical-induced myocardial injury. To date, the mechanism underlying melatonin's cardioprotective effect is not clear. In this study, we assessed the ability of melatonin to protect against I/R injury in mice deficient in glutathione peroxidase 1 (Gpx1). Mice hearts were subjected to 40 min of global ischemia in vitro followed by 45 min of reperfusion. Myocardial I/R injury (expressed as % of recovery of left ventricular developed pressure x heart rate) was exacerbated in mice deficient in Gpx1 (51 +/- 3% for Gpx1+/+ mice versus 31 +/- 6% for Gpx1(-/-) mice, P < 0.05). Administration of melatonin for 30 min protected against I/R injury in both Gpx1+/+ mice (72 +/- 4.8%) and Gpx1(-/-) mice (63 +/- 4.7%). This protection was accompanied by a significant improvement in left ventricular end-diastolic pressure and a twofold decrease in lactate dehydrogenase (LDH) level released from melatonin-treated hearts. In another set of experiments, mice were subjected to 50 min of ligation of the left descending anterior coronary artery in vivo followed by 4 hr of reperfusion. The infarct sizes, expressed as the percentage of the area at risk, were significantly larger in Gpx1(-/-) mice than in Gpx1+/+ mice (75 +/- 9% versus 54 +/- 6%, P < 0.05) and were reduced significantly in melatonin-treated mice (31 +/- 3.7% Gpx1(-/-) mice and 33 +/- 6.0% Gpx1+/+ mice). In hearts subjected to 30 min of coronary artery occlusion followed by 3 hr of reperfusion, melatonin-treated hearts had significantly fewer in situ oligo ligation-positive myocytes and less protein nitration. Our results demonstrate that the cardioprotective function of melatonin is independent of Gpx1.
Collapse
Affiliation(s)
- Zhongyi Chen
- Cecile Cox Quillen Laboratory of Geriatric Research, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN
| | - Chu C. Chua
- Cecile Cox Quillen Laboratory of Geriatric Research, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN
| | - Jinping Gao
- Cecile Cox Quillen Laboratory of Geriatric Research, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN
| | - Kao-Wei Chua
- Cecile Cox Quillen Laboratory of Geriatric Research, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN
| | - Ye-Shih Ho
- Institute of Environmental Health Sciences and Department of Biochemistry and Molecular Biology, Wayne State University, Detroit, MI
| | - Ronald C. Hamdy
- Cecile Cox Quillen Laboratory of Geriatric Research, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN
| | - Balvin H.L. Chua
- Cecile Cox Quillen Laboratory of Geriatric Research, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN
- Correspondence to Dr. Balvin H.L. Chua, James H. Quillen College of Medicine, East Tennessee State University, Box 70432, Johnson City, TN 37614, Phone: (423) 926-1171 Ext. 7674, Fax: (423) 979-3408,
| |
Collapse
|
47
|
Carter JM, Buerke U, Rössner E, Russ M, Schubert S, Schmidt H, Ebelt H, Pruefer D, Schlitt A, Werdan K, Buerke M. Anti-inflammatory actions of aprotinin provide dose-dependent cardioprotection from reperfusion injury. Br J Pharmacol 2008; 155:93-102. [PMID: 18536753 PMCID: PMC2527842 DOI: 10.1038/bjp.2008.223] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2007] [Revised: 11/29/2007] [Accepted: 04/17/2008] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Myocardial injury following ischaemia and reperfusion has been attributed to activation and transmigration of polymorphonuclear leukocytes (PMNs) with release of mediators including oxygen-derived radicals and proteases causing damage. EXPERIMENTAL APPROACH We studied the serine protease inhibitor aprotinin in an in vivo rabbit model of 1 h of myocardial ischaemia followed by 3 h of reperfusion (MI+R). Aprotinin (10,000 Ukg(-1)) or its vehicle were injected 5 min prior to the start of reperfusion. KEY RESULTS Myocardial injury was significantly reduced with aprotinin treatment as indicated by a reduced necrotic area (11+/-2.7% necrosis as percentage of area at risk after aprotinin; 24+/-3.1% after vehicle; P<0.05) and plasma creatine kinase activity (12.2+/-1.5 and 17.3+/-2.3 IU g(-1) protein in aprotinin and vehicle groups, respectively, P<0.05). PMN infiltration (assessed by myeloperoxidase activity) was significantly decreased in aprotinin-treated animals compared to vehicle (P<0.01). Histological analysis also revealed a substantial increase in PMN infiltration following MI+R and this was significantly reduced by aprotinin therapy (44+/-15 vs 102+/-2 PMN mm2 in aprotinin vs vehicle-treated animals, P<0.05). In parallel in vitro experiments, aprotinin inhibited neutrophil-endothelium interaction by reducing PMN adhesion on isolated, activated aortic endothelium. Finally, immunohistochemical analysis illustrated aprotinin significantly reduced myocardial apoptosis following MI+R. CONCLUSIONS AND IMPLICATIONS Inhibition of serine proteases by aprotinin inhibits an inflammatory cascade initiated by MI+R. The cardioprotective effect appears to be at least partly due to reduced PMN adhesion and infiltration with subsequently reduced myocardial necrosis and apoptosis.
Collapse
Affiliation(s)
- J M Carter
- Department of Medicine III, Martin-Luther-University Halle, Germany
| | - U Buerke
- Department of Medicine III, Martin-Luther-University Halle, Germany
| | - E Rössner
- Department of Medicine III, Martin-Luther-University Halle, Germany
| | - M Russ
- Department of Medicine III, Martin-Luther-University Halle, Germany
| | - S Schubert
- Department of Medicine III, Martin-Luther-University Halle, Germany
| | - H Schmidt
- Department of Medicine III, Martin-Luther-University Halle, Germany
| | - H Ebelt
- Department of Medicine III, Martin-Luther-University Halle, Germany
| | - D Pruefer
- Department of Cardiothoracic and Vascular Surgery, Johannes-Gutenberg University Mainz Mainz, Germany
| | - A Schlitt
- Department of Medicine III, Martin-Luther-University Halle, Germany
| | - K Werdan
- Department of Medicine III, Martin-Luther-University Halle, Germany
| | - M Buerke
- Department of Medicine III, Martin-Luther-University Halle, Germany
| |
Collapse
|
48
|
Orhan G, Sargin M, Senay S, Yuksel M, Kurc E, Tasdemir M, Ozay B, Aka SA. Systemic and myocardial inflammation in traditional and off-pump cardiac surgery. Tex Heart Inst J 2007; 34:160-5. [PMID: 17622361 PMCID: PMC1894692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
In this study, we attempted to determine the role of off-pump coronary artery bypass grafting (CABG) in the myocardial and systemic inflammatory responses. Twenty patients who underwent elective CABG were enrolled in this study. Ten patients underwent on-pump CABG, and 10 patients underwent off-pump CABG. There were no differences between patients in preoperative clinical variables. We took systemic venous blood samples for the measurement of tumor necrosis factor-alpha, the MB isoenzyme of creatine kinase (CK-MB), and cardiac troponin I, and we took myocardial biopsies from the interventricular septum for chemiluminescence assay of reactive oxygen species (hydroxyl, hydrogen peroxide, hypochlorite, and superoxide). There was no significant difference in the myocardial tissue release of hydrogen peroxide, hydroxyl, hypochlorite, and superoxide between the 2 groups (P > 0.05). The systemic tumor necrosis factor-alpha levels in the off-pump group were significantly lower than in the on-pump group (P <0.01). The cardiac troponin I and creatine kinase-MB levels at 6, 12, and 24 postoperative hours were not statistically different between the 2 groups (P >0.05). We conclude that off-pump CABG appears to reduce systemic inflammation, without reducing myocardial oxidative stress and inflammation.
Collapse
Affiliation(s)
- Gokcen Orhan
- Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Center, 34100 Istanbul, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|