A novel intracoronary hypothermia device reduces myocardial reperfusion injury in pigs

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国家科技期刊平台
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外文摘要：Background:Hypothermia therapy has been suggested to attenuate myocardial necrosis;however,the clinical implementation as a valid therapeutic strategy has failed,and new approaches are needed to translate into clinical applications.This study aimed to assess the feasibility,safety,and efficacy of a novel selective intracoronary hypothermia(SICH)device in mitigating myocardial reperfusion injury.Methods:This study comprised two phases.The first phase of the SICH was performed in a normal porcine model for 30 minutes(n=5)to evaluate its feasibility.The second phase was conducted in a porcine myocardial infarction(MI)model of myocardial ischemia/reperfusion which was performed by balloon occlusion of the left anterior descending coronary artery for 60 minutes and maintained for 42 days.Pigs in the hypothermia group(n=8)received hypothermia intervention onset reperfusion for 30 minutes and controls(n=8)received no intervention.All animals were followed for 42 days.Cardiac magnetic resonance analysis(five and 42 days post-MI)and a series of biomarkers/histological studies were performed.Results:The average time to lower temperatures to a steady state was 4.8±0.8 s.SICH had no impact on blood pressure or heart rate and was safely performed without complications by using a 3.9 F catheter.Interleukin-6(IL-6),tumor necrosis factor-α,C-reactive protein(CRP),and brain natriuretic peptide(BNP)were lower at 60 min post perfusion in pigs that underwent SICH as compared with the control group.On day 5 post MI/R,edema,intramyocardial hemorrhage,and microvascular obstruction were reduced in the hypothermia group.On day 42 post MI/R,the infarct size,IL-6,CRP,BNP,and matrix metalloproteinase-9 were reduced,and the ejection fraction was improved in pigs that underwent SICH.Conclusions:The SICH device safely and effectively reduced the infarct size and improved heart function in a pig model of MI/R.These beneficial effects indicate the clinical potential of SICH for treatment of myocardial reperfusion injury.

外文关键词：

Acute myocardial infarctionCardioprotectionHypothermiaInflammationLeft ventricular systolic functionPercutaneous coronary interventionCardiac magnetic resonance imaging

作者：

Zhiqiang Pei、Jin Qiu、Yongchao Zhao、Shuai Song、Rui Wang、Wei Luo、Xingxing Cai、Bin Liu、Han Chen、Jiasheng Yin、Xinyu Weng、Yizhe Wu、Chenguang Li、Li Shen、Junbo Ge

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作者单位：

Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China

Shanghai Institute of Cardiovascular Diseases,Shanghai 200032,China

Department of Cardiology,Taiyuan Central Hospital of Shanxi Medical University,Taiyuan,Shanxi 030009,China

Department of Cardiology,Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563000,China

National Clinical Research for Interventional Medicine,Shanghai 200032,China

Department of Cardiology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 201322,China

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基金：

National Natural Science Foundation of ChinaShanghai Engineering Research Center of Interventional MedicineNational Key R&D Program of ChinaChinese Academy of Medical SciencesChinese Academy of Medical SciencesFellowship of the China National Postdoctoral Program for Innovative TalentsChina Postdoctoral Science FoundationShanghai Shenkang Hospital Development Center

项目编号：

8217034219DZ22503002021YFA12013002019-I2M-5-0602020-JKCS-0154020BX202200942022M710776SHDC2020CR3023B

出版年：

2024

DOI：

10.1097/CM9.0000000000003033

中华医学杂志(英文版)

中华医学会

中华医学杂志(英文版)

CSTPCD

影响因子：0.838

ISSN：0366-6999

年,卷(期)：2024.137(20)