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Sample records for acute myocardial ischemia

  1. Silent ischemia and severity of pain in acute myocardial infarction

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    Nielsen, F E; Nielsen, S L; Knudsen, F

    1991-01-01

    An overall low tendency to complain of pain, due to a low perception of pain, has been suggested in the pathogenesis of silent ischemia, independent of the extent of the diseased coronaries and a history of previous acute myocardial infarction. This hypothesis has been tested indirectly...... in this retrospective study by comparison of the use of analgesics during admission for a first acute myocardial infarction with the occurrence of silent ischemia at exertion tests four weeks after discharge from hospital. The study did not show a lower use of analgesics in patients with silent ischemia, but this may...

  2. Nifedipine for angina and acute myocardial ischemia

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    P.G. Hugenholtz (Paul); J.W. de Jong (Jan Willem); P.D. Verdouw (Pieter); P.W.J.C. Serruys (Patrick)

    1983-01-01

    textabstractThis paper reviews the mechanisms believed to be responsible for myocardial ischaemia and the mode of action of calcium antagonist drugs. The clinical management of patients with myocardial ischaemia is discussed in the context of current knowledge about patho-physiology and drug action.

  3. Depressive symptoms are associated with mental stress-induced myocardial ischemia after acute myocardial infarction.

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    Jingkai Wei

    Full Text Available Depression is an adverse prognostic factor after an acute myocardial infarction (MI, and an increased propensity toward emotionally-driven myocardial ischemia may play a role. We aimed to examine the association between depressive symptoms and mental stress-induced myocardial ischemia in young survivors of an MI.We studied 98 patients (49 women and 49 men age 38-60 years who were hospitalized for acute MI in the previous 6 months. Patients underwent myocardial perfusion imaging at rest, after mental stress (speech task, and after exercise or pharmacological stress. A summed difference score (SDS, obtained with observer-independent software, was used to quantify myocardial ischemia under both stress conditions. The Beck Depression Inventory-II (BDI-II was used to measure depressive symptoms, which were analyzed as overall score, and as separate somatic and cognitive depressive symptom scores.There was a significant positive association between depressive symptoms and SDS with mental stress, denoting more ischemia. After adjustment for demographic and lifestyle factors, disease severity and medications, each incremental depressive symptom was associated with 0.14 points higher SDS. When somatic and cognitive depressive symptoms were examined separately, both somatic [β = 0.17, 95% CI: (0.04, 0.30, p = 0.01] and cognitive symptoms [β = 0.31, 95% CI: (0.07, 0.56, p = 0.01] were significantly associated with mental stress-induced ischemia. Depressive symptoms were not associated with ischemia induced by exercise or pharmacological stress.Among young post-MI patients, higher levels of both cognitive and somatic depressive symptoms are associated with a higher propensity to develop myocardial ischemia with mental stress, but not with physical (exercise or pharmacological stress.

  4. Circadian variation of transient myocardial ischemia in the early out-of-hospital period after first acute myocardial infarction

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    Mickley, H; Pless, P; Nielsen, J R

    1991-01-01

    Circadian rhythms have been demonstrated in acute myocardial infarction (AMI) and in other clinical cardiac dysfunctions. The purpose of this study was to elucidate whether a circadian pattern of transient myocardial ischemia exists after first AMI. Prospectively, 24-hour ambulatory ST......-segment monitoring was initiated at discharge on day 11 +/- 5 in 123 consecutive survivors of first AMI. A total of 93 ischemic episodes (91 asymptomatic) occurred in 21 of the 123 patients (17%) (mean duration of 30 minutes, range 4 to 292). A significant circadian rhythm of transient myocardial ischemia was found...... was significantly higher during morning episodes (p less than 0.02). Patients with transient myocardial ischemia had a diurnal distribution similar to the circadian variation displayed during ischemic activity. Thus, 16 of the 21 patients had ischemic episodes from 6 P.M. to 12 midnight versus 10 patients from 6 A...

  5. Transient myocardial ischemia after myocardial infarction

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    Mickley, H

    1995-01-01

    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction...... the prevalence of ambulatory or transient myocardial ischemia is lower than in patients with chronic, stable coronary artery disease. A greater proportion of ischemic episodes, however, are silent than in other subgroups with ischemic heart disease. Early after the infarction, transient myocardial ischemia...... exhibits a circadian variation with a peak activity occurring in the late evening hours. Patients with non-Q wave infarction have more transient myocardial ischemia, whereas thrombolytic therapy seems to result in less residual ischemia. Exercise testing is more sensitive than ambulatory monitoring...

  6. Serial Holter ST-segment monitoring after first acute myocardial infarction. Prevalence, variability, and long-term prognostic importance of transient myocardial ischemia

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    Mickley, H; Nielsen, J R; Berning, J;

    1998-01-01

    Based on serial Holter monitoring performed 7 times within 3 years after a first acute myocardial infarction, we assessed the prevalence, variability and long-term clinical importance of transient myocardial ischemia (TMI) defined as episodes of ambulatory ST-segment depression. In all, 121...... consecutive male patients variability was found within and between patients...

  7. [Effectiveness of various dopamine doses in acute myocardial ischemia complicated by cardiogenic shock (an experimental study)].

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    Kipshidze, N N; Korotkov, A A; Marsagishvili, L A; Prigolashvili, T Sh; Bokhua, M R

    1981-06-01

    The effect of various doses of dopamine on the values of cardiac contractile and hemodynamic function under conditions of acute two-hour ischemia complicated by cardiogenic shock was studied in 27 experiments on dogs. In a dose of 5 microgram/kg/min dopamine caused an optimum increase in cardiac productive capacity, reduction of peripheral resistance, adequate increase in coronary circulation and decrease in ST segment depression on the ECG. Infusion of 10 microgram/kg/min dopamine usually caused myocardial hyperfunction with an increase in total peripheral resistance and cardiac performance. Maximum dopamine doses (10 microgram/kg/min and more) were effective in the areactive form of cardiogenic shock. In longterm dopamine infusion it is necessary to establish continuous control over the hemodynamic parameters and the ECG to prevent aggravation of ischemia and for stage-by-stage reduction of the drug concentration and determination of the minimum maintenance dose.

  8. Metabonomic analysis of Allium macrostemon Bunge as a treatment for acute myocardial ischemia in rats.

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    Li, Fang; Xu, Qian; Zheng, Ting; Huang, Fang; Han, Lintao

    2014-01-01

    Myocardial ischemia (MI) refers to a pathological state of the heart caused by reduced cardiac blood perfusion, which leads to a decreased oxygen supply in the heart and an abnormal myocardial energy metabolism. Acute myocardial ischemia (AMI) has posed a significant health risk for humans. Allium macrostemon Bunge (AMB), a popular traditional Chinese medicine, is used for MI treatment. The therapeutic effects of AMB were assessed and the detailed mechanisms of AMB for AMI treatment were investigated. We characterized the metabonomic variations in rats from the sham surgery, AMI, and AMB-pretreated AMI groups through a combination of nuclear magnetic resonance (NMR) spectroscopy and multivariate statistical analysis. Thirty-five metabolites including carbohydrates, a range of amino acids, and organic acids were detected. The (1)H NMR spectra of the rat serum were analyzed using the principal component analysis (PCA) and orthogonal projection to latent structures discriminate analysis (OPLS-DA). Results showed that AMI induced some physiological changes in rats and also led to metabolic disorders related to glycolysis promotion, amino acid metabolism disruption, and other metabolite metabolism perturbation. AMB pretreatment reduced the AMI injury and maintained metabolic balance, possibly by limiting the change in energy metabolism and regulating amino acid metabolism. These findings provide a comprehensive insight on the metabolic response of AMI rats to AMB pretreatment and are important for the use of AMB for AMI therapy.

  9. [Newly developed stenocardia: lack of ventricular electrical instability in the absence of acute myocardial ischemia].

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    Areshev, G P; Agapov, A A; Gratsianskiĭ, N A; Ananich, V A

    1988-02-01

    A total of 130 patients with angina of new onset were examined within first 3 months of the disease. Macrofocal myocardial infarction survivors were not admitted to the study. The investigation included selective coronaro-angiography and ventriculography, Holter's ECG monitoring over 24 to 48 hours and bicycle ergometry. Programmed right-ventricular electric stimulation was conducted in 41 patients. Only one major coronary artery was affected in 78% of patients. Left-ventricular ejection fraction nearly always exceeded 50%. Groups of ventricular extrasystoles were detected by ECG monitoring in 10.8% and by bicycle ergometry in 2.5%. No signs of electrical instability were ever detected at programmed stimulation, done in the absence of anginal attacks. Groups of ventricular extrasystoles were more common, as compared to single extrasystoles (p less than 0.001), in acute myocardial ischemia, being more frequently associated with unstable rather than stable angina of new onset (p less than 0.05). In early coronary heart disease, signs of electric ventricular instability are not detectable in the absence of myocardial ischemia.

  10. Acute myocardial ischemia after aortic valve replacement: A comprehensive diagnostic evaluation using dynamic multislice spiral computed tomography

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    Lembcke, Alexander [Department of Radiology, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany)]. E-mail: alexander.lembcke@gmx.de; Hein, Patrick A. [Department of Radiology, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany); Enzweiler, Christian N.H. [Department of Radiology, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany); Hoffmann, Udo [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Klessen, Christian [Department of Radiology, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany); Dohmen, Pascal M. [Department of Cardiovascular Surgery, Charite-Universitaetsmedizin Berlin, Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin (Germany)

    2006-03-15

    We describe the case of a 72-year-old man presenting with endocarditis and clinical signs of acute myocardial ischemia after biological aortic valve replacement. A comprehensive cardiac dynamic multislice spiral computed tomography demonstrated: (1) an endocarditic vegetation of the aortic valve; (2) a subvalvular leakage feeding a paravalvular pseudoaneurysm based on an aortic root abscess with subsequent compromise of the systolic blood flow in the left main coronary artery and the resulting myocardial perfusion deficit.

  11. Tramadol Alleviates Myocardial Injury Induced by Acute Hindlimb Ischemia Reperfusion in Rats

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    Hamed Ashrafzadeh Takhtfooladi

    2015-01-01

    Full Text Available Background: Organ injury occurs not only during periods of ischemia but also during reperfusion. It is known that ischemia reperfusion (IR causes both remote organ and local injuries. Objective: This study evaluated the effects of tramadol on the heart as a remote organ after acute hindlimb IR. Methods: Thirty healthy mature male Wistar rats were allocated randomly into three groups: Group I (sham, Group II (IR, and Group III (IR + tramadol. Ischemia was induced in anesthetized rats by left femoral artery clamping for 3 h, followed by 3 h of reperfusion. Tramadol (20 mg/kg, intravenous was administered immediately prior to reperfusion. At the end of the reperfusion, animals were euthanized, and hearts were harvested for histological and biochemical examination. Results: The levels of superoxide dismutase (SOD, catalase (CAT, and glutathione peroxidase (GPx were higher in Groups I and III than those in Group II (p < 0.05. In comparison with other groups, tissue malondialdehyde (MDA levels in Group II were significantly increased (p < 0.05, and this increase was prevented by tramadol. Histopathological changes, including microscopic bleeding, edema, neutrophil infiltration, and necrosis, were scored. The total injuryscore in Group III was significantly decreased (p < 0.05 compared with Group II. Conclusion: From the histological and biochemical perspectives, treatment with tramadol alleviated the myocardial injuries induced by skeletal muscle IR in this experimental model.

  12. Tramadol Alleviates Myocardial Injury Induced by Acute Hindlimb Ischemia Reperfusion in Rats

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    Takhtfooladi, Hamed Ashrafzadeh; Asl, Adel Haghighi Khiabanian [Department of Pathobiology, Science and Research Branch, Islamic Azad University, Tehran (Iran, Islamic Republic of); Shahzamani, Mehran [Department of Cardiovascular Surgery, Isfahan University of Medical Sciences, Tehran (Iran, Islamic Republic of); Takhtfooladi, Mohammad Ashrafzadeh, E-mail: dr-ashrafzadeh@yahoo.com [Young Researchers and Elites Club, Science and Research Branch, Islamic Azad University, Tehran (Iran, Islamic Republic of); Allahverdi, Amin [Department of Surgery, Science and Research Branch, Islamic Azad University, Tehran (Iran, Islamic Republic of); Khansari, Mohammadreza [Department of Physiology, Science and Research Branch, Islamic Azad University, Tehran (Iran, Islamic Republic of)

    2015-08-15

    Organ injury occurs not only during periods of ischemia but also during reperfusion. It is known that ischemia reperfusion (IR) causes both remote organ and local injuries. This study evaluated the effects of tramadol on the heart as a remote organ after acute hindlimb IR. Thirty healthy mature male Wistar rats were allocated randomly into three groups: Group I (sham), Group II (IR), and Group III (IR + tramadol). Ischemia was induced in anesthetized rats by left femoral artery clamping for 3 h, followed by 3 h of reperfusion. Tramadol (20 mg/kg, intravenous) was administered immediately prior to reperfusion. At the end of the reperfusion, animals were euthanized, and hearts were harvested for histological and biochemical examination. The levels of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were higher in Groups I and III than those in Group II (p < 0.05). In comparison with other groups, tissue malondialdehyde (MDA) levels in Group II were significantly increased (p < 0.05), and this increase was prevented by tramadol. Histopathological changes, including microscopic bleeding, edema, neutrophil infiltration, and necrosis, were scored. The total injuryscore in Group III was significantly decreased (p < 0.05) compared with Group II. From the histological and biochemical perspectives, treatment with tramadol alleviated the myocardial injuries induced by skeletal muscle IR in this experimental model.

  13. Selective cyclooxygenase-2 inhibition protects against myocardial damage in experimental acute ischemia

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    Alberto Carnieto Jr.

    2009-03-01

    Full Text Available BACKGROUND: Acute myocardial infarction is associated with tissue inflammation. Early coronary reperfusion clearly improves the outcome but may help propagate the inflammatory response and enhance tissue damage. Cyclooxygenase-2 is an enzyme that catalyzes the initial step in the formation of inflammatory prostaglandins from arachidonic acid. Cyclooxygenase-2 levels are increased when ischemic cardiac events occur. The overall function of COX-2 in the inflammatory process generated by myocardial ischemic damage has not yet been elucidated. GOAL: The objective of this study was to determine whether a selective cyclooxygenase-2 inhibitor (rofecoxib could alter the evolution of acute myocardial infarction after reperfusion. METHODS AND RESULTS: This study was performed with 48 mongrel dogs divided into two groups: controls and those treated with the drug. All animals were prepared for left anterior descending coronary artery occlusion. The dogs then underwent 180 minutes of coronary occlusion, followed by 30 minutes of reperfusion. Blood samples were collected from the venous sinus immediately before coronary occlusion and after 30 minutes of reperfusion for measurements of CPK-MB, CPK-MBm and troponin I. During the experiment we observed the mean blood pressure, heart rate and coronary flow. The coronary flow and heart rate did not change, but in the control group, there was blood pressure instability, in addition to maximal levels of CPK-MB post-infarction. The same results were observed for CPK-MBm and troponin I. CONCLUSION: In a canine model of myocardial ischemia-reperfusion, selective inhibition of Cyclooxygenase-2 with rofecoxib was not associated with early detrimental effects on the hemodynamic profile or the gross extent of infarction; in fact, it may be beneficial by limiting cell necrosis.

  14. Effects of Corocalm (Shuguan Capsule,疏冠胶囊) on Acute Myocardial Ischemia in Anesthetized Dogs

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To investigate the effects of Corocalm (Shuguan Capsule, 疏冠胶囊) on acute myocardial ischemia in anesthetized dogs and its possible therapeutic mechanism. Methods: The acute ischemia model was established by ligating the left anterior descending (LAD) artery. Twentyfive dogs were randomly divided into 5 groups (5 dogs in each group): the control group (treated with normal saline 3 mL/kg), the refined Guanxin Capsule group (精制冠心胶囊, GXC 200 mg/kg), high and Iow dose Corocalm groups (48.5 mg/kg for low dose group and 194.0 mg/kg for high dose group) and the Diltiazem group (5 mg/kg). The animals were treated via a single duodenal administration after the model was established. The experiments used epicardial electrocardiogram (EECG) to measure the scope and degree of myocardial ischemia. Simultaneously, the coronary blood flow (CBF) and serum activity levels of creatine phosphokinase (CK) and lactate dehydrogenase (LDH) were measured by electromagnetic flow meter and automatic biochemical analyzer respectively. The plasma endothelin (ET) content was quantified by radioimmunoassay. Results: Corocalm (48.5 mg/kg and 194.0 mg/kg) significantly decreased the degree and scope of myocardial ischemia, reduced the infarct area, markedly increased the CBF, and inhibited the increase of CK and LDH activities and ET levels induced by myocardial ischemia/infarction. Conclusion: Corocalm could improve the state of acute myocardial ischemia and infarction in dogs. The mechanism of action might be correlated to increasing CBF,inhibiting CK and LDH activities and preventing ET release.

  15. Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction

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    Sparrow Patrick

    2008-10-01

    Full Text Available Abstract Background The acute coronary syndrome diagnosis includes different classifications of myocardial infarction, which have been shown to differ in their pathology, as well as their early and late prognosis. These differences may relate to the underlying extent of infarction and/or residual myocardial ischemia. The study aim was to compare scar and ischemia mass between acute non-ST elevation myocardial infarction (NSTEMI, ST-elevation MI with Q-wave formation (Q-STEMI and ST-elevation MI without Q-wave formation (Non-Q STEMI in-vivo, using cardiovascular magnetic resonance (CMR. Methods and results This was a prospective cohort study of twenty five consecutive patients with NSTEMI, 25 patients with thrombolysed Q-STEMI and 25 patients with thrombolysed Non-Q STEMI. Myocardial function (cine imaging, ischemia (adenosine stress first pass myocardial perfusion and scar (late gadolinium enhancement were assessed by CMR 2–6 days after presentation and before any invasive revascularisation procedure. All subjects gave written informed consent and ethical committee approval was obtained. Scar mass was highest in Q-STEMI, followed by Non-Q STEMI and NSTEMI (24.1%, 15.2% and 3.8% of LV mass, respectively; p Conclusion Prior to revascularisation, the ratio of scar to ischemia differs between NSTEMI, Non-Q STEMI and Q-STEMI, whilst the combined scar and ischemia mass is similar between these three types of MI. These results provide in-vivo confirmation of the diverse pathophysiology of different types of acute myocardial infarction and may explain their divergent early and late prognosis.

  16. Silent myocardial ischemia.

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    Gutterman, David D

    2009-05-01

    Although much progress has been made in reducing mortality from ischemic cardiovascular disease, this condition remains the leading cause of death throughout the world. This might in part be due to the fact that over half of patients have a catastrophic event (heart attack or sudden death) as their initial manifestation of coronary disease. Contributing to this statistic is the observation that the majority of myocardial ischemic episodes are silent, indicating an inability or failure to sense ischemic damage or stress on the heart. This review examines the clinical characteristics of silent myocardial ischemia, and explores mechanisms involved in the generation of angina pectoris. Possible mechanisms for the more common manifestation of injurious reductions in coronary flow; namely, silent ischemia, are also explored. A new theory for the mechanism of silent ischemia is proposed. Finally, the prognostic importance of silent ischemia and potential future directions for research are discussed.

  17. Experimental Study of the Effect of Autonomic Nervous System on the Transmural Dispersion of Ventricular Repolarization under Acute Myocardial Ischemia in Vivo

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    张存泰; 徐大文; 李泱; 刘念; 钟江华; 王琳; 陆再英

    2002-01-01

    Summary: The effect of the autonomic nerves on the transmural dispersion of ventricular repolariza tion (TDR) under acute myocardial ischemia in intact canine was investigated. Using the monophasic action potential (MAP) recording technique, MAPs of the epicardium (Epi), midmyocardium (Mid) and endocardium (Endo) were recorded simultaneously by specially designed plunge-needle electrodes at the left ventricular free wall under acute myocardial ischemia in 12 open-chest dogs.MAPD90 and TDR among three myocardial layers as well as the incidence of the early afterdepolar ization (EAD) before autonomic nervous stimulation and during autonomic nervous stimulation were compared. It was found that 10 min after acute myocardial I~hemia, TDR was increased from 55±8.ms to 86± 15 ms during sympathetic stimulation (P<0. 01). The TDR (53± 9 ms) during parasympathetic stimulation was not significantly different from that of the control (55±8 ms) (P>0.05). The EAD was elicited in the Mid of 2 dogs (16 %) 10 min after acute myocardial ischemia,but the EAD were elicited in the Mid of 7 dogs (58 %) during sympathetic stimulation (P<0. 01).It was concluded that: (1) Sympathetic stimulation can increase the transmural dispersion of repolari zation and induce early afterdepolarizations in the Mid under acute myocardial ischemia, which pro-vide the opportunity for the ventricular arrhythmia developing; (2) Parasympathetic stimulation has no significant effect on the transmural dispersion of repolarization under myocardial ischemia.

  18. Arrhythmias following Revascularization Procedures in the Course of Acute Myocardial Infarction: Are They Indicators of Reperfusion or Ongoing Ischemia?

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    Ersan Tatli

    2013-01-01

    Full Text Available Objective. The most important step in the treatment of ST elevation myocardial infarction is to sustain myocardial blood supply as soon as possible. The two main treatment methods used today to provide myocardial reperfusion are thrombolytic therapy and percutaneous coronary intervention. In our study, reperfusion arrhythmias were investigated as if they are indicators of coronary artery patency or ongoing ischemia after revascularization. Methods. 151 patients with a diagnosis of acute ST elevation myocardial infarction were investigated. 54 patients underwent primary percutaneous coronary intervention and 97 patients were treated with thrombolytic therapy. The frequency of reperfusion arrythmias following revascularization procedures in the first 48 hours after admission was examined. The relation between reperfusion arrhythmias, ST segment regression, coronary artery patency, and infarct related artery documented by angiography were analyzed. Results. There was no statistically significant difference between the two groups in the frequency of reperfusion arrhythmias (P=0.355. Although angiographic vessel patency was higher in patients undergoing percutaneous coronary intervention, there was no significant difference between the patency rates of each group with and without reperfusion arrythmias. Conclusion. Our study suggests that recorded arrhythmias following different revascularization procedures in acute ST elevation myocardial infarction may not always indicate vessel patency and reperfusion. Ongoing vascular occlusion and ischemia may lead to various arrhythmias which may not be distinguished from reperfusion arrhythmias.

  19. Acute myocardial ischemia in a patient with heterozygous alpha-2-plasmin inhibitor deficiency

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    Brands-Nijenhuis, Angelique V. M.; van Geel, Peter P.; Meijer, Karina

    2009-01-01

    In this brief report we present a patient with heterozygous alpha 2 plasmin inhibitor (alpha 2PI) deficiency who developed atherosclerosis and myocardial ischemia in the presence of multiple classical risk factors. Management was complicated by fear of bleeding complications with the use of antiplat

  20. Protective Effects of Berberine on Isoproterenol-Induced Acute Myocardial Ischemia in Rats through Regulating HMGB1-TLR4 Axis

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    Tianzhu Zhang

    2014-01-01

    Full Text Available Berberine, an isoquinoline alkaloid originally isolated from the Chinese herb Coptis chinensis (Huanglian, has been shown to display a wide array of pharmacological activities. The present study was to investigate the effects of berberine against myocardial ischemia produced in rats by isoproterenol. 50 male Sprague-Dawley rats were randomized equally into five groups: a control group, an untreated model group, berberine (30, 60 mg/kg treatment, or propranolol (30 mg/kg. Rats were treated for 12 days and then given isoproterenol, 85 mg/kg for 2 consecutive days by subcutaneous injection. ST-segment elevation was measured after the last administration. Serum levels of creatine kinase isoenzyme (CK-MB, lactate dehydrogenase (LDH, tumor necrosis factor-α (TNF-α, and interleukin-6 (IL-6 were measured after the rats were sacrificed. The hearts were excised for determining heart weight index, microscopic examination, high mobility group box 1 (HMGB1, toll-like receptor (TLR4, prodeath protein (Bax, antideath protein (Bcl-2, and tumor necrosis factor (TNF-α protein were determined by western blot. Berberine decreased the ST elevation induced by acute myocardial ischemia, and decreased serum levels of CK-MB, LDH, TNF-α, and IL-6. Berberine increased total superoxide dismutase (T-SOD activity and decreased malondialdehyde (MDA content in myocardial tissue. Berberine can regulate HMGB1-TLR4 axis to protect myocardial ischemia.

  1. Global Ischemia ECG pattern for diagnosis of acute left main occlusion: prevalence and associated mortality in patients with suspected acute myocardial infarction

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    Stengaard, Carsten; Sørensen, Jacob Thorsted; Andersen, M.P.

    2011-01-01

    Abstract: P5632 Global ischemia ECG pattern for diagnosis of acute left main occlusion: prevalence and associated mortality in patients with suspected acute myocardial infarction Authors: C. Stengaard1, J.T. Sorensen2, M.P. Andersen3, K. Thygesen1, J.F. Lassen2, K. Nikus4, G. Wagner5, C.J. Terkel......Abstract: P5632 Global ischemia ECG pattern for diagnosis of acute left main occlusion: prevalence and associated mortality in patients with suspected acute myocardial infarction Authors: C. Stengaard1, J.T. Sorensen2, M.P. Andersen3, K. Thygesen1, J.F. Lassen2, K. Nikus4, G. Wagner5, C...... ischemia ECG pattern (GIP) has been proposed for diagnosis of acute left main stem (LM) occlusion. The GIP is defined by ST-elevation of 1mm in lead aVR and ST-depression of 0.5mm in seven or more ECG leads. Previous studies focus on the sensitivity of GIP in patients with confirmed LM occlusion. We...... present data of prevalence and associated mortality of GIP in patients with suspected acute myocardial infarction (AMI). Methods: The study population consists of 4905 patients suspected of AMI, transported by emergency medical service, in whom a prehospital ECG was acquired. GIP was identified...

  2. Changes of transmural heterogeneity of Cx43 expression in acute myocardial ischemia reperfusion

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    Jiang-Hua Zhong; Shi-Juan Lu; Xiao-Pan Chen; Qi Zuo; Zheng-Wang Liu; Ding-Jun Sun; Miao Wu

    2016-01-01

    Objective:To observe the change of transmural heterogeneity of Cx43 protein among three myocardial layers and explore physiological mechanisms of malignant ventricular arrhythmia (MVA) in myocardial ischemia reperfusion (MIR).Methods: Twenty rabbits were randomly divided into MIR group (n=10) which rabbits with MIR were made in and sham group (n=10). 90% monophasic action potential repolarization duration (APD90), transmural dispersion of repolarization (TDR) and Cx43 protein (Cx43-pro) and mRNA (Cx43-Cq) expression among three myocardial layers were measured in both groups.Results:Compared with APD90 and TDR among three myocardial layers in the sham group, those in the MIR group were significant increased (P<0.01), which showed that transmural dispersion of repolarization increased significantly in MIR. Compared to those in the sham group, all three myocardial Cx43-pro significantly decreased (P<0.05) and△Cx43-pro obviously increased (P<0.05) in the MIR group which indicated transmural expression heterogeneity of Cx43 protein enlarged in MIR. 3. Cx43-Cq in all myocardium were significantly reduced (P<0.05) and△Cx43-Cq was significantly increased (P<0.05) in the MIR group compared to those in the sham group, which proved that transmural heterogeneity of Cx43 mRNA raised in MIR.Conclusions:Transmural heterogeneity of Cx43 expression among three myocardial layers in MIR significantly increased, which may enlarge dispersion of repolarization and prone to MVA.

  3. Impact of acute propranolol administration on dobutamine-induced myocardial ischemia as evaluated by myocardial perfusion imaging and echocardiography.

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    Shehata, A R; Gillam, L D; Mascitelli, V A; Herman, S D; Ahlberg, A W; White, M P; Chen, C; Waters, D D; Heller, G V

    1997-08-01

    Beta-blocker therapy may delay or completely prevent myocardial ischemia during exercise testing, as assessed by ST-segment shifts, myocardial perfusion defects, or echocardiographic wall motion abnormalities. However, the impact of beta-blocker therapy on these end points during dobutamine stress testing has not been well established. The purpose of this study was to determine the impact of propranolol on dobutamine stress testing with ST-segment monitoring, technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) imaging, and echocardiography. In 17 patients with known reversible perfusion defects, dobutamine stress tests with and without propranolol were performed in randomized order and on separate days, following discontinuation of oral beta blockers and calcium antagonists. Propronolol was administered intravenously to a cumulative dose of 8 mg or to a maximum heart rate reduction of 25% and dobutamine was infused in graded doses in 3 minute stages until a standard clinical end point or the maximum dose of 40 microg/kg/min was achieved. The dobutamine stress test after propranolol was associated with a lower maximum heart rate (83 +/- 18 vs 125 +/- 17, p <0.001) and rate pressure product (14,169 +/- 4,248 vs 19,894 +/- 3,985, p <0.001) despite a higher infusion dose. The SPECT myocardial ischemia score was also lower (6.9 +/- 5.8 vs 10.1 +/- 7.1, p = 0.047) and fewer echocardiographic segments were abnormal (3.4 +/- 3.0 vs 4.6 +/- 3.4, p = 0.042). In 4 of 17 patients, reversible perfusion defects and echocardiographic wall motion abnormalities were detected during the control but not during the propranolol test. Thus, during dobutamine stress testing, beta-blocker therapy attenuates, and in some cases eliminates, evidence of myocardial ischemia.

  4. QRS-ST-T triangulation with repolarization shortening as a precursor of sustained ventricular tachycardia during acute myocardial ischemia.

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    Batchvarov, Velislav N; Behr, Elijah R

    2015-04-01

    We present segments from a 24-hour 12-lead digital Holter recording in a 48-year-old man demonstrating transient ST elevations in the inferior leads that triggered sustained ventricular tachycardia/ventricular fibrillation (VT/VF) requiring cardioversion. The onset of VT was preceded by a gradual increase in the ST with marked QRS broadening that lacked distinction between the end of the QRS and the beginning of the ST (QRS-ST-T "triangulation"), and shortening of the QT interval not caused by an increased heart rate. This is a relatively rare documentation of the mechanisms immediately triggering sustained ventricular arrhythmias during acute myocardial ischemia obtained with 12-lead ECG.

  5. A RARE CASE OF CEFTRIAXONE INDUCED CORONARY SPASM WITH ACUTE MYOCARDIAL ISCHEMIA

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    Basavaraj

    2014-12-01

    Full Text Available : Kounis syndrome has been known as allergic angina and/or allergic myocardial infarction. Allergic insults usually may include drugs, latex, and food. Although ceftriaxone administration has been associated with various allergic reactions such as urticaria, angioedema, erythema, rash and anaphylactic shock, there are very few published report that has shown an association between ceftriaxone use and Kounis syndrome. Here, we describe a case report of allergic vasospasm, leading to acute anterior wall myocardial infarction, probably as the result of an acute allergic reaction, after ceftriaxone use.

  6. Changing circadian variation of transient myocardial ischemia during the first year after a first acute myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H; Pless, P; Nielsen, J R;

    1992-01-01

    In a consecutive series of 123 men (aged 55 +/- 8 years) with a recent first acute myocardial infarction (AMI), 24-hour ambulatory ST-segment monitoring was performed early after discharge (day 11 +/- 5), 6 months (day 185 +/- 6) and 1 year (day 368 +/- 8) after AMI. No difference in the prevalen...

  7. Characterization of QT and RR interval series during acute myocardial ischemia by means of recurrence quantification analysis.

    Science.gov (United States)

    Peng, Yi; Sun, Zhongwei

    2011-01-01

    This study is aimed to investigate the nonlinear dynamic properties of the fluctuations in ventricular repolarization, heart rate and their correlation during acute myocardial ischemia. From 13 ECG records in long-term ST-T database, 170 ischemic episodes were selected with the duration of 34 s to 23 min 18 s, and two 5-min episodes immediately before and after each ischemic episode as non-ischemic ones for comparison. QT interval (QTI) and RR interval (RRI) were extracted and the ectopic beats were removed. Recurrence quantification analysis (RQA) was performed on QTI and RRI series, respectively, and cross recurrence quantification analysis (CRQA) on paired normalized QTI and RRI series. Wilcoxon signed-rank test was used for statistical analysis. Results revealed that the RQA indexes for QTI and HRI series had the same changing trend during ischemia with more significantly changed indexes in QTI series. In the CRQA, indexes related to the vertical and horizontal structures in recurrence plot significantly increased, representing decreased dependency of QTI on RRI. Both QTI and RRI series showed reduced complexity during ischemia with higher sensitivity in ventricular repolarization. The weakened coupling between QTI and RRI suggests the decreased influence of sinoatrial node on QTI modulation during ischemia.

  8. Effects of electroacupuncture on cardiac and gastric activities in acute myocardial ischemia rats

    Institute of Scientific and Technical Information of China (English)

    Shu-Bin Wang; Shu-Ping Chen; Yong-Hui Gao; Hing-Fu Luo; Jun-Ling Liu

    2008-01-01

    AIM: To observe the effect of electroacupuncture (EA) of "Neiguan" (PC6) and "Gongsun" (SP4) on pathological changes of the heart and stomach in rats with acute myocardial ischemia (AMI), and to explore its underlying mechanism. METHODS: Fifty Wistar rats were randomized into control, model, PC6, SP4 and PC6 + SP4 groups (n = 8 each group). An AMI model was established by occlusion of the descending anterior branch (DAB) of the left coronary artery. ECG-ST of cervico-thoracic lead and electrogastrogram (EGG) were recorded. EA was applied to PC6, SP4 and PC6 + SP4 groups, respectively. At the end of experiments, the rats were transcardically perfused with 4% paraformaldehyde, and the heart base myocardium, gastric antrum and duodenum tissues were sampled, sectioned and stained with a reduced form of nicotinamide-adenine dinucleotide phosphate (NADPH)-diaphorase histochemical method for displaying nitric oxide synthase (NOS) activity. RESULTS: After AMI, ECG-ST values elevated. After EA, the elevated ECG-ST values at 20 min in PC6 group, at 30 min in PC6 + SP4 and SP4 groups had no significant differences in comparison with their respective basal values before AMI. Following AMI, the amplitude and frequency of slow waves of EGG decreased remarkably (P < 0.05). At 30 min after EA, the mean amplitude and frequency of slow waves of EGG in the three EA groups had no marked differences compared with their individual basal levels and those in the control group. After AMI, the mean integral grey values of NOS-positive product in myocardium, gastric antrum and duodenum tissues in the model group increased remarkably in comparison with the control group, while those in three EA groups were lower than those in the model group. No significant differences were found in ECG-ST and EGG improvement among the three EA groups. However, EA of PC6 had a better effect on ECG-ST and EA of PC4 had a better effect on EGG, respectively. CONCLUSION: EA of PC6, SP4 and PC6 + SP4 can

  9. Acute Mesenteric Ischemia

    Science.gov (United States)

    ... Side Effects Additional Content Medical News Acute Mesenteric Ischemia By Parswa Ansari, MD, Department of Surgery, Lenox ... Abscesses Abdominal Wall Hernias Inguinal Hernia Acute Mesenteric Ischemia Appendicitis Ileus Intestinal Obstruction Ischemic Colitis Perforation of ...

  10. Ultrasonic tissue characterization with integrated backscatter. Acute myocardial ischemia, reperfusion, and stunned myocardium in patients

    Energy Technology Data Exchange (ETDEWEB)

    Milunski, M.R.; Mohr, G.A.; Perez, J.E.; Vered, Z.; Wear, K.A.; Gessler, C.J.; Sobel, B.E.; Miller, J.G.; Wickline, S.A. (Washington Univ., St. Louis, MO (USA))

    1989-09-01

    We have previously shown in studies of experimental animals that myocardium exhibits a cardiac cycle-dependent variation of integrated backscatter that reflects regional myocardial contractile performance and that is blunted promptly after arterial occlusion and recovers after reperfusion. To define the clinical utility of ultrasonic tissue characterization with integrated backscatter for detection of acute myocardial infarction and reperfusion, 21 patients (14 men and seven women) were studied in the cardiac care unit within the first 24 hours (mean time, 11.3 hours; range, 3.5-23.8 hours) after the onset of symptoms indicative of acute myocardial infarction with conventional two-dimensional and M-mode echocardiography and with analysis of integrated backscatter. The magnitude of cyclic variation of integrated backscatter was measured from several sites within acute infarct regions and normal regions remote from the infarct zone for each patient. The average magnitude of cyclic variation among all patients (n = 21) was 4.8 +/- 0.5 dB in normal regions compared with 0.8 +/- 0.3 dB in infarct regions (p less than 0.05) within the first 24 hours after the onset of symptoms. Among the patients who had two studies, 15 (mean, 7.1 days; range, 2-31 days for second study) underwent coronary arteriography to define vessel patency. In patients with vessels with documented patency (n = 10), the magnitude of cyclic variation in infarct regions increased over time from 1.3 +/- 0.6 to 2.5 +/- 0.5 dB from the initial to final study (p less than 0.05). Patients with occluded infarct-related arteries (n = 5) exhibited no significant recovery of cyclic variation (0.3 +/- 0.3-0.6 +/- 0.3 dB). A blinded analysis of standard two-dimensional echocardiographic images revealed no significant recovery of wall thickening in either group over the same time intervals.

  11. Transient myocardial ischemia after a first acute myocardial infarction and its relation to clinical characteristics, predischarge exercise testing and cardiac events at one-year follow-up

    DEFF Research Database (Denmark)

    Mickley, H; Pless, P; Nielsen, J R

    1993-01-01

    recording 11 +/- 5 days after AMI 23 patients (19%) had 123 ischemic episodes (group 1), whereas 100 patients demonstrated no ischemia (group 2). Exercise-induced ST-segment depression was more prevalent in group 1 (83%) than in group 2 (47%) (p ... as judged from a shorter exercise duration before significant ST-segment depression (5.5 +/- 2.4 vs 7.7 +/- 4.1 minutes; p depression on exercise testing (4.1 +/- 2.6 vs 2.6 +/- 1.6 mm; p exercise test results revealed an impaired hemodynamic......The relation between early out-of-hospital ambulatory ST-segment monitoring, clinical characteristics, predischarge maximal exercise testing and cardiac events was determined in 123 consecutive men (age 55 +/- 8 years) with a first acute myocardial infarction (AMI). During 36 hours of ambulatory...

  12. Core-shell hybrid liposomal vesicles loaded with panax notoginsenoside: preparation, characterization and protective effects on global cerebral ischemia/reperfusion injury and acute myocardial ischemia in rats

    Directory of Open Access Journals (Sweden)

    Zhang J

    2012-08-01

    Full Text Available Jing Zhang,1,* Xizhen Han,1,* Xiang Li,2 Yun Luo,1 Haiping Zhao,1 Ming Yang,1 Bin Ni,1 Zhenggen Liao11Key Laboratory of Modern Preparation of TCM, Ministry of Education, 2National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, People's Republic of China*These authors contributed equally to this workPurpose: Novel panax notoginsenoside-loaded core-shell hybrid liposomal vesicles (PNS-HLV were developed to resolve the restricted bioavailability of PNS and to enhance its protective effects in vivo on oral administration.Methods: Physicochemical characterizations of PNS-HLV included assessment of morphology, particle size and zeta potential, encapsulation efficiency (EE%, stability and in vitro release study. In addition, to evaluate its oral treatment potential, we compared the effect of PNS-HLV on global cerebral ischemia/reperfusion and acute myocardial ischemia injury with those of PNS solution, conventional PNS-loaded nanoparticles, and liposomes.Results: In comparison with PNS solution, conventional PNS-loaded nanoparticles and liposomes, PNS-HLV was stable for at least 12 months at 4°C. Satisfactory improvements in the EE% of notoginsenoside R1, ginsenoside Rb1, and ginsenoside Rg1 were shown with the differences in EE% shortened and the greater controlled drug release profiles were exhibited from PNS-HLV. The improvements in the physicochemical properties of HLV contributed to the results that PNS-HLV was able to significantly inhibit the edema of brain and reduce the infarct volume, while it could markedly inhibit H2O2, modified Dixon agar, and serum lactate dehydrogenase, and increase superoxide dismutase (P < 0.05.Conclusion: The results of the present study imply that HLV has promising prospects for improving free drug bioactivity on oral administration.Keywords: liposomes, nanoparticles, panax notoginsenoside, physicochemical properties

  13. Study on Effect of Shenmai Injection Protecting Myocardium against Ischemia-Reperfusion Injury in Thrombolytic Therapy with Urokinase for Acute Myocardial Infarction Patient Evaluated by 99mTc-MIBI Myocardial Imaging

    Institute of Scientific and Technical Information of China (English)

    郭松鹏; 张言镇

    2001-01-01

    Objective: To evaluate the myocardial protecting effect of Shenmai injection (SMI) against ischemia/reperfusion injury in thrombolytic therapy with urokinase (UK) for acute myocardial infarction patients by 99mTc-MIBI myocardial imaging (SPECT). Methods: Five hundred and thirty-seven patients were divided into two groups randomly. The SMI group (n=292) was treated with thrombolytictreatment plus SMI and the control group (n=245) with thrombolytic treatment solely. Single photon emission computed tomography (SPECT) was carried out on the 7th day after thrombolysis to determine the ischemic myocardial area (IMA) and ejection fraction (EF) in both groups and compared. Results: The infarction related area (IRA) of reperfusion rate in the two groups was not different significantly (72.26% vs 72.65%, P >0.05). The IMA in patients of the SMI group, no matter with or without reperfused IRA (211 cases and 81 cases) respectively, was significantly lower than that in the control group (178 cases and 67 cases) respectively, P<0.01 and P<0.05 respectively. The EF value in the SMI group was significantly higher than that in the control group (P<0.01). Conclusion:Using SMI in early stage of thrombolytic treatment in acute myocardial infarction could significantly reduce IMA and increase EF. SMI showed good protective effect against myocardial ischemia/reperfusion injury in thrombolytic treatment.

  14. Study on Effect of Shenmai Injection Protecting Myocardium against Ischemia-Reperfusion Injury in Thrombolytic Therapy with Urokinase for Acute Myocardial Infarction Patient Evaluated by 99mTc-MIBI Myocardial Imaging

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To evaluate the myocardial protecting effect of Shenmai injection (SMI) against ischemia/reperfusion injury in thrombolytic therapy with urokinase (UK) for acute myocardial infarction patients by 99mTc-MIBI myocardial imaging (SPECT). Methods: Five hundred and thirty-seven patients were divided into two groups randomly. The SMI group (n=292) was treated with thrombolytictreatment plus SMI and the control group (n=245) with thrombolytic treatment solely. Single photon emission computed tomography (SPECT) was carried out on the 7th day after thrombolysis to determine the ischemic myocardial area (IMA) and ejection fraction (EF) in both groups and compared. Results: The infarction related area (IRA) of reperfusion rate in the two groups was not different significantly (72.26% vs 72.65%, P >0.05). The IMA in patients of the SMI group, no matter with or without reperfused IRA (211 cases and 81 cases) respectively, was significantly lower than that in the control group (178 cases and 67 cases) respectively, P<0.01 and P<0.05 respectively. The EF value in the SMI group was significantly higher than that in the control group (P<0.01). Conclusion:Using SMI in early stage of thrombolytic treatment in acute myocardial infarction could significantly reduce IMA and increase EF. SMI showed good protective effect against myocardial ischemia/reperfusion injury in thrombolytic treatment.

  15. Evaluation of acute ischemia in pre-procedure ECG predicts myocardial salvage after primary PCI in STEMI patients with symptoms >12hours

    DEFF Research Database (Denmark)

    Fakhri, Yama; Busk, Martin; Schoos, Mikkel Malby

    2016-01-01

    -presenters). The Anderson-Wilkin's score (AW-score) estimates the acuteness of myocardial ischemia from the electrocardiogram (ECG) in STEMI patients. We hypothesized that the AW-score is superior to symptom duration in identifying substantial salvage potential in late-presenters. METHODS: The AW-score (range 1......-4) was obtained from the pre-pPCI ECG in 55 late-presenters and symptoms 12-72 hours. Myocardial perfusion imaging was performed to assess area at risk before pPCI and after 30days to assess myocardial salvage index (MSI). We correlated both the AW-score and pain-to-balloon with MSI and determined the salvage...

  16. Dietary n-3 fatty acids promote arrhythmias during acute regional myocardial ischemia in isolated pig hearts

    NARCIS (Netherlands)

    Coronel, R.; Wilms-Schopman, F.J.G.; Ruijter, den H.M.; Belterman, C.N.; Schumacher, C.A.; Opthof, T.; Hovernier, R.; Lemmens, A.G.; Terpstra, A.H.M.; Katan, M.B.; Zock, P.L.

    2007-01-01

    Objective Dietary supplementation with fish oil-derived n-3 fatty acids reduces mortality in patients with myocardial infarction, but may have adverse effects in angina patients. The underlying electrophysiologic mechanisms are poorly understood. We studied the arrhythmias and the electrophysiologic

  17. Algorithm for the automatic computation of the modified Anderson-Wilkins acuteness score of ischemia from the pre-hospital ECG in ST-segment elevation myocardial infarction

    DEFF Research Database (Denmark)

    Fakhri, Yama; Sejersten, Maria; Schoos, Mikkel Malby

    2017-01-01

    BACKGROUND: The acuteness score (based on the modified Anderson-Wilkins score) estimates the acuteness of ischemia based on ST-segment, Q-wave and T-wave measurements obtained from the electrocardiogram (ECG) in patients with ST Elevation Myocardial Infarction (STEMI). The score (range 1 (least...... the acuteness score. METHODS: We scored 50 pre-hospital ECGs from STEMI patients, manually and by the automated algorithm. We assessed the reliability test between the manual and automated algorithm by interclass correlation coefficient (ICC) and Bland-Altman plot. RESULTS: The ICC was 0.84 (95% CI 0.......72-0.91), PECGs, all within the upper (1.46) and lower (-1.12) limits...

  18. Myocardial Ischemia Caused by Subepicardial Hematoma

    Science.gov (United States)

    Grieshaber, Philippe; Nef, Holger; Böning, Andreas; Niemann, Bernd

    2017-01-01

    Background Bleeding from bypass anastomosis leakage occurs early after coronary artery bypass grafting. Later, once the anastomosis is covered by intima, spontaneous bleeding is unlikely. Case Description A 63-year-old male patient developed a pseudoaneurysm-like, subepicardial late-term bleeding resulting in a hematoma that compromised coronary artery flow by increasing extracoronary pressure. This resulted in severe angina pectoris (Canadian Cardiovascular Society IV) and myocardial ischemia within the affected area. After surgical removal of the hematoma and repair of the anastomosis, the patient's symptoms disappeared and no signs of myocardial ischemia were present. Conclusion Surgical removal is an efficient therapy for subepicardial hematoma inducing myocardial ischemia.

  19. Controversies in cardiovascular care: silent myocardial ischemia

    Science.gov (United States)

    Hollenberg, N. K.

    1987-01-01

    The objective evidence of silent myocardial ischemia--ischemia in the absence of classical chest pain--includes ST-segment shifts (usually depression), momentary left ventricular failure, and perfusion defects on scintigraphic studies. Assessment of angina patients with 24-hour ambulatory monitoring may uncover episodes of silent ischemia, the existence of which may give important information regarding prognosis and may help structure a more effective therapeutic regimen. The emerging recognition of silent ischemia as a significant clinical entity may eventually result in an expansion of current therapy--not only to ameliorate chest pain, but to minimize or eliminate ischemia in the absence of chest pain.

  20. Effect of angiopoietin-related protein 2 on coronary angiogenesis and myocardial function in a porcine model of acute myocardial ischemia

    Institute of Scientific and Technical Information of China (English)

    Shu Meng; Changqian Wang; Fei Wang; Renjian Zhou; Fangbao Ding; Fuxin Chen

    2008-01-01

    Our previous studies have suggested that angiopoietin-related protein 2 (Arp2) may improve rat cardiac function after acute myocardial infarction (AMI) by accelerating angiogenesis.We want to study the efficacy of the adenoviral vector-mediated gene transfer of Arp2 (Ad.Arp2) in inducing angiogenesis and in improving the myocardial perfusion and function in a porcine acute myocardial ischemic model.Methods The minipigs underwent ligation of the proximal circumflex coronary artery (LCx) and were randomly assigned to treatment with Ad.Arp2,adenoviral vectors with no transgene (Ad.Null) or PBS.Four weeks later,the animals were evaluated using echocardiography,cardiac perfusion imaging and pathologic observation.Results Four weeks after treatment,the Arp2 protein was revealed in the myocardium of Ad.Arp2 animals,but was not found in the Ad.Null or PBS animals.Also,a significant revival of myocardial perfusion was found in the ischemic area in Ad.Arp2-treated animals,whose global and regional myocardial function was greatly improved.The quantitation of new capillaries was much greater in the Ad.Arp2 group than in the Ad.Null or PBS groups.Conclusion Treatment with Ad.ARP2 offers the obvious advantage of greatly improving the blood supply and the heart function.(J Geriatr Cardiol 2008;5:230-234)

  1. 急性心肌缺血状态下左心室心肌的力学研究%Mechanics study on Left Ventricular myocardial During Acute Myocardial Ischemia

    Institute of Scientific and Technical Information of China (English)

    刘会若; 张瑞芳; 滑少华; 董刚; 高珂; 候苏芸; 许建威; 孙梦娇

    2016-01-01

    Objective To investigate segmental subendocardial mechanical pattern of left ventricle (LV) during acute myocardial ischemia using ultrasonic velocity vector imaging(VVI),and to demonstrate LV subendocardial mechanicals changs for the precise quantitative evaluation of early ischemic myocardial function.MethodsNine mongrel dogs after thoracotomy and the heart was exposed by ligation of the left anterior descending branch of the induced acute myocardial ischemia were collected before ischemia, after different left ventricular short axis two-dimensional dynamic grey scale of image plane, by off-line velocity vector imaging were left ventricular endocardium myocardial 16 segments of radial strain and the variation of circumferential strain.Results Beforeischemia,the myocardial circumferential strain of the left ventricle was increased from the basal level to the apical level in the same wall, thechanges disappear after ischemia, andthecircumferential strain of all segments decreased.Before ischemia with one compartment wall radial strain basal segment level were lower than those of the papillary muscle level segments and apical level segments, all room wall papillary myotome segments and apical section radial stress appeared as homogeneous change, after ischemia, part of segmental radial strain increases and the corresponding segment of strain is reduced.Conclusion Demonstrates that abnormal mechanical pattern of LV subendocardium induced by acute myocardial ischemia is the important pathophysiological mechanism of LV functional and anatomical remodeling.%目的:通过构建动物急性心肌缺血模型,运用速度向量成像技术观察急性心肌缺血前、后左心室心肌的径向应变、周向应变的变化,探讨急性心肌缺血状态下左心室心肌部分力学变化规律。方法9只杂种犬经开胸暴露心脏后,通过结扎左前降支造成急性心肌缺血,分别采集缺血前、后左心室不同的短轴二维动态灰阶切

  2. Calpain system and its involvement in myocardial ischemia and reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Christiane; Neuhof; Heinz; Neuhof

    2014-01-01

    Calpains are ubiquitous non-lysosomal Ca2+-dependent cysteine proteases also present in myocardial cytosol and mitochondria.Numerous experimental studies reveal an essential role of the calpain system in myocardial injury during ischemia,reperfusion and postischemic structural remodelling.The increasing Ca2+-content and Ca2+-overload in myocardial cytosol and mitochondria during ischemia and reperfusion causes an activation of calpains.Upon activation they are able to injure the contractile apparatus and impair the energy production by cleaving structural and functional proteins of myocytes and mitochondria.Besides their causal involvement in acute myocardial dysfunction they are also involved in structural remodelling after myocardial infarction by the generation and release of proapoptotic factors from mitochondria.Calpain inhibition can prevent or attenuate myocardial injury during ischemia,reperfusion,and in later stages of myocardial infarction.

  3. Screening of Bioactive Ingredients in Ligusticum Chuanxiong Hort for Protection against Myocardial Ischemia

    Directory of Open Access Journals (Sweden)

    Xu Liu

    2016-12-01

    Full Text Available Background/Aims: To study the spectrum-effect relationship and effective components of Ligusticum Chuanxiong Hort. (LCH on the protection of canine myocardial ischemia. Methods: Fingerprint spectrum of LCH extracts was developed using high performance liquid chromatography (HPLC, and a canine model of acute myocardial ischemia was established by ligating the coronary artery. Bivariate correlation analysis and multivariate regression analysis were used to correlate the pharmacodynamics of LCH extract and its common peaks in HPLC. Results: The bioactive components of LCH were ligustrazine, ferulic acid, cnidilide and ligustilide. Ligustrazine and ferulic acid could significantly reduce serum lactic acid in canine model of acute myocardial ischemia, while ligustilide could significantly reduce the elevation of serum free fatty acid. Conclusions: The spectrum-effect relationship study shows that the effective components of LCH are ligustrazine, ferulic acid, cnidilide and ligustilide, which have protective effect on myocardial ischemia.

  4. Cardiac MRI for myocardial ischemia.

    LENUS (Irish Health Repository)

    Daly, Caroline

    2013-01-01

    Proper assessment of the physiologic impact of coronary artery stenosis on the LV myocardium can affect patient prognosis and treatment decisions. Cardiac magnetic resonance imaging (CMR) assesses myocardial perfusion by imaging the myocardium during a first-pass transit of an intravenous gadolinium bolus, with spatial and temporal resolution substantially higher than nuclear myocardial perfusion imaging. Coupled with late gadolinium enhancement (LGE) imaging for infarction during the same imaging session, CMR with vasodilating stress perfusion imaging can qualitatively and quantitatively assess the myocardial extent of hypoperfusion from coronary stenosis independent of infarcted myocardium. This approach has been validated experimentally, and multiple clinical trials have established its diagnostic robustness when compared to stress single-photon emission computed tomography. In specialized centers, dobutamine stress CMR has been shown to have incremental diagnostic value above stress echocardiography due to its high imaging quality and ability to image the heart with no restriction of imaging window. This paper reviews the technical aspects, diagnostic utility, prognostic values, challenges to clinical adaptation, and future developments of stress CMR imaging.

  5. Effectiveness of Panax ginseng on Acute Myocardial Ischemia Reperfusion Injury Was Abolished by Flutamide via Endogenous Testosterone-Mediated Akt Pathway.

    Science.gov (United States)

    Pei, Luo; Shaozhen, Hou; Gengting, Dong; Tingbo, Chen; Liang, Liu; Hua, Zhou

    2013-01-01

    Mechanisms for Panax ginseng's cardioprotective effect against ischemia reperfusion injury involve the estrogen-mediated pathway, but little is known about the role of androgen. A standardized Panax ginseng extract (RSE) was orally given with or without flutamide in a left anterior descending coronary artery ligation rat model. Infarct size, CK and LDH activities were measured. Time-related changes of NO, PI3K/Akt/eNOS signaling, and testosterone concentration were also investigated. RSE (80 mg/kg) significantly inhibited myocardial infarction and CK and LDH activities, while coadministration of flutamide abolished this effect of RSE. NO was increased by RSE and reached a peak after 15 min of ischemia; however, flutamide cotreatment suppressed this elevation. Western blot analysis showed that RSE significantly reversed the decreases of expression and activation of PI3K, Akt, and eNOS evoked by ischemia, whereas flutamide attenuated the effects of these protective mechanisms induced by RSE. RSE completely reversed the dropping of endogenous testosterone level induced by I/R injury. Flutamide plus RSE treatment not only abolished RSE's effect but also produced a dramatic change on endogenous testosterone level after pretreatment and ischemia. Our results for the first time indicate that blocking androgen receptor abolishes the ability of Panax ginseng to protect the heart from myocardial I/R injury.

  6. Myocardial ischemia in hypertrophic cardiomyopathy; Isquemia miocardica na cardiomiopatia hipertrofica

    Energy Technology Data Exchange (ETDEWEB)

    Lima Filho, Moyses de Oliveira; Figueiredo, Geraldo L.; Simoes, Marcus V.; Pyntia, Antonio O.; Marin Neto, Jose Antonio [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia

    2000-08-01

    Myocardial ischemia in hypertrophic cardiomyopathy is multifactorial and explains the occurrence of angina, in about 50% of patients. The pathophysiology of myocardial ischemia may be explained by the increase of the ventricular mass and relative paucity of the coronary microcirculation; the elevated ventricular filling pressures and myocardial stiffness causing a compression of the coronary microvessels; the impaired coronary vasodilator flow reserve caused by anatomic and functional abnormalities; and the systolic compression of epicardial vessel (myocardial bridges). Myocardial ischemia must be investigated by perfusion scintigraphic methods since its presence influences the prognosis and has relevant clinical implications for management of patients. Patients with hypertrophic cardiomyopathy and documented myocardial ischemia usually need to undergo invasive coronary angiography to exclude the presence of concomitant atherosclerotic coronary disease. (author)

  7. Myocardial bridging as a cause of acute myocardial infarction: a case report

    Directory of Open Access Journals (Sweden)

    Emiroglu Yunus

    2002-09-01

    Full Text Available Abstract Background Systolic compression of a coronary artery by overlying myocardial tissue is termed myocardial bridging. Myocardial bridging usually has a benign prognosis, but some cases resulting in myocardial ischemia, infarction and sudden cardiac death have been reported. We are reporting a case of myocardial bridging which was complicated with acute myocardial infarction associated with inappropriate blood donation. Case presentation A 33 year-old-man was admitted to our emergency with acute anteroseptal myocardial infarction after a blood donation. The electrocardiography showed sinus rhythm and was consistent with an acute anteroseptal myocardial infarction. We decided to perform primary percutanous intervention (PCI. Myocardial bridging was observed in the mid segment of the left anterior descending coronary artery on coronary angiogram. PCI was canceled and medical follow up was decided. Blood transfusion was made because he had a deep anemia. A normal hemaglobin level and clinical reperfusion was achieved after ten hours by blood transfusion. At the one year follow up visit, our patient was healthy and had no cardiac complaints. Conclusions Myocardial bridging may cause acute myocardial infarction in various clinical conditions. Although the condition in this case caused profound anemia related acute myocardial infarction, its treatment and management was unusual.

  8. Hepatocyte growth factor gene therapy reduces ventricular arrhythmia in animal models of myocardial ischemia.

    Directory of Open Access Journals (Sweden)

    Yumoto,Akihisa

    2005-06-01

    Full Text Available

    It was recently reported that gene therapy using hepatocyte growth factor (HGF has the potential to preserve cardiac function after myocardial ischemia. We speculated that this HGF gene therapy could also prevent ventricular arrhythmia. To investigate this possibility, we examined the antiarrhythmic effect of HGF gene therapy in rat acute and old myocardial infarction models. Myocardial ischemia was induced by ligation of the left descending coronary artery. Hemagglutinating virus of Japan (HVJ-coated liposome containing HGF genes were injected directly into the myocardium fourteen days before programmed pacing. Ventricular fibrillation (VFwas induced by programmed pacing. The VF duration was reduced and the VF threshold increased after HGF gene therapy ( p< 0.01. Histological analyses revealed that the number of vessels in the ischemic border zone was greatly increased after HGF gene injection. These findings revealed that HGF gene therapy has an anti-arrhythmic effect after myocardial ischemia.

  9. Detection of myocardial ischemia and infarction by radionuclide studies

    Energy Technology Data Exchange (ETDEWEB)

    Tamaki, Nagara [Hokkaido Univ., Sapporo (Japan). School of Medicine

    1996-12-31

    Myocardial ischemia and myocardial infarction are the common diseases caused by reduced coronary artery blood flow to the myocardium. Although the radionuclide studies cannot identify stenotic lesions on the coronary arteries, they can demonstrate regional myocardial perfusion at rest and during stress as well which is particularly important for the accurate diagnosis of angina pectoris. (J.P.N.)

  10. Effects of resting ischemia assessed by thallium scintigraphy on QRS scoring system for estimating left ventricular function quantified by radionuclide angiography in acute myocardial infarction patients

    Energy Technology Data Exchange (ETDEWEB)

    DePace, N.L.; Hakki, A.H.; Iskandrian, A.S.

    1984-06-01

    The purpose of this study was to determine whether resting ischemia limits the usefulness of the QRS scoring system in predicting left ventricular (LV) ejection fraction (EF) in patients with acute infarction. We studied 48 patients after acute infarction by means of 12-lead ECG, thallium-201 scintigraphy, and radionuclide angiography. The thallium-201 scintigrams showed fixed defects in 25 patients, perfusion defects with partial or complete redistribution in the delayed images in 19 patients, and normal images in the remaining four patients. In the 48 patients there was a significant correlation between the QRS score and LVEF (r . -0.67; p less than 0.001). Patients with fixed defects showed a better correlation than patients with resting ischemia (r . -0.77 vs r . -0.60). A QRS score of 3 or less was used to separate patients with LVEF of 40% or greater from those with lower LVEF in patients with fixed defects (p . 0.0005), but this cutoff did not categorize patients with resting ischemia as to LVEF. Thus the presence of rest ischemia in patients with acute infarction may affect the correlation between QRS score and LVEF.

  11. Effects of resting ischemia assessed by thallium scintigraphy on QRS scoring system for estimating left ventricular function quantified by radionuclide angiography in acute myocardial infarction patients.

    Science.gov (United States)

    DePace, N L; Hakki, A H; Iskandrian, A S

    1984-06-01

    The purpose of this study was to determine whether resting ischemia limits the usefulness of the QRS scoring system in predicting left ventricular (LV) ejection fraction (EF) in patients with acute infarction. We studied 48 patients after acute infarction by means of 12-lead ECG, thallium-201 scintigraphy, and radionuclide angiography. The thallium-201 scintigrams showed fixed defects in 25 patients, perfusion defects with partial or complete redistribution in the delayed images in 19 patients, and normal images in the remaining four patients. In the 48 patients there was a significant correlation between the QRS score and LVEF (r = -0.67; p less than 0.001). Patients with fixed defects showed a better correlation than patients with resting ischemia (r = -0.77 vs r = -0.60). A QRS score of 3 or less was used to separate patients with LVEF of 40% or greater from those with lower LVEF in patients with fixed defects (p = 0.0005), but this cutoff did not categorize patients with resting ischemia as to LVEF. Thus the presence of rest ischemia in patients with acute infarction may affect the correlation between QRS score and LVEF.

  12. Acute coronary ischemia during alcohol withdrawal: a case report

    Directory of Open Access Journals (Sweden)

    Sriram Ganeshalingam

    2011-08-01

    Full Text Available Abstract Introduction The potential of alcohol withdrawal to cause acute coronary events is an area that needs the urgent attention of clinicians and researchers. Case presentation We report the case of a 52-year-old heavy-alcohol-using Sri Lankan man who developed electocardiogram changes suggestive of an acute coronary event during alcohol withdrawal. Despite the patient being asymptomatic, subsequent echocardiogram showed evidence of ischemic myocardial dysfunction. We review the literature on precipitation of myocardial ischemia during alcohol withdrawal and propose possible mechanisms. Conclusions Alcohol withdrawal is a commonly observed phenomenon in hospitals. However, the number of cases reported in the literature of acute coronary events occurring during withdrawal is few. Many cases of acute ischemia or sudden cardiac deaths may be attributed to other well known complications of delirium tremens. This is an area needing the urgent attention of clinicians and epidemiologists.

  13. [Follow-up of surgical therapy in patients with threatened and acute myocardial ischemia for an average of 5 years].

    Science.gov (United States)

    Brunke, W; Anders, G; Müller, J H; Abet, U

    1990-11-01

    Out of a total group of 300 patients after local intracoronary fibrinolysis, systemic ultra-high short-term fibrinolysis and instable angina pectoris 73 (24% out of 300) patients, in whom acutely or in the course of the treatment a surgical therapy of their coronary heart disease was performed, were analysed. Constellations of the findings of the coronary heart disease, when according to this connection with an adequate conservative therapy on the basis of a diagnostic and therapeutic step programme in 44% of the patients an improvement of the load capacity and in 73% an improvement of the subjective well-being is to be stated. In patients with diseases of one vessel compared with patients with diseases of several vessels significantly more frequently an intraindividual increase of the bicycle-ergometric performance develops.

  14. Distinct effects of acute pretreatment with lipophilic and hydrophilic statins on myocardial stunning, arrhythmias and lethal injury in the rat heart subjected to ischemia/reperfusion.

    Science.gov (United States)

    Čarnická, S; Adameová, A; Nemčeková, M; Matejíková, J; Pancza, D; Ravingerová, T

    2011-01-01

    Although both lipophilic and more hydrophilic statins share the same pathway of the inhibition of HMG-CoA reductase, their pleiotropic cardioprotective effects associated with the ability to cross cellular membranes, including membranes of heart cells, may differ. To test this hypothesis, isolated rat hearts were Langendorff-perfused either with simvastatin (S, 10 micromol/l) or pravastatin (P, 30 micromol/l), 15 min prior to ischemia. Control untreated hearts (C) were perfused with perfusion medium only. Postischemic contractile dysfunction, reperfusion-induced ventricular arrhythmias and infarct size were investigated after exposure of the hearts to 30-min global ischemia and 2-h reperfusion. Both lipophilic S and hydrophilic P reduced the severity of ventricular arrhythmias (arrhythmia score) from 4.3 +/- 0.2 in C to 3.0 +/- 0 and 2.7 +/- 0.2 in S and P, respectively, (both P statins indicating a different ability to cross cardiac membranes may underlie their distinct cardioprotective effects on myocardial stunning and lethal injury induced by ischemia/reperfusion.

  15. Effects of ischemic postconditioning on myocardial apoptosis and infarction in rabbits with acute myocardial ischemia and reperfusion%缺血后处理对缺血再灌注大鼠心肌梗死和心肌细胞凋亡的作用

    Institute of Scientific and Technical Information of China (English)

    李源; 陶凌; 臧益民; 高峰

    2002-01-01

    AIM To observe the effects of ischemic postconditioning (IPC) on cardiomyocyte apoptosis and myocardial infarct size in myocardial ischemia/reperfusion rabbits. METHODS Rabbit acute myocardial ischemia/reperfusion model was used and the heart was conditioned either pre-or post-myocardial ischemia followed by reperfusion. Cardiomyocyte apoptosis and myocardial infarct size were determined by in situ TDT-mediated dUTP nick end labeling (TUNEL) and Evan's blue-TTC dual staining, respectively. RESULTS Compared with those in the control group, both cardiomyocyte apoptotic index and myocardial infarct size were significantly reduced in IPC group [apoptotic index: (15±7)% vs (30±12)% of control, P<0.05; infarction:(13±5)% vs (27±7)% of control, P<0.01, respectively]. No significant difference was found between ischemic preconditioning (IP) and IPC groups. CONCLUSION Ischemic postconditioning, like ischemic preconditioning, exerts an anti-apoptotic effect, which may contribute partly to the ultimate reduction of myocardial infarction in acute myocardial ischemia-reperfusion.%目的观察在体情况下缺血后处理(IPC)对兔心肌梗死范围及缺血心肌细胞凋亡的影响,并与缺血预处理(IP)心脏保护作用比较. 方法采用兔心肌缺血/再灌注模型,在缺血后、再灌注前多次短暂再灌/停灌处理. 以Even's blue-TTC法检测心肌梗死范围,TUNEL方法检测缺血心肌细胞凋亡. 结果与对照组相比,缺血后处理明显减小心肌梗死范围(12.5±5.4% vs对照组26.7±6.7%, P<0.01),缺血区心肌凋亡指数明显下降(14.6±7.4 vs对照组30.4±12.3, P<0.05). 结论对于已缺血心肌,再灌前予多次短暂复灌、停灌处理具有与IP类似缩小心梗范围作用,IPC对缺血心肌的保护效应可能与其抑制缺血心肌细胞凋亡有关.

  16. INVIVO EFFECT OF BRADYKININ DURING ISCHEMIA AND REPERFUSION - IMPROVED ELECTRICAL STABILITY 2 WEEKS AFTER MYOCARDIAL-INFARCTION IN THE PIG

    NARCIS (Netherlands)

    TOBE, TJM; DELANGEN, CDJ; TIO, RA; BEL, KJ; MOOK, PH; WESSELING, H

    1991-01-01

    In this study, the effect of bradykinin or saline infusion during ischemia and reperfusion on electrical stability, 2 weeks after myocardial infarction, was assessed. Acute myocardial infarction was induced in 21 pigs by a transluminal occlusion of the left coronary artery with a catheter balloon, i

  17. Effects of β2 adrenergic receptor agonists on acute myocardial ischemia%沙丁胺醇对急性心肌缺血模型大鼠心电图及血清心肌酶谱的影响

    Institute of Scientific and Technical Information of China (English)

    李艳; 李明; 高伟

    2011-01-01

    目的:探讨β2肾上腺素受体激动剂沙丁胺醇(Salbutamol)对急性心肌缺血模型大鼠心电图及血清天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)和超氧化物歧化酶(SOD)表达的影响.方法:采用舌下静脉注射垂体后叶素(1U/kg,6U/ml)的方法制备大鼠急性心肌缺血模型.静脉滴注5%葡萄糖500ml含沙丁胺醇(Sal butamol)0.18 mg(滴速0.5 ml/min),记录大鼠心电图J点位移及T波变化.测定血清AST、LDH、CK和SOD的含量.结果:β2受体激动剂Salbutamol恢复了由急性心肌缺血造成的心电图J点位移及T波变化值的异常改变,降低了心肌缺血大鼠血清AST、LDH和CK的水平,升高了血清SOD含量.结论:Salbutamol对急性心肌缺血具有一定的保护作用,该作用可能与降低肿瘤坏死因子-α的表达有关.%Objective: To observe the effects of p2 adrenergic agonists-salbutamol on the ECG and the levels of serum AST, LD, CK and SOD in the acute myocardial ischemia rats models. Methods: Injecting pituitrin (lU/kg, 6U/ml) into sublingual vein simulated the acute ischemic rats models. Intravenous 5% glucose containing salbutamol 0. 18 mg to record the displacement of J point and the changing of T wave. To determine the contents of serum AST, LDH, CK and SOD. Results: (32 adrenergic agonists-salbutamol reversed the abnormal changes of ECG induced by acute myocardial ischemia, and decreased the levels of serum AST, LDH, CK and SOD. Conclusion: Salbutamol have a certain protective effect on acute myocardial ischemia, which might involved with an downregulation of TNF2α.

  18. Intracoronary levosimendan during ischemia prevents myocardial apoptosis.

    Directory of Open Access Journals (Sweden)

    Markus eMalmberg

    2012-02-01

    Full Text Available Background. Levosimendan is a calcium-sensitizing inotropic agent that prevents myocardial contractile depression following cardiac surgery. Levosimendan has also anti-apoptotic properties, but the role of this mechanism is not clear. We studied whether levosimendan prevents cardiomyocyte apoptosis and post-operative stunning after either intracoronary administration or intravenous infusion in an experimental model. Methods. Pigs (n=24 were subjected to 40 minutes of global, cardioplegic ischemia under cardiopulmonary bypass and 240 minutes of reperfusion. L-IV group received intravenous infusion of levosimendan (65 μg/kg 40 minutes before ischemia and L-IC group received levosimendan (65 μg/kg during ischemia administered intracoronary. Control group was operated without levosimendan. Echocardiography was performed to all animals. Apoptosis was determined from transmyocardial biopsies taken from left ventricle using TUNEL assay and immunohistochemistry of active caspace-3. Results. Apoptosis was induced after ischemia-reperfusion in all groups (pre L-IV 0.002±0.004 % vs. post L-IV 0.020±0.017 % p=0.02, pre L-IC 0.001±0.004 % vs. post L-IC 0.020±0.017 % p<0.001, pre control 0.007±0.013 % vs. post control 0.062±0.044 % p=0.01. The amount of apoptosis was higher in the controls, compared with the L-IV (p=0.03 and the L-IC (p=0.03 groups. Longitudinal left ventricular contraction was significantly reduced in the L-IC and the control groups when compared to the L-IV group (L-IV 0.75±0.12 mm vs. L-IC 0.53±0.11 mm p=0.003, L-IV vs. control 0.54±0.11 p=0.01. Conclusions. Both intracoronary administration and pre-ischemic intravenous infusion of levosimendan equally prevented apoptosis, but intravenous administration was required for optimal preservation of the post-operative systolic left ventricle function.

  19. Antioxidative and cardioprotective effects of total flavonoids extracted from Dracocephalum moldavica L. against acute ischemia/reperfusion-induced myocardial injury in isolated rat heart.

    Science.gov (United States)

    Jiang, Jiangtao; Yuan, Xuan; Wang, Ting; Chen, Hongmei; Zhao, Hong; Yan, Xinyan; Wang, Zhiping; Sun, Xiling; Zheng, Qiusheng

    2014-03-01

    This study evaluates antioxidative and cardioprotective effects of total flavonoids extracted from Dracocephalum moldavica L. (DML). The total flavonoids showed remarkable scavenging effects against 1,1-diphenyl-2-picrylhydrazyl, hydroxyl and superoxide anion radicals in vitro. Compared with the ischemia/reperfusion (I/R) group as demonstrated by the use of improved Langendorff retrograde perfusion technology, the total flavonoids (5 μg/mL) pretreatment improved the heart rate and coronary flow, rised left ventricular developed pressure and decreased creatine kinase, lactate dehydrogenase levels in coronary flow. The infarct size/ischemic area at risk of DML-treated hearts was smaller than that of I/R group; the superoxide dismutase activity and glutathione/glutathione disulfide ratio increased and malondialdehyde content reduced obviously (P total flavonoids treatment groups. In conclusion, the total flavonoids possess obvious protective effects on myocardial I/R injury, which may be related to the improvement of myocardial oxidative stress states.

  20. 缺血修饰白蛋白在诊断急性心肌缺血中的作用%Significance of ischemia modified albumin level in diagnosing acute myocardial ischemia

    Institute of Scientific and Technical Information of China (English)

    朱振华; 颜彦; 王齐兵; 王翔飞; 钱菊英; 葛均波

    2009-01-01

    目的 观察急诊胸痛患者中,缺血修饰白蛋白(ischemia modified albumin,IMA)在心肌缺血引起的心源性胸痛者中的变化情况、其在不同疾病组人群中水平的差异以及对急性心肌缺血严重程度的反映.方法 连续收集2008年4月5日起因"胸闷胸痛"至中山医院急诊就诊的患者100例,除外慢性心功能不全、肾功能不全者,留取其不同时间送检的血清标本人工测定IMA值.检测前综合所有临床资料将病例分为非缺血性胸痛(non-ischemic chest pain,NICP)组和急性冠脉综合征(acute coronary syndrome,ACS)组,后者又进一步分成不稳定心绞痛(unstable angina,UA)组、非ST段抬高心梗(non-ST elevated myocardial infarction,NSTEMI)组和ST段抬高心梗(ST elevated myocardial infarction,STEMI)组.比较不同组人群中血清IMA的水平,并结合其他辅助检查结果分析该指标是否能反映心肌缺血的程度.结果 共收集病例100例,血清标本188份,其中男性63例,女性37例,年龄31~88(64.6±17.3)岁.各组血清IMA水平(ABSU/mL):NICP组(54.1±16.8),ACS组(69.7±15.3),两组间差异有统计学意义;UA组(64.4±11.7),NSTEMI组(68.3±12.9),STEMI组(75.6±15.2),其余4组与NICP组进行组间比较,各组间IMA均值不全相等,其中NICP与其余各组、STEMI与UA组之间差异有统计学意义.以最终的出院诊断为标准,由ROC曲线得出IMA诊断ACS的最佳截断值为66.1 ABSU/mL,曲线下面积(area under the curve,AUC)为0.745(0.649~0.841),敏感性 71.0%,特异性 64.8%.IMA升高的水平与心电图ST-T异常的程度及范围有关(P<0.05).结论 在不稳定型冠心病患者中血清IMA水平升高,可以帮助鉴别急性心肌缺血引起的胸痛,并能反映缺血的严重程度.

  1. An initial study on the feasibility of diagnosing myocardial ischemia with CT first-pass myocardial perfusion imaging at rest

    Institute of Scientific and Technical Information of China (English)

    汪奇

    2013-01-01

    Objective To assess the feasibility and accuracy of CT first-pass myocardial perfusion imaging(CT first-pass MPI)at rest for diagnosis of myocardial ischemia.Results of adenosine-induced myocardial perfusion scintigraphy(MPS)

  2. Activation of Poly(ADP-Ribose) Polymerase by Myocardial Ischemia and Coronary Reperfusion in Human Circulating Leukocytes

    OpenAIRE

    Tóth-Zsámboki, Emese; Horváth, Eszter; Vargova, Katarina; Pankotai, Eszter; Murthy, Kanneganti; Zsengellér, Zsuzsanna; Bárány, Tamás; Pék, Tamás; Fekete, Katalin; Kiss, Róbert Gábor; Préda, István; Lacza, Zsombor; Gerö, Domokos; SzabÓ, Csaba

    2006-01-01

    Reactive free radical and oxidant production leads to DNA damage during myocardial ischemia/reperfusion. Consequent overactivation of poly(ADP-ribose) polymerase (PARP) promotes cellular energy deficit and necrosis. We hypothesized that PARP is activated in circulating leukocytes in patients with myocardial infarction and reperfusion during primary percutaneous coronary intervention (PCI). In 15 patients with ST segment elevation acute myocardial infarction, before and after primary PCI and 2...

  3. Experimental Approaches to Acute Myocardial Infarction

    NARCIS (Netherlands)

    D.B. Uitterdijk (André)

    2015-01-01

    markdownabstractAbstract This thesis is dedicated to i) novel methods and optimization studies to improve the diagnosis of myocardial ischemia and myocardial infarction as well as fundamental studies that precede novel therapies for myocardial infarction. In part ii) 2 novel, adjunctive therapies f

  4. 外源性硫化氢对大鼠急性心肌缺血损伤时炎性反应的影响%Effects of exogenous hydrogen sulfide on inflammatory responses during acute myocardial ischemia in rats

    Institute of Scientific and Technical Information of China (English)

    刘芳; 刘广杰; 张建新; 李兰芳

    2014-01-01

    Objective To evaluate the effects of exogenous hydrogen sulfide on inflammatory responses during acute myocardial ischemia in rats.Methods Twenty-four adult male Sprague-Dawley rats,weighing 250-290 g,were randomly divided into 3 groups (n =8 each):sham operation group,acute myocardial ischemia group,and sodium hydrosulfide (NaHS) group.The animals were anesthetized with intraperitoneal chloral hydrate.The model of acute myocardial ischemia was established by ligating the left anterior descending branch of coronary artery.Normal saline 2 ml/kg and NaHS 3.12 mg/kg were intraperitoneally injected at 3 h of ischemia in AMI and NaHS groups,respectively.The rats were sacrificed at 6 h after ligation and hearts were removed for determination of interleukin-1β (IL-1β),IL-6 and tumor necrosis factor-α (TNF-α) contents (by ELISA) and intercellular adhesion molecule-1 (ICAM-1) mRNA expression (by semi-quantitative PCR) in myocardial tissues and for examination of myocardial ultrastructure with transmission electron microscope.Results Compared with S group,IL-1β,IL-6 and TNF-α conte.nts and ICAM-1 mRNA expression in myocardial tissues were significantly increased in AMI group (P < 0.05).Compared with AMI group,IL-1β,IL-6 and TNF-α contents and ICAM-1 mRNA expression in myocardial tissues were significantly decreased in NaHS group (P < 0.05).The damage to myocardial ultrastructure was significantly alleviated in NaHS group when compared with AMI group.Conclusion The mechanism by which exogenous H2S alleviates the acute myocardial ischemia injury is related to inhibition of the inflammatory responses in rats.%目的 评价外源性硫化氢对大鼠急性心肌缺血损伤时炎性反应的影响.方法 清洁级健康成年雄性SD大鼠24只,体重250 ~ 290 g,采用随机数字表法分为3组(n=6):假手术组(S组)、急性心肌缺血组(AMI组)和硫氢化钠组(NaHS组).采用结扎大鼠左冠状动脉前降支的方法制备急性心肌缺血模型.AMI

  5. The Effects of Electroacupuncture at the Heart Meridian on Myocardial Contractile Function in Rabbits with Myocardial Ischemia

    Institute of Scientific and Technical Information of China (English)

    方志斌; 周逸平; 王月兰

    2002-01-01

    @@ Acute myocardial ischemia was induced by intravenous injection of pituitrin, and electroacupuncture (EA) was applied at the Heart and Lung Meridians (HM and LM), 3 points on each meridian. The changes in the left intraventricular pressure (LVP), the maximum rise rate of intraventricular pressure (LVP dp/dtmax), the area of cardiac force loop (ACFL), and the maximum shortening velocity of myocardial contractile element (Vmax) were observed. As a result, there were significant differences in the improvement of LVP, LVP dp/dtmax, ACFL and Vmax between EA at HM and LM. The regulatory action of EA at HM on the myocardial contractile function was significantly better than that of EA at LM, indicating that HM has a close relationship with the myocardial contractile function.

  6. B lymphocytes trigger monocyte mobilization and impair heart function after acute myocardial infarction

    Science.gov (United States)

    Zouggari, Yasmine; Ait-Oufella, Hafid; Bonnin, Philippe; Simon, Tabassome; Sage, Andrew P; Guérin, Coralie; Vilar, José; Caligiuri, Giuseppina; Tsiantoulas, Dimitrios; Laurans, Ludivine; Dumeau, Edouard; Kotti, Salma; Bruneval, Patrick; Charo, Israel F; Binder, Christoph J; Danchin, Nicolas; Tedgui, Alain; Tedder, Thomas F; Silvestre, Jean-Sébastien; Mallat, Ziad

    2014-01-01

    Acute myocardial infarction is a severe ischemic disease responsible for heart failure and sudden death. Here, we show that after acute myocardial infarction in mice, mature B lymphocytes selectively produce Ccl7 and induce Ly6Chi monocyte mobilization and recruitment to the heart, leading to enhanced tissue injury and deterioration of myocardial function. Genetic (Baff receptor deficiency) or antibody-mediated (CD20- or Baff-specific antibody) depletion of mature B lymphocytes impeded Ccl7 production and monocyte mobilization, limited myocardial injury and improved heart function. These effects were recapitulated in mice with B cell–selective Ccl7 deficiency. We also show that high circulating concentrations of CCL7 and BAFF in patients with acute myocardial infarction predict increased risk of death or recurrent myocardial infarction. This work identifies a crucial interaction between mature B lymphocytes and monocytes after acute myocardial ischemia and identifies new therapeutic targets for acute myocardial infarction. PMID:24037091

  7. Evaluation of myocardial ischemia by multiple detector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Fabio Vieira, E-mail: rccury@me.com [Hospital do Coracao (HCor), Sao Paulo, SP (Brazil); Cury, Roberto Caldeira [Hospital Samaritano, Sao Paulo, SP (Brazil)

    2015-01-15

    For years, cardiovascular diseases have been the leading cause of death worldwide, bringing on important social and economic consequences. Given this scenario, the search for a method capable of diagnosing coronary artery diseases in an early and accurate way is increasingly higher. The coronary computed tomography angiogram is already widely established for the stratification of coronary artery diseases, and, more recently, the computed tomography myocardial perfusion imaging has been providing relevant information by correlating ischemia and the coronary anatomy. The objective of this review is to describe the evaluation of myocardial ischemia by multiple detector computed tomography. This study will resort to controlled clinical trials that show the possibility of a single method to identify the atherosclerotic load, presence of coronary artery luminal narrowing and possible myocardial ischemia, by means of a fast, practical and reliable method validated by a multicenter study. (author)

  8. A Translational Study of a New Therapeutic Approach for Acute Myocardial Infarction: Nanoparticle-Mediated Delivery of Pitavastatin into Reperfused Myocardium Reduces Ischemia-Reperfusion Injury in a Preclinical Porcine Model

    Science.gov (United States)

    Ichimura, Kenzo; Matoba, Tetsuya; Nakano, Kaku; Tokutome, Masaki; Honda, Katsuya; Koga, Jun-ichiro; Egashira, Kensuke

    2016-01-01

    Background There is an unmet need to develop an innovative cardioprotective modality for acute myocardial infarction, for which interventional reperfusion therapy is hampered by ischemia-reperfusion (IR) injury. We recently reported that bioabsorbable poly(lactic acid/glycolic acid) (PLGA) nanoparticle-mediated treatment with pitavastatin (pitavastatin-NP) exerts a cardioprotective effect in a rat IR injury model by activating the PI3K-Akt pathway and inhibiting inflammation. To obtain preclinical proof-of-concept evidence, in this study, we examined the effect of pitavastatin-NP on myocardial IR injury in conscious and anesthetized pig models. Methods and Results Eighty-four Bama mini-pigs were surgically implanted with a pneumatic cuff occluder at the left circumflex coronary artery (LCx) and telemetry transmitters to continuously monitor electrocardiogram as well as to monitor arterial blood pressure and heart rate. The LCx was occluded for 60 minutes, followed by 24 hours of reperfusion under conscious conditions. Intravenous administration of pitavastatin-NP containing ≥ 8 mg/body of pitavastatin 5 minutes before reperfusion significantly reduced infarct size; by contrast, pitavastatin alone (8 mg/body) showed no therapeutic effects. Pitavastatin-NP produced anti-apoptotic effects on cultured cardiomyocytes in vitro. Cardiac magnetic resonance imaging performed 4 weeks after IR injury revealed that pitavastatin-NP reduced the extent of left ventricle remodeling. Importantly, pitavastatin-NP exerted no significant effects on blood pressure, heart rate, or serum biochemistry. Exploratory examinations in anesthetized pigs showed pharmacokinetic analysis and the effects of pitavastatin-NP on no-reflow phenomenon. Conclusions NP-mediated delivery of pitavastatin to IR-injured myocardium exerts cardioprotective effects on IR injury without apparent adverse side effects in a preclinical conscious pig model. Thus, pitavastatin-NP represents a novel therapeutic

  9. Acute myopericarditis masquerading as acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  10. Effects of intracoronary melatonin on ischemia-reperfusion injury in ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Ekeløf, Sarah V; Halladin, Natalie L; Jensen, Svend E

    2016-01-01

    Acute coronary occlusion is effectively treated by primary percutaneous coronary intervention. However, myocardial ischemia-reperfusion injury is at the moment an unavoidable consequence of the procedure. Oxidative stress is central in the development of ischemia-reperfusion injury. Melatonin......, an endogenous hormone, acts through antioxidant mechanisms and could potentially minimize the myocardial injury. The aim of the experimental study was to examine the cardioprotective effects of melatonin in a porcine closed-chest reperfused infarction model. A total of 20 landrace pigs were randomized...... to a dosage of 200 mg (0.4 mg/mL) melatonin or placebo (saline). The intervention was administered intracoronary and intravenous. Infarct size, area at risk and microvascular obstruction were determined ex vivo by cardiovascular magnetic resonance imaging. Myocardial salvage index was calculated. The plasma...

  11. Effect of thrombolytic therapy on postinfarction myocardial ischemia

    DEFF Research Database (Denmark)

    Mickley, H; Junker, A; Møller, M

    1994-01-01

    be responsible for the reduction in cardiac death. So far it has not been clearly established how thrombolytic therapy affects postinfarction myocardial ischemia. From studies evaluating ST segment changes on exercise testing or ambulatory monitoring it is concluded that thrombolysis probably results...... in a reduction of residual ischemia. The reduced ischemic burden is proposed to be one important pathophysiological mechanism underlying the frequently observed improvement in hemodynamic stress test variables following thrombolytic treatment....

  12. Diabetic Inhibition of Preconditioning- and Postconditioning-Mediated Myocardial Protection against Ischemia/Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Xia Yin

    2012-01-01

    Full Text Available Ischemic preconditioning (IPC or postconditioning (Ipost is proved to efficiently prevent ischemia/reperfusion injuries. Mortality of diabetic patients with acute myocardial infarction was found to be 2–6 folds higher than that of non-diabetic patients with same myocardial infarction, which may be in part due to diabetic inhibition of IPC- and Ipost-mediated protective mechanisms. Both IPC- and Ipost-mediated myocardial protection is predominantly mediated by stimulating PI3K/Akt and associated GSK-3β pathway while diabetes-mediated pathogenic effects are found to be mediated by inhibiting PI3K/Akt and associated GSK-3β pathway. Therefore, this review briefly introduced the general features of IPC- and Ipost-mediated myocardial protection and the general pathogenic effects of diabetes on the myocardium. We have collected experimental evidence that indicates the diabetic inhibition of IPC- and Ipost-mediated myocardial protection. Increasing evidence implies that diabetic inhibition of IPC- and Ipost-mediated myocardial protection may be mediated by inhibiting PI3K/Akt and associated GSK-3β pathway. Therefore any strategy to activate PI3K/Akt and associated GSK-3β pathway to release the diabetic inhibition of both IPC and Ipost-mediated myocardial protection may provide the protective effect against ischemia/reperfusion injuries.

  13. Edema is a sign of early acute myocardial infarction on post-mortem magnetic resonance imaging.

    Science.gov (United States)

    Ruder, Thomas D; Ebert, Lars C; Khattab, Ahmed A; Rieben, Robert; Thali, Michael J; Kamat, Pranitha

    2013-12-01

    The aim of this study was to investigate if acute myocardial infarction can be detected by post-mortem cardiac magnetic resonance (PMMR) at an earlier stage than by traditional autopsy, i.e., within less than 4 h after onset of ischemia; and if so, to determine the characteristics of PMMR findings in early acute infarcts. Twenty-one ex vivo porcine hearts with acute myocardial infarction underwent T2-weighted cardiac PMMR imaging within 3 h of onset of iatrogenic ischemia. PMMR imaging findings were compared to macroscopic findings. Myocardial edema induced by ischemia and reperfusion was visible on PMMR in all cases. Typical findings of early acute ischemic injury on PMMR consist of a central zone of intermediate signal intensity bordered by a rim of increased signal intensity. Myocardial edema can be detected on cardiac PMMR within the first 3 h after the onset of ischemia in porcine hearts. The size of myocardial edema reflects the area of ischemic injury in early acute (per-acute) myocardial infarction. This study provides evidence that cardiac PMMR is able to detect acute myocardial infarcts at an earlier stage than traditional autopsy and routine histology.

  14. A New Therapeutic Modality for Acute Myocardial Infarction: Nanoparticle-Mediated Delivery of Pitavastatin Induces Cardioprotection from Ischemia-Reperfusion Injury via Activation of PI3K/Akt Pathway and Anti-Inflammation in a Rat Model.

    Directory of Open Access Journals (Sweden)

    Kazuhiro Nagaoka

    Full Text Available There is an unmet need to develop an innovative cardioprotective modality for acute myocardial infarction (AMI, for which the effectiveness of interventional reperfusion therapy is hampered by myocardial ischemia-reperfusion (IR injury. Pretreatment with statins before ischemia is shown to reduce MI size in animals. However, no benefit was found in animals and patients with AMI when administered at the time of reperfusion, suggesting insufficient drug targeting into the IR myocardium. Here we tested the hypothesis that nanoparticle-mediated targeting of pitavastatin protects the heart from IR injury.In a rat IR model, poly(lactic acid/glycolic acid (PLGA nanoparticle incorporating FITC accumulated in the IR myocardium through enhanced vascular permeability, and in CD11b-positive leukocytes in the IR myocardium and peripheral blood after intravenous treatment. Intravenous treatment with PLGA nanoparticle containing pitavastatin (Pitavastatin-NP, 1 mg/kg at reperfusion reduced MI size after 24 hours and ameliorated left ventricular dysfunction 4-week after reperfusion; by contrast, pitavastatin alone (as high as 10 mg/kg showed no therapeutic effects. The therapeutic effects of Pitavastatin-NP were blunted by a PI3K inhibitor wortmannin, but not by a mitochondrial permeability transition pore inhibitor cyclosporine A. Pitavastatin-NP induced phosphorylation of Akt and GSK3β, and inhibited inflammation and cardiomyocyte apoptosis in the IR myocardium.Nanoparticle-mediated targeting of pitavastatin induced cardioprotection from IR injury by activation of PI3K/Akt pathway and inhibition of inflammation and cardiomyocyte death in this model. This strategy can be developed as an innovative cardioprotective modality that may advance currently unsatisfactory reperfusion therapy for AMI.

  15. Usefulness of percutaneous transluminal coronary angioplasty in silent myocardial ischemia

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    Hou, Mami [Toho Univ., Tokyo (Japan). School of Medicine

    1996-04-01

    The usefulness of percutaneous transluminal coronary angioplasty (PTCA) was assessed in patients with exercise-induced asymptomatic myocardial ischemia (silent ischemia) and compared with exercise-induced symptomatic myocardial ischemia (symptomatic ischemia). Patients with single vessel coronary artery disease (51 with angina pectoris, 40 with old myocardial infarction) and evidence of stress-induced ischemia on thallium-201 single photon emission computed tomography (SPECT) underwent successful PTCA. Thirty-seven percent of angina patients and 60% of infarction patients showed asymptomatic exercise-induced ischemia. There was no significant difference in population characteristics between silent and symptomatic patients. Patients with silent angina had significantly higher percentage thallium uptake and washout rate than symptomatic patients. After PTCA, both percentage diameter stenosis and percentage thallium uptake were improved in all patients with angina irrespective of the presence or absence of symptoms. There were no significant differences in percentage thallium uptake and washout rate between patients with silent and symptomatic infarction. After PTCA, percentage diameter stenosis, percentage thallium uptake, and washout rate improved in all infarction patients irrespective of the symptoms. Zero percent of silent angina patients, 12% of symptomatic angina patients, 12% of silent infarction patients, 19% of symptomatic infarction patients had cardiac events during about 4.5 years after PTCA. The incidence of cardiac events did not significantly differ in any patient group. PTCA improved myocardial perfusion in all patients, and the incidence of cardiac events did not differ between the silent and symptomatic groups. Revascularization with PTCA is suitable for patients with silent as well as symptomatic ischemia. (author).

  16. Protective effect of Shenfu injection on myocardial mitochondria injured by ischemia-reperfusion in rabbits

    Institute of Scientific and Technical Information of China (English)

    CAO Jun; ZHENG Chuan-dong; ZHANG Guang-xin; ZHANG You-jun; MIN Su

    2005-01-01

    @@ The main active components of Shenfu injection (SFI), an extract of traditional Chinese herbs, are ginsenoside and higenamine. Ginsenoside can improve ischemic myocardium metabolism, scavenge free radicals, protect myocardial ultrastructure and reduce Ca2+ overload. Higenamine can enhance heart contractility, improve coronary circulation and decrease the effect of acute myocardial ischemia. SFI was found to have had some cardiac protective effect during cardiopulmonary bypass.1,2 SFI was added into St. Thomas crystal cardioplegic solution in this study to investigate the protective effect of SFI on ischemic-reperfused rabbit heart and to observe the influence on mitochondrial oxygen free radical (OFR), Ca2+ and mitochondrial ultrastructure.

  17. Late reperfusion of a totally occluded infarct-related artery increases granulocyte-colony stimulation factor and reduces stroma-derived factor-1alpha blood levels in patients with ongoing ischemia after acute myocardial infarction.

    Science.gov (United States)

    Kuo, Li-Tang; Chen, Shih-Jen; Cherng, Wen-Jin; Yang, Ning-I; Lee, Chen-Chin; Cheng, Chi-Wen; Verma, Subodh; Wang, Chao-Hung

    2009-07-01

    After acute myocardial infarction (AMI), reopening of a totally occluded infarct-related artery (IRA) at a subacute stage is still controversial in symptom-free patients. However, in patients with persistent ischemic symptoms and inadequate collaterals to the infarct area, recanalization is thought to provide beneficial effects. In addition to augmenting myocardial perfusion, we hypothesized that the benefit of recanalization involves the manipulation of circulating stem cell-mobilizing cytokines. This study included 30 patients with a totally occluded IRA and ongoing ischemic symptoms (the study group) and 30 patients with a partially occluded IRA (the control group). All patients underwent successful angioplasty and/or stenting. Before and immediately after the coronary intervention, blood granulocyte-colony-stimulating factor (G-CSF), stem-cell factor (SCF), vascular endothelial growth factor (VEGF), and stroma-derived factor-1 (SDF-1alpha) were measured. After recanalization, G-CSF levels significantly increased in the study group compared to the control group (P=0.03). SDF-1alpha levels in the study group decreased relative to the controls (P=0.02). However, no significant changes in VEGF or SCF levels between the two groups were found. In the multivariate analysis, reopening of a totally occluded IRA was independently and significantly associated with changes in G-CSF and SDF-1alpha levels after recanalization. In conclusion, our data suggest that the benefits of late reperfusion of a totally occluded IRA in patients with ongoing myocardial ischemia may involve mechanisms associated with stem cell-mobilizing and plaque-stabilizing cytokines. This study provides the rationale to investigate serial changes in cytokines and the numbers of circulating progenitors after reperfusion in the future.

  18. Energy Drinks and Myocardial Ischemia: A Review of Case Reports.

    Science.gov (United States)

    Lippi, Giuseppe; Cervellin, Gianfranco; Sanchis-Gomar, Fabian

    2016-07-01

    The use and abuse of energy drinks (EDs) is constantly increasing worldwide. We performed a systematic search in Medline, Scopus and Web of Science to identify evidence about the potential link between these beverages and myocardial ischemia. Overall, 8 case reports could be detected, all of which described a realistic association between large intake of EDs and episodes of myocardial ischemia. Interestingly, no additional triggers of myocardial ischemia other than energy drinks could be identified in the vast majority of cases. Some plausible explanations can be brought in support of this association. Most of the biological effects of EDs are seemingly mediated by a positive inotropic effect on cardiac function, which entails increase in heart rate, cardiac output and contractility, stroke volume and arterial blood pressure. Additional biological abnormalities reported after EDs intake include increased platelet aggregation, endothelial dysfunction, hyperglycemia as well as an increase in total cholesterol, triglycerides and low-density lipoprotein cholesterol. Although a causal relationship between large consumption of EDs and myocardial ischemia cannot be definitely established so far, concerns about the cardiovascular risk of excessive consumption of these beverages are seemingly justified.

  19. Acute mesenteric ischemia in young adults.

    Science.gov (United States)

    Ozturk, Gurkan; Aydinli, Bulent; Atamanalp, S Selcuk; Yildirgan, M Ilhan; Ozoğul, Bünyami; Kısaoğlu, Abdullah

    2012-08-01

    Acute mesenteric ischemia is commonly seen in old patients. This study was undertaken to show that mesenteric ischemia might be seen in individuals under 40 years of age and that its diagnosis is challenging. Twenty-six patients with acute mesenteric ischemia under the age of 40 were studied. The main symptom on admission was abdominal pain. Symptom duration varied between 12 h and 5 days. The medical history of the patients revealed that 9 had no previous diseases. Other 17 had predisposing factors in the first evaluation. None of the patients had any history of narcotic or drug abuse. Ten patients presented with signs and symptoms of sepsis and septic shock. Preoperative diagnosis was acute intestinal ischemia only in 6 patients. Preoperatively, all the patients had intestinal or colonic ischemia and necrosis; one had additional ischemia of the liver, stomach, duodenum, and pancreas. Six patients had massive intestinal necrosis. The overall postoperative complication and overall mortality rates were 61.5 and 26.9 %, respectively. Complications and mortality were determined to be associated with previous pulmonary disease, acidosis, presence of septic shock, acute renal failure, extent of the ischemia and extent of resection, second look operations, previous cardiac events, and the kind of affected bowel (colon involvement).

  20. Transmural myocardial ischemia due to slow coronary flow

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies, clinical manifestations and treatment of this unique angiographic phenomenon. In our case report, we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries, especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.

  1. Holmium:YAG laser coronary angioplasty in acute myocardial infarction

    Science.gov (United States)

    Topaz, On; Luxenberg, Michael; Schumacher, Audrey

    1994-07-01

    Patients who sustain complicated acute myocardial infarction in whom thrombolytic agents either fail or are contraindicated often need mechanical revascularization other than PTCA. In 24 patients with acute infarction complicated by continuous chest pain and ischemia who either received lytics or with contraindication to lytics, a holmium:YAG laser (Eclipse Surgical Technologies, Palo Alto, CA) was utilized for thrombolysis and plaque ablation. Clinical success was achieved in 23/24 patients, with 23 patients (94%) surviving the acute infarction. Holmium:YAG laser is very effective and safe in thrombolysis and revascularization in this complicated clinical setting.

  2. Effects of grade of ischemia on arrhythmia in patients with acute myocardial infarction%缺血分级对急性心肌梗死患者心律失常的影响

    Institute of Scientific and Technical Information of China (English)

    王荣英; 石汉文; 田英平; 郭宪立; 马玉腾; 苏建玲

    2012-01-01

    myocardial infarction(STEMI).Methods Patients with acute ST-segment elevation myocardial infarction(STEMI)admitted to emergency department from July 2003 to April 2008 were enrolled.A total of 223 patients met the criteria(ischemic chest pain ≥ 30 min,2 or more adjacent leads of ST segment elevation and onset time within 12 h).Exclusion criteria were bundle branch block and left ventricular hypertrophy.All enrolled patients were divided into two groups based on the enrollment electrocardiogram:grade 2 ischemia(ST elevation without terminal QRS distortion; n =134)and grade 3 ischemia(ST elevation with terminal QRS distortion; n =89).Patients of the two groups had comparable genderproportion,average age and coronary heart disease risk factors etc.All patients received thrombolytic therapy.The incidence rate of ST segment resolution(STR)and severe arrithmia in hospital stay were observed.Numerical variables were expressed mean ± standard deviation and compared by unpaired Student't test,Categorical variables were expressed percentage and compared by chi square test.Multiple logistic regression analysis was used to determine independent predictors of severe arrithmia.Results Patients with grade 3 ischemia had greater Σ ST on admission and 2 h after thrombolysis ECGs(P < 0.01),the incidence rate of STR in patients with grade 3 ischemia was lower than that in patients with grade 2 ischemia(P <0.01).The peak creatine kinase MB fraction was higher in patients with grade 3 ischemia than that in patients with grade 2 ischemia(P < 0.01).There was no significant difference of the incidence of severe arrithmia,such as ventricular premature beat,ventricular tachycardia or fibrillation,second-degree or third-degree atrioventricular block,and sinus arrest between the two groups(P > 0.05),but there was a trend of higher incidence of severe arrithmia in patients with grade 3 ischemia compared with that in patients with grade 2 ischemia.Multiple logistic regression analysis

  3. [Effect of emoxypine on myocardial electrical instability and homeostasis parameters in patients with acute disturbance of cerebrovascular circulation].

    Science.gov (United States)

    Stoliarova, V V

    2002-01-01

    The frequency of myocardial ischemia onsets, QT interval dispersion, homeostasis characteristics, and lipid peroxidation parameters were studied in a group of 49 patients with acute disturbance of cerebral circulation (ADCC). The Holter ECG monitoring revealed myocardial ischemia episodes in 42% of patients, and myocardial instability manifested by the QT interval variance in 82% of patients. The control group (30 patients) received standard complex therapy, while the test group (19 patients) additionally received emoxypine. The administration of emoxypine reduced the incidence of myocardial ischemia and positively influenced the QT interval variance and the main parameters of homeostasis.

  4. Infant acute myocarditis mimicking acute myocardial infarction

    Science.gov (United States)

    Tilouche, Samia; Masmoudi, Tasnim; Sahnoun, Maha; Chkirbène, Youssef; Mestiri, Sarra; Boughamoura, Lamia; Ben Dhiab, Mohamed; Souguir, Mohamed Kamel

    2016-01-01

    Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image. Cardiac enzyme tests revealed a significant elevation of troponin and creatine phosphokinase levels. A diagnosis of acute myocardial infarction was made, and heparin therapy was prescribed. The infant died on the third day after admission with cardiogenic shock. The autopsy showed dilatation of the ventricles and massive edema of the lungs. Histological examinations of myocardium samples revealed the presence of a marked lymphocytic infiltrate dissociating myocardiocytes. Death was attributed to acute myocarditis. The authors call attention to the difficulties of differential diagnosis between acute myocarditis and acute myocardial infarction especially in children, and to the important therapeutic implications of a correct diagnosis. PMID:28210569

  5. Dephosphorylation of cardiomyocyte Cx43 is associated with myocardial ischemia and reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Zhijuan Cao; Xuan Xu; Linli Que; Qi Chen; Yuehua Li

    2009-01-01

    Objective:Myocardial ischemia/reperfusion(I/R) injury is the leading cause of death in the world. However, the details of the mechanism of its pathophysioiogy are still unknown. The present study was designed to investigate the role of connexin 43(Cx63) in acute models of myocardial I/R injury. Methods: Male C57BL/6 mice were subjected to myocardial ischemia(45 rain) followed by reperfusion(4 hrs) in vivo. The whole operation was monitored using a two-lead ECG. Hearts were harvested and the level of protein was assessed by western blot analysis. Haematoxylin and Eosin(HE) staining was used to detect the extent of neutrophil infiltration. The expression level of IL-6 was detected by ELISA. Results: A murine myocardial I/R injury model was constructed successfully. Phosphorylated Cx43 decreased 83.45% while non-phosphorylated Cx43 increased 1.62- fold in the myocardium after I/R injury. Neutrophil infiltration and the expression of the inflammatory cytokine IL-6 increased in the myocardium following I/R. Conclusion: During myocardial I/R injury, cardiomyocyte Cx43 is dephosphorylated, and this may be associated with an inflammatory response.

  6. In vivo study of myocardial elastography under graded ischemia conditions

    Science.gov (United States)

    Lee, Wei-Ning; Provost, Jean; Fujikura, Kana; Wang, Jie; Konofagou, Elisa E.

    2011-02-01

    The capability of currently available echocardiography-based strain estimation techniques to fully map myocardial abnormality at early stages of myocardial ischemia is yet to be investigated. In this study, myocardial elastography (ME), a radio-frequency (RF)-based strain imaging technique that maps the full 2D transmural angle-independent strain tensor in standard echocardiographic views at both high spatial and temporal resolution is presented. The objectives were to (1) evaluate the performance of ME on mapping the onset, extent and progression of myocardial ischemia at graded coronary constriction levels (from partial to complete coronary flow reduction), and (2) validate the accuracy of the strain estimates against sonomicrometry (SM) measurements. A non-survival canine ischemic model (n = 5) was performed by gradually constricting the left anterior descending (LAD) coronary blood flow from 0% (baseline blood flow) to 100% (zero blood flow) at 20% increments. An open-architecture ultrasound system was used to acquire RF echocardiograms in a standard full short-axis view at the frame rate of 211 fps, at least twice higher than what is typically used in conventional echocardiographic systems, using a previously developed, fully automated composite technique. Myocardial deformation was estimated by ME and validated against sonomicrometry. ME estimates and maps transmural (1) 2D displacements using RF cross-correlation and recorrelation; and (2) 2D polar (radial and circumferential) strains, derived from 2D (i.e. both lateral and axial) displacement components, at high accuracy. Full-view strain images were shown and found to reliably depict decreased myocardial function in the region at risk at increased levels of coronary flow reduction. The ME radial strain was deemed to be a more sensitive, quantitative, regional measure of myocardial ischemia as a result of coronary flow reduction when compared to the conventional wall motion score index and ejection fraction

  7. In vivo study of myocardial elastography under graded ischemia conditions

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Wei-Ning; Provost, Jean; Konofagou, Elisa E [Department of Biomedical Engineering, Columbia University, New York, NY (United States); Fujikura, Kana [Department of Radiology, Columbia University, New York, NY (United States); Wang Jie, E-mail: ek2191@columbia.edu [Department of Medicine, Columbia University, New York, NY (United States)

    2011-02-21

    The capability of currently available echocardiography-based strain estimation techniques to fully map myocardial abnormality at early stages of myocardial ischemia is yet to be investigated. In this study, myocardial elastography (ME), a radio-frequency (RF)-based strain imaging technique that maps the full 2D transmural angle-independent strain tensor in standard echocardiographic views at both high spatial and temporal resolution is presented. The objectives were to (1) evaluate the performance of ME on mapping the onset, extent and progression of myocardial ischemia at graded coronary constriction levels (from partial to complete coronary flow reduction), and (2) validate the accuracy of the strain estimates against sonomicrometry (SM) measurements. A non-survival canine ischemic model (n = 5) was performed by gradually constricting the left anterior descending (LAD) coronary blood flow from 0% (baseline blood flow) to 100% (zero blood flow) at 20% increments. An open-architecture ultrasound system was used to acquire RF echocardiograms in a standard full short-axis view at the frame rate of 211 fps, at least twice higher than what is typically used in conventional echocardiographic systems, using a previously developed, fully automated composite technique. Myocardial deformation was estimated by ME and validated against sonomicrometry. ME estimates and maps transmural (1) 2D displacements using RF cross-correlation and recorrelation; and (2) 2D polar (radial and circumferential) strains, derived from 2D (i.e. both lateral and axial) displacement components, at high accuracy. Full-view strain images were shown and found to reliably depict decreased myocardial function in the region at risk at increased levels of coronary flow reduction. The ME radial strain was deemed to be a more sensitive, quantitative, regional measure of myocardial ischemia as a result of coronary flow reduction when compared to the conventional wall motion score index and ejection fraction

  8. Ginsenoside-Rg1 promotes angiogenesis in rats with acute myocardial ischemia%人参皂苷Rg1对大鼠急性缺血心肌血管再生的促进作用

    Institute of Scientific and Technical Information of China (English)

    张庆勇; 陈燕萍; 刘芬; 陈霞

    2013-01-01

    目的 研究人参皂苷Rg1对急性心肌缺血大鼠心肌血管再生的分子机制.方法 建立大鼠急性心肌缺血模型,48只大鼠随机抽签法分为急性心肌缺血模型组,阳性药组(美托洛尔4.5 mg/kg),人参皂苷Rg1 5、10、15 mg/kg组,假手术组,每组各8只.连续腹腔注射14 d后取材.TTC法测定心肌梗死面积,免疫组化染色法测定心肌梗死边缘区微血管密度,心肌梗死边缘区VEGF、VEGFR1、VEGFR2和p-Akt表达,Griess法测定大鼠心肌组织NO水平.结果 与模型组比较,人参皂苷Rg1 10、15 mg/kg组心肌梗死面积明显减小(P<0.01),微血管密度显著增加(P<0.01).人参皂苷Rg1 10 mg/kg组VEGF、VEGFR1、VEGFR2及p-Akt表达均为次强阳性,Rg1 15 mg/kg组VEGF、VEGFR1、VEGFR2及p-Akt表达则均为强阳性,结果与阳性药物作用相当,其中以Rg1 15 mg/kg剂量效果最佳.此外,与模型组比较,人参皂苷Rg110、15 mg/kg组心肌组织NO水平明显升高(P<0.05,P<0.01).结论 人参皂苷Rg1可促进大鼠急性缺血心肌血管再生,该作用与人参皂苷Rg1增加心肌组织VEGF、VEGFR、p-Akt以及NO的表达有关.%Objective To investigate the role of ginsenoside-Rg1 in the angiogenesis in rats with acute myocardial ischemia (AMI). Methods The acute ischemia model was established by ligation of the left front descending branch of the coronary artery. The rats were divided randomly into the model group, metoprolol treatment (MET, 4.5 mg/kg) group, ginsenoside-Rg1 treatment groups (5, 10, and 15 mg/kg) , 8 rats in each group. Another 8 rats receiving sham operation served as sham operation group. The drugs were administered for 14 d. The myocardial infarction area was measured after 2,3, 5-triphenyltetrazoliumchloride (TTC) staining. The microvascular density (MVD) was observed by immunohistochemistry staining. The expression of myocardial VEGF, VEGFR1, VEGFR2 and p-Akt was examined by immunohistochemical staining. The myocardial NO levels were

  9. Dictionary-Driven Ischemia Detection From Cardiac Phase-Resolved Myocardial BOLD MRI at Rest.

    Science.gov (United States)

    Bevilacqua, Marco; Dharmakumar, Rohan; Tsaftaris, Sotirios A

    2016-01-01

    Cardiac Phase-resolved Blood-Oxygen-Level Dependent (CP-BOLD) MRI provides a unique opportunity to image an ongoing ischemia at rest. However, it requires post-processing to evaluate the extent of ischemia. To address this, here we propose an unsupervised ischemia detection (UID) method which relies on the inherent spatio-temporal correlation between oxygenation and wall motion to formalize a joint learning and detection problem based on dictionary decomposition. Considering input data of a single subject, it treats ischemia as an anomaly and iteratively learns dictionaries to represent only normal observations (corresponding to myocardial territories remote to ischemia). Anomaly detection is based on a modified version of One-class Support Vector Machines (OCSVM) to regulate directly the margins by incorporating the dictionary-based representation errors. A measure of ischemic extent (IE) is estimated, reflecting the relative portion of the myocardium affected by ischemia. For visualization purposes an ischemia likelihood map is created by estimating posterior probabilities from the OCSVM outputs, thus obtaining how likely the classification is correct. UID is evaluated on synthetic data and in a 2D CP-BOLD data set from a canine experimental model emulating acute coronary syndromes. Comparing early ischemic territories identified with UID against infarct territories (after several hours of ischemia), we find that IE, as measured by UID, is highly correlated (Pearson's r=0.84) with respect to infarct size. When advances in automated registration and segmentation of CP-BOLD images and full coverage 3D acquisitions become available, we hope that this method can enable pixel-level assessment of ischemia with this truly non-invasive imaging technique.

  10. Effect of flaxseed supplementation and exercise training on lipid profile, oxidative stress and inflammation in rats with myocardial ischemia

    Directory of Open Access Journals (Sweden)

    Nounou Howaida A

    2012-10-01

    Full Text Available Abstract Background Flaxseed has recently gained attention in the area of cardiovascular disease primarily because of its rich contents of α-linolenic acid (ALA, lignans, and fiber. Although the benefits of exercise on any single risk factor are unquestionable, the effect of exercise on overall cardiovascular risk, when combined with other lifestyle modifications such as proper nutrition, can be dramatic. This study was carried out to evaluate the protective role of flaxseed and exercise on cardiac markers, lipids profile and inflammatory markers in isoproterenol (ISO-induced myocardial ischemia in rats. Methods The research was conducted on 40 male albino rats, divided into 4 groups (n=10: group I served as control, group II has acute myocardial ischemia induced by isoproterenol, groups III and IV have acute myocardial ischemia induced by isoproterenol pretreated with flaxseed supplementation orally for 6 weeks, additionally group IV practiced muscular exercise through swimming. Results Alterations of lipid profile, cardiac and inflammatory markers (Il-1β, PTX 3 and TNF- α were observed in myocardial ischemia group. Flaxseed supplementation combined with exercise training showed significant increase of HDL and PON 1, on the other hand cardiac troponin, Il- 1β and TNF- α levels significantly decreased as compared to myocardial ischemic group. Receiver Operating Characteristics (ROC analysis of cTnI, PTX 3, Il-1β and TNF- α revealed a satisfactory level of sensitivity and specificity. Conclusion Regular exercise enhances the improvement in plasma lipoprotein levels and cardiovascular protection that results from flaxseed supplementation by mitigating the pathophysiology of atherosclerosis. Elevation of HDL, the antioxidant PON 1 and the cardioprotective marker PTX 3 emphasizes the protective effects of flaxseed and muscular exercise mutually against the harmful effects of acute myocardial ischemia.

  11. Chest pain with myocardial ischemia in a child: should we think about coronary slow flow phenomenon?

    Science.gov (United States)

    Kocabaş, Abdullah; Kardelen, Fırat; Akçurin, Gayaz; Ertuğ, Halil

    2013-10-01

    The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by delayed opacification of epicardial coronary arteries in the absence of stenotic lesion. Herein, we present a 13-year-old boy with recurrent chest pain who was diagnosed with acute ST-segment elevation myocardial infarction associated with CSFP, which has not been reported previously in the pediatric age group. Coronary angiography revealed only the presence of slow flow in the left anterior descending (LAD) coronary artery. Myocardial perfusion scintigraphy revealed a reversible perfusion defect in the LAD territory, which regressed partially at rest and showed complete improvement after dipyridamole infusion. All the symptoms, electrocardiogram abnormalities and cardiac markers returned to normal after dipyridamole treatment during the follow-up. We conclude that CSFP should be kept in mind in the differential diagnosis of chest pain with myocardial ischemia in the pediatric age group.

  12. [Perioperative myocardial ischemia in patients with peripheral arterial occlusive diseases].

    Science.gov (United States)

    Rapp, H J; Buselmeier, P; Gasteiger, P; Hoberg, E; Striebel, J P

    1990-04-01

    Patients with peripheral vascular disease (PVD) often have coronary artery disease (CAD) which means an increased risk during anesthesia. The prevalence of CAD is nearly 50% among such patients. Owing to claudication, diagnostic stress tests can rarely be performed in PVD patients. In order to evaluate the frequency of transient perioperative myocardial ischemia, Holter monitoring was performed in 30 consecutive PVD patients with ASA II-III and AVK scale (Fontaine) II-IV who were undergoing femoropopliteal bypass surgery. Patients who had left bundle branch block and left ventricular hypertrophy or were taking digitalis medication were excluded from Holter monitoring. The ST-segment analysis of the frequency modulated recordings (n = 19) revealed episodes of myocardial ischemia in 26% of the patients. Most (75%) of the episodes occurred preoperatively, and 25%, during or after the anesthesia or during preparation for it. Risk factors for CAD were more often found in patients with ST segment alterations than in patients without ST segment deviations, even though the preoperative antianginal medication administered was comparable in the two subgroups. It is concluded that in a considerable subset of PVD patients silent myocardial ischemia occurs, which can be related to the different perioperative intervals by means of ST segment analyses of Holter recordings. The ST segment may allow a better insight into the cardiac state of PVD patients. Further studies are necessary in larger populations to test our suspicion.

  13. Protective Effect of Trichosanthes Pericarpium on the Hyperlipemia Accompany Model Rat with Acute Myocardial Ischemia%瓜蒌皮对高血脂合并急性心肌缺血大鼠保护作用

    Institute of Scientific and Technical Information of China (English)

    李航; 李建峰; 张宇; 赵启韬

    2016-01-01

    .We make high cholesterol accompany with acute myocardial ischemia model by intragastrical administration with high fat emulsion and ligating the coronary artery of the Wistar rats.The control group implement the sham.the Trichosanthes decoction group and the Danshenpian group is to give intragastrical administration with Trichosanthes decoction and Danshenpian solution.The control group and the model group treat with physiological saline solution.We observe the cholesterol-lowering effect by using the biochemical diagnostic kits to detect total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL) and high-density lipoprotein (HDL) levels in plasma,detect the cardiac function by recording ECG changes with physiological recorder,evaluate the infarction rate by staining the myocardial sections with triphenyl tetrazolium chloride (TTC) and evaluate the degree of myocardial injury by using biochemical kits to detect levels of creatine kinase (CK),creatine kinase isoenzyme (CKMB),aspertate aminotransferase (AST),alpha hydroxybutyrate dehydrogenase (α-HBDH)and lactate dehydrogenase (LDH).Results:The level of TC/TG/LDL in the serum of the model group increased evidently and that of HDL decreased compared with the control group.The level of TC/TG/LDL of the Trichosanthes decoction group and the danshenpian group is lower compared with model group,but that of HDL is inverse,the positive rate of the ECG and myocardial infarction rate decreased obviously,also the activity of CK/CK-MB/LDH/AST/α-HBDH were remarkably lower (P<0.05).Conclusion:The Trichosanthes decoction can reduce blood lipids,decrease myocardial infarction rate of rat model with high cholesterol accompany with acute myocardial ischemia remarkedly,prevent myocardial necrosis and improve myocardial function.

  14. Effect of hydroxy safflower yellow A on myocardial apoptosis after acute myocardial infarction in rats.

    Science.gov (United States)

    Zhou, M X; Fu, J H; Zhang, Q; Wang, J Q

    2015-04-10

    This study aimed to investigate the effect of hydroxy safflower yellow A (HSYA) on myocardial apoptosis after acute myocardial infarction (AMI) in rats. We randomly divided 170 male Wistar rats into 6 groups (N = 23): normal control, sham, control, SY (90 mg/kg), HSYA high-dose (HSYA-H, 40 mg/kg), and HSYA low-dose groups (HSYA-L, 20 mg/kg). Myocardial ischemic injury was induced by ligating the anterior descending coronary artery, and the degree of myocardial ischemia was evaluated using electrocardiography and nitroblue tetrazolium staining. Bax and Bcl-2 expressions in the ischemic myocardium were determined using immunohistochemical analysis. Peroxisome proliferator-activated receptor-γ (PPAR-γ) expression in the myocardium of rats with AMI was determined using reverse transcription-polymerase chain reaction. Compared to rats in the control group, those in the HYSA-H, HSYA-L, and SY groups showed a decrease in the elevated ST segments and an increase in the infarct size. The rats in the drug-treated groups showed a significantly lower percentage of Bax-positive cells and a significantly higher percentage of Bcl-2-positive cells than those in the control group (P myocardial ischemia in rats, possibly by increasing the level of Bcl-2/Bax, and PPAR-γ may be not a necessary link in this process.

  15. Effect of verapamil on ischemia and ventricular arrhythmias after an acute myocardial infarction: prognostic implications. The Danish Verapamil Infarction Trial II Study Group

    DEFF Research Database (Denmark)

    Vaage-Nilsen, M; Rasmussen, Verner; Hansen, J F

    1991-01-01

    : In the placebo group the prevalence and incidence of many ventricular ectopic beats (VEBs), i.e., more than 10 VEBs/h, increased significantly during the first years after infarction; this was not the case in the verapamil patients group. The mean HR was significantly reduced by verapamil treatment after 1 month...... for 24-48 h at 1 week, i.e., before randomization to long-term treatment with placebo or verapamil, and after 1 month and about 1 year of study treatment. Ischemia: 18% of the patients had transient ST-segment deviation before randomization; 24% of the placebo- and 8% of the verapamil-treated patients (p...... = 0.04) showed ischemia after 1 month; and after 1 year, the figures were 26 and 4%, respectively (p = 0.02). The 18-month major event rate, i.e., first reinfarction or death, in patients with ischemia before randomization were 40 and 23.8% in patients without ischemia (p = 0.06). Arrhythmias...

  16. Aortoenteric Fistula Assocaited with Acute Myocardial Infarcation

    OpenAIRE

    Fingerote, Robert J.; Alan BR Thomson

    1990-01-01

    A 64-year-old male with a prior abdominal aortic graft for lower limb ischemia presented with melena and myocardial infarction. Despite aggressive investigation, an aortoenteric fistula was not diagnosed until after massive gastrointestinal hemorrhage. The patient's myocardial infarction may have heen precipitated by hypotension induced by hemorrhage through the aortoenteric fistula. Patients with prior abdominal aortic graft surgery presenting with gastrointestinal bleeding, abdominal pain o...

  17. Gadolinium decreases inflammation related to myocardial ischemia and reperfusion injury

    Directory of Open Access Journals (Sweden)

    Nicolosi Alfred C

    2009-12-01

    control and GdCl3 treated rats. Likewise, IL-8 levels increased throughout the 3 hour time period in the Sham group. There was no difference in IL-8 detected in the myocardium after 120 min reperfusion between groups. In contrast, after 120 min reperfusion GdCl3 decreased the myocardial tissue levels of macrophage secreted cytokines, GM-CSF and IL-1. Conclusion GdCl3 treatment prior to ischemia and reperfusion injury decreased circulating monocytes and neutrophils, macrophage secreted cytokines, and leukocyte infiltration into injured myocardium. These results suggest GdCl3 decreased monoctye and neutrophil migration and activation and may be a novel treatment for inflammation during ischemia and reperfusion.

  18. The tole of ischemic preconditioning in acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Ristić Anđelka

    2005-01-01

    Full Text Available Introduction Ischemic preconditioning is a phenomenon in which brief episodes of ischemia and reperfusion increase myocardial tolerance and substantially reduce the infarction size. Case report Two patients with acute left anterior descending artery occlusion received fibrinolytic therapy within 6 hours of symptom onset, but nevertheless developed myocardial infarctions of different size. The first patient, without a history of preinfarction angina, developed a large anterior infarction, because there was no time for ischemic preconditioning or development of coronary collateral vessels. The second patient, with a 4-day history of preinfarction angina, had a more favorable outcome-he developed apical necrosis, with greater myocardial viability in the infarct-related area. Conclusion The beneficial effects of angina occurring 24-48h before infarction are resulting from ischemic preconditioning, which reduces cardiac mortality, infarct size and occurrence of life-threatening ventricular arrhythmias. .

  19. Identification of residual ischemia in the occluded coronary artery irrigation area using myocardial perfusion scintigraphy

    Directory of Open Access Journals (Sweden)

    Baškot Branislav

    2007-01-01

    Full Text Available Background. Inspite the indisputable significance of coronarography, the implications of a revealed stenosis - and how close it is to occlusion could vary in regard to its physiological importance. Myocardial perfusion scintigraphy (MPS possibility to prove and objectivise the presence of ischemia and myocardial viability within an occlusion found coronarographically is especially significant since it makes possible to the clinician to choose an adequate therapy. Case report. We reported a 43- year-old male patient who had been hospitalized to another institution due to acute myocardial infarction (AMI of posterolateral localisation. Following the acute AMI stage the ergometric test per Bruce protocole was performed, negative to ischemic heart disease, while multislice computed tomography showed no significant changes on the coronary arteries. The performed one-day-protocole MPS showed a massive area of residual ischemia within myocardial infarction (MI type culprit lesion of the posterolateral zone starting from the subapical level to the basal cross-section. According to the MPS findings coronarography was indicated due to a revascularisation assessment. The performed coronarography revealed an occlusion of the circumflex coronary artery (CCA right after the division of obtuse branch (OB that presented discretely in the distal parts from the homo- and heterocolaterals. The distal portion of CCA presented discretely out off the right coronary artery (RCA. Echocardiography confirmed an ejection fraction of 50% with hypokinesia of inferior and posterior walls, as well as the septum, showing a mild reduction of the general contractility. Flows through confluences were well. A month after MI a percutane coronary intervention (PCI was performed with the implantation of a drug-releasing stent (Taxus. Early after PCI (within two weeks a control MPS was done to evaluate the effects of the therapy giving the normal findings of myocardial perfusion

  20. Detection of myocardial ischemia with myocardial perfusion SPECT in patients with diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Seo, J. H.; Jeong, S. Y.; Bae, J. H.; Anh, B. C.; Lee, J.; Lee, K. B [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2004-07-01

    Diabetes mellitus(DM) is a critical disease associated with higher rates of cardiovascular morbidity and mortality. Atherosclerosis accounts for 65-80% of all deaths in diabetic patients and patients with DM are known to show high prevalence of coronary artery diseases(CAD). We evaluated the incidence of scintigraphic evidence of CAD in diabetic patients and results were compared with cardiovascular symptoms and clinical factors. 169 patients with DM(mean age 629years, 68 males) were referred for evaluation of CAD between Jan 2002 and Dec 2003. 101(60%) patients were with chest pain and 68(40%) were asymptomatic. Patients underwent exercise(n=6) or adenosine stress(n=163) SPECT myocardial perfusion imaging(MPI). Exclusion criteria included history of documented myocardial infarction, prior revascularization, clinically significant valvular heart disease, left-bundle branch block on rest ECG. We evaluated symptoms associated with cardiac problem and other clinical and laboratory data to reveal correlation with presence of CAD. MPI were assessed visually and semi-quantitatively with C-Equal program. Myocardial ischemia was detected in 52(31%) patients. Among them, 41 had 1-vessel and 9 had 2-vessel disease. In 52 patients with ischemia, 28(54%) were male and 24(46%) were female. 20/68(29%) asymptomatic and 32/101(32%) symptomatic patients had ischemia. Higher prevalence of neuropathy, hypertension, higher blood glucose level, HbA1c and CRP was noted in patients with myocardial ischemia. Serum levels of cholesterol and LDL was not significantly different between patients with ischemia and with normal MPI findings. Abnormal MPI findings were not related with gender and age. These results show a high prevalence of abnormal MPI results in diabetic patients regardless of symptoms. Screening stress MPI in diabetic patients should be indicated irrespective of symptoms, especially in patients with neuropathy, hypertension, higher level of blood glucose, or increased CRP.

  1. 芬太尼预处理对兔心肌缺血再灌注后心肌梗死范围及心功能的影响%Effects of pretreatment with fentanyl on myocardial infarction size and cardiac function in rabbits with acute myocardial ischemia reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    郑向明; 孟凡民; 王春亭

    2012-01-01

    Objective To study the myocardial protective effect of pretreatment with fentanyl on rabbits with acute myocardial ischemia reperfusion injury.Methods Twenty-four male New Zealand White rabbits were randomly divided into 3 groups:group C ( acute myocardial ischemia reperfusion injury group),group F ( fentanyl group) and group N-F ( naloxone-fentanyl group),with 8 cases in each group.All rabbits experienced 30 min of regional ischemia through the occlusion of the left anterior descending coronary artery( LAD),followed by 120 min of reperfusion.The rabbits in C group were only subjected to the above ischemia/reperfusion (I/R) sequence.The rabbits in Group F were intravenously injected with fentany1 0.15 mg/kg at 15 minutes before the coronary occlusion.The rabbits in Group N-F were intravenously injected with naloxone 3 mg/kg,followed by 70 μg/(kg · min) infusion before reperfusion and were intravenously injected with fentanyl 0.15 mg/kg at 15 min before myocardial ischemia.Heart rate(HR),left ventricular systolic pressure( LVSP),left ventricular end diastolic pressure( LVEDP),maximum positive and minimum negative left ventricular pressure derivatives ( + dp/dt and-dp/dt) were continuously monitored and recorded at baseline ( T0 ),30 min after ischemia( T1 ),and 10 min ( T2 ),30 min(T3 ),120 min(T4) after reperfusion during I/R process.After 120 min reperfusion,hearts were removed for the measurement of myocardial ischemia and infarction size.Results Compared with the baseline(T0),LVSP,± dp/dt decreased whereas LVEDP increased significantly during T1-T4 (P <0.05 ).There were no significant differences in homodynamic parameters between group C and group N F ( P > 0.05 ).In F group,the LVSP and + dp/dt were significantly higher than those of group C and group N-F after 30 min in reperfusion ( P < 0.05 ) and the infarction size and weight were smaller (P <0.01 ).Conclusions Pretreatment with fentanyl has protective effect against ischemia/reperfusion injury

  2. Endovascular management of acute limb ischemia.

    Science.gov (United States)

    Peeters, P; Verbist, J; Keirse, K; Deloose, K; Bosiers, M

    2010-06-01

    Acute limb ischemia (ALI) refers to a rapid worsening of limb perfusion resulting in rest pain, ischemic ulcers or gangrene. With an estimated incidence of 140 million/year, ALI is serious limb-threatening and life-threatening medical emergency demanding prompt action. Three prospective, randomized clinical trials provide data on trombolytic therapy versus surgical intervention in patients with acute lower extremity ischemia. Although they did not give us the final answer, satisfactory results are reported for percutaneous thrombolysis compared with surgery. Moreover, they suggest an important advantage of thrombolysis in acute bypass graft occlusions. Therefore, we believe thrombolytic therapy should be a part of the vascular surgeon's armamentarium to safely and successfully treat ALI patients.

  3. [Silent myocardial ischemia in patients with transient ischemic attacks].

    Science.gov (United States)

    Sánchez Valiente, S; Mostacero, E; del Río, A; Morales, F

    1994-10-01

    Given evidence that ischemic heart disease is the most frequent cause of death in patients with cerebrovascular disease, we used ergometrics to screen 80 patients with TIA for silent myocardial ischemia (SMI) at the neurological unit of Hospital Clínico Universitario in Zaragoza, Spain. The patients were compared with a control group of 80 with no signs of heart disease. Neither the patients nor the controls had ever shown clinical signs of coronary ischemia and their baseline electrocardiograms were normal. Stress test results were positive in 25 (31%) of the TIA patients, and in 4 (5%) (p Hiperlipidemia (75% testing positive versus 43% negative, p < 0.01) and diabetes (31% testing positive versus 13% negative, p < 0.01) were the risk factors statistically related with a positive stress test.

  4. Increased cardiac BNP expression associated with myocardial ischemia

    DEFF Research Database (Denmark)

    Goetze, J P; Christoffersen, Christina; Perko, M;

    2003-01-01

    without coronary artery disease. BNP mRNA was quantified by real-time PCR, and plasma BNP and proBNP concentrations were measured with radioimmunoassays. Quantitative analysis of BNP mRNA in atrial and ventricular biopsies from coronary bypass grafting patients revealed close associations of plasma BNP...... and proBNP concentrations to ventricular, but not atrial, BNP mRNA levels. Plasma BNP and proBNP concentrations were markedly increased in patients with coronary artery disease but without concomitant left ventricular dysfunction. These results are compatible with the notion that myocardial ischemia, even...

  5. [Pharmacological properties of phosphorylacetohydrazides in experimental myocardial ischemia].

    Science.gov (United States)

    Balashov, V P; Al'miasheva, M I; Tarasova, R I; Rusina, I F; Kul'kova, N P; Kurmysheva, T V; Voskresenskaia, O V

    2007-01-01

    It is shown that 2-chloroethoxy-para-N-dimethylphosphorylacetohydrazide and N-acethylhydrazide-para-dimethylaminophenyl-2-chloroethoxyphosphorylacetic acid reliably reduce ischemia-induced depression of inotropic functions of the left ventricle in cats with experimental myocardial infarction model. The effect of both compounds can be explained by the maintenance of viability of the injured myocardium via a delay of the development of acidosis and the support of oxygen recycling in the ischemized zone. Both compounds show pronounced antiradical properties with a non-standard mechanism of action.

  6. Myocardial ischemia, carotid, and peripheral arterial disease and their interrelationship in type 2 diabetes patients

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Henriksen, Jan Erik; Dahl, Jordi;

    2009-01-01

    for the first time and age-matched nondiabetic reference subjects (n = 40) were screened for myocardial ischemia, carotid, and peripheral arterial disease by means of myocardial perfusion scintigraphy, carotid artery ultrasonography, and peripheral ankle and toe systolic blood pressure measurements. RESULTS......: In the T2DM patients, the prevalence of myocardial ischemia, carotid, and peripheral arterial disease was 30%, 42%, and 15%, respectively, almost three times higher than in the reference subjects (P = 0.007, P = 0.001, and P = 0.09, respectively). T2DM patients with myocardial ischemia, carotid...

  7. The CD133+ cell as advanced medicinal product for myocardial and limb ischemia.

    Science.gov (United States)

    Bongiovanni, Dario; Bassetti, Beatrice; Gambini, Elisa; Gaipa, Giuseppe; Frati, Giacomo; Achilli, Felice; Scacciatella, Paolo; Carbucicchio, Corrado; Pompilio, Giulio

    2014-10-15

    Ischemic diseases are the major cause of death and morbidity in Western countries. In the last decade, cell therapy has been suggested to be a promising treatment both in acute/chronic myocardial and peripheral ischemia. Different cell lineages have been tested, including endothelial progenitor cells. A subpopulation of bone marrow-derived immature ECPs, expressing the highly conserved stem cell glycoprotein antigen prominin-1 or CD133 marker, was shown to possess pro-angiogenic and antiapoptotic effects on ischemic tissues. The mechanisms implicated in CD133+ cells ability to contribute to neovascularization processes have been attributed to their ability to directly differentiate into newly forming vessels and to indirectly activate pro-angiogenic signaling by paracrine mechanisms. A large body of in vivo experimental evidences has demonstrated the potential of CD133+ cells to reverse ischemia. Moreover, several clinical trials have reported promising beneficial effects after infusion of autologous CD133+ into ischemic heart and limbs exploiting various delivery strategies. These trials have contributed to characterize the CD133+ manufacturing process as an advanced cell product (AMP). The aim of this review is to summarize available experimental and clinical data on CD133+ cells in the context of myocardial and peripheral ischemia, and to focus on the development of the CD133+ cell as an anti-ischemic AMP.

  8. Translational Medicine Study on Cardiac Microvascular Endothelial Barrier Function and Myocardial Ischemia/Re-perfusion Injury

    Directory of Open Access Journals (Sweden)

    Yeong Yeh Lee

    2015-09-01

    Full Text Available Vascular endothelial barrier is defined as the ability of endothelial cells and their components that make up the microvascular wall structure in controlling the cellular components and marco-molecular substances in blood from penetrating vascular walls. It is the place for the selective exchange of oxygen, nutrients and metabolites, and has kernel effect in maintaining myocardial micro-environmental homeostasis. In clinic, microvascular permeability is commonly used as the index for evaluating endothelial barrier function. Myocardial microvascular endothelial cells, inter-endothelial connexin and basilar membrane (BM interact synergically to constitute the basis for barrier function, which has a selective permeability effect on interaction between nutrient substances and other myocardial cell molecules. Increase of microvascular permeability is closely associated with cardiovascular events like coronary heart disease (CHD and myocardial ischemia, and is the risk factor for CHD attack. And deep exploration of the mechanism of endothelial permeability and positive selection of new-type re-perfusion complementary drugs for alleviating endothelial permeability can be beneficial in improving the prognosis of patients with acute myocardial infarction (AMI. Therefore, from the view of translational medicine, this study mainly summarized the increase of microvascular permeability and its pathological significance after AMI, physiological and pathological mechanisms of regulating microvascular permeability and complementary therapies for AMI re-perfusion as well as microvascular endothelial barrier function, hoping to provide a basis for improving the prognosis of patients with AMI.

  9. Translational Medicine Study on Cardiac Microvascular Endothelial Barrier Function and Myocardial Ischemia/Re-perfusion Injury

    Institute of Scientific and Technical Information of China (English)

    Yeong Yeh Lee

    2015-01-01

    Vascular endothelial barrier is defined as the ability of endothelial cells and their components that make up the microvascular wall structure in controlling the cellular components and marco-molecular substances in blood from penetrating vascular walls. It is the place for the selective exchange of oxygen, nutrients and metabolites, and has kernel effect in maintaining myocardial micro-environmental homeostasis. In clinic, microvascular permeability is commonly used as the index for evaluating endothelial barrier function. Myocardial microvascular endothelial cells, inter-endothelial connexin and basilar membrane (BM) interact synergically to constitute the basis for barrier function, which has a selective permeability effect on interaction between nutrient substances and other myocardial cell molecules. Increase of microvascular permeability is closely associated with cardiovascular events like coronary heart disease (CHD) and myocardial ischemia, and is the risk factor for CHD attack. And deep exploration of the mechanism of endothelial permeability and positive selection of new-type re-perfusion complementary drugs for alleviating endothelial permeability can be beneifcial in improving the prognosis of patients with acute myocardial infarction (AMI). Therefore, from the view of translational medicine, this study mainly summarized the increase of microvascular permeability and its pathological signiifcance after AMI, physiological and pathological mechanisms of regulating microvascular permeability and complementary therapies for AMI re-perfusion as well as microvascular endothelial barrier function, hoping to provide a basis for improving the prognosis of patients with AMI.

  10. Oxygen free radicals in myocardial ischemia and reperfusion

    NARCIS (Netherlands)

    A.M.M. van der Kraaij

    1989-01-01

    textabstractIn patients with acute myocardial infarction, death normally results from rhythmic disturbances or pump failure. Over the past 3 decades, the mortality rate from this disease has been substantially reduced predominantly by vigorous treatment of dysrhythmias using modern monitoring techni

  11. Acute myocardial involvement after heroin inhalation

    Directory of Open Access Journals (Sweden)

    Ritu Karoli

    2012-01-01

    Full Text Available Amongst the illicit drugs cocaine, amphetamines and cannabis have been studied and documented well to cause myocardial infarction by different mechanisms but there is very sparse data available on myocardial involvement after heroin abuse. We report a young man who developed acute myocardial injury after heroin inhalation and alcohol binge drinking. Heroin induced cardio toxic effect and vasospasm compounded by alcohol were suspected to be the cause of this.

  12. Pharmacokinetics of ligustrazine ethosome patch in rats and anti-myocardial ischemia and anti-ischemic reperfusion injury effect

    Directory of Open Access Journals (Sweden)

    Liu X

    2011-07-01

    Full Text Available Xingyan Liu1, Hong Liu1, Zhaowu Zeng2, Weihua Zhou3, Jianqiang Liu2, Zhiwei He11China-America Cancer Research Institute, Guangdong Medical College, 2Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical College, Dongguan, Guangdong, 3Yichun University, Yichun, Jiangxi, People's Republic of ChinaAbstract: The objective of this study was to investigate the pharmacokinetics of the ligustrazine ethosome patch and antimyocardial ischemia and anti-ischemic reperfusion injury effect. Male Sprague Dawley rats were divided randomly into 3 groups: Group A (intragastric ligustrazine, Group B (transdermal ligustrazine ethosome patch, and Group C (conventional transdermal ligustrazine patch. After treatment, samples of blood and of various tissues such as heart, liver, spleen, lung, kidney, brain, and muscle samples were taken at different time points. Drug concentration was measured with HPLC, and the drug concentration–time curve was plotted. Pharmacokinetic software 3p97 was applied to calculate pharmacokinetic parameters and the area under the drug concentration–time curve (AUC in various tissues. The rat model of acute myocardial ischemia was constructed with intravenous injection of pituitrin and the model of myocardial ischemia-perfusion injury was constructed by tying off the left anterior descending coronary artery of rats to observe the effect of ligustrazine ethosome patches on ischemic myocardium and ischemia-reperfusion injury. Results showed that AUC was highest in the transdermal drug delivery group of ligustrazine ethosome patch. There were significant differences in whole blood viscosity, plasma viscosity, hematocrit, red blood cell aggregation index, and deformation index between ligustrazine the ethosome patch group and ischemic control group (P < 0.01. Moreover, ligustrazine ethosome patches could reduce the scope of myocardial infarction induced by long-term ischemia. Ligustrazine ethosome patches

  13. An uncommon cause of myocardial ischemia after coronary artery bypass grafting: "the dangerous drainage".

    Science.gov (United States)

    Beiras-Fernandez, Andres; Möhnle, Patrick; Kopf, Carsten; Vicol, Calin; Kur, Felix; Reichart, Bruno

    2011-06-01

    The most common causes of myocardial ischemia and myocardial infarction early after coronary artery bypass grafting surgery are early graft occlusion/thrombosis or occlusion/ thrombosis of coronary arteries due to advanced coronary heart disease. We describe a case of postoperative myocardial ischemia due to an uncommon and quickly reversible cause: mechanical compression of a vein graft by a 19F flexible silicone mediastinal drainage tube.

  14. Endovascular Management of Acute Limb Ischemia.

    LENUS (Irish Health Repository)

    Hynes, Brian G

    2011-09-14

    Despite major advances in pharmacologic and endovascular therapies, acute limb ischemia (ALI) continues to result in significant morbidity and mortality. The incidence of ALI may be as high as 13-17 cases per 100,000 people per year, with mortality rates approaching 18% in some series. This review will address the contemporary endovascular management of ALI encompassing pharmacologic and percutaneous interventional treatment strategies.

  15. Myocardial ischemia/reperfusion impairs neurogenesis and hippocampal-dependent learning and memory.

    Science.gov (United States)

    Evonuk, Kirsten S; Prabhu, Sumanth D; Young, Martin E; DeSilva, Tara M

    2017-03-01

    The incidence of cognitive impairment in cardiovascular disease (CVD) patients has increased, adversely impacting quality of life and imposing a significant economic burden. Brain imaging of CVD patients has detected changes in the hippocampus, a brain region critical for normal learning and memory. However, it is not clear whether adverse cardiac events or other associated co-morbidities impair cognition. Here, using a murine model of acute myocardial ischemia/reperfusion (I/R), where the coronary artery was occluded for 30min followed by reperfusion, we tested the hypothesis that acute myocardial infarction triggers impairment in cognitive function. Two months following cardiac I/R, behavioral assessments specific for hippocampal cognitive function were performed. Mice subjected to cardiac I/R performed worse in the fear-conditioning paradigm as well as the object location memory behavioral test compared to sham-operated mice. Reactive gliosis was apparent in the hippocampal subregions CA1, CA3, and dentate gyrus 72h post-cardiac I/R as compared with sham, which was sustained two months post-cardiac I/R. Consistent with the inflammatory response, the abundance of doublecortin positive newborn neurons was decreased in the dentate gyrus 72h and 2months post-cardiac I/R as compared with sham. Therefore, we conclude that following acute myocardial infarction, rapid inflammatory responses negatively affect neurogenesis, which may underlie long-term changes in learning and memory.

  16. Cardioprotective Effects of Total Flavonoids Extracted from Xinjiang Sprig Rosa rugosa against Acute Ischemia/Reperfusion-Induced Myocardial Injury in Isolated Rat Heart.

    Science.gov (United States)

    Hou, Xuejiao; Han, Jichun; Yuan, Changsheng; Ren, Huanhuan; Zhang, Ya; Zhang, Tao; Xu, Lixia; Zheng, Qiusheng; Chen, Wen

    2016-01-01

    This study evaluated the antioxidative and cardioprotective effects of total flavonoids extracted from Xinjiang sprig Rosa rugosa on ischemia/reperfusion (I/R) injury using an isolated Langendorff rat heart model. The possible mechanism of Xinjiang sprig rose total flavonoid (XSRTF) against I/R injury was also studied. XSRTF (5, 10, and 20 µg/mL) dissolved in Krebs-Henseleit buffer was administered to isolated rat heart. The XSRTF showed remarkable scavenging effects against 1,1-diphenyl-2-picrylhydrazyl, hydroxyl, and superoxide anion radicals in vitro. XSRTF pretreatment improved the heart rate, increased LVDP, and decreased CK and LDH levels in coronary flow. This pretreatment also increased SOD activity and GSH/GSSG ratio but decreased MDA, TNF-α, and CRP levels and IL-8 and IL-6 activities. The infarct size and cell apoptosis in the hearts from the XSRTF-treated group were lower than those in the hearts from the I/R group. Therefore, the cardioprotective effects of XSRTF may be attributed to its antioxidant, antiapoptotic, and anti-inflammatory activities.

  17. [Histoautoradiographic study of the heart in experimental myocardial ischemia].

    Science.gov (United States)

    Makhova, A N; Shliapnikov, V N

    1979-01-01

    Autoradiographic examinations of the heart muscle in experimental myocardial necroses using 3H-thymidine, revealed a high DNA synthesis in the connective tissue cells in the zone of necrosis in the acute period of infarction and its subsequent decrease. Deviations from this regularity were observed when relapses of necrosis developed. The activation of DNA synthesis occurred to a lesser extent in stromal cells of the periinfarction and remote zones of the heart. Muscle cells incorporated 3H-thymidine extremely rarely. When myocardial infarction was combined with aterosclerosis, relapses of necrosis occurred frequently, and morphological changes in many arteries and veins were accompanied by 3H-thymidine incorporation into the nuclei of the endothelium, smooth cells and adventitial cells. Inhibition of DNA synthesis in connective tissue cells of various heart zones was observed in cases of combined myocardial infarction and aterosclerosis and hypertension.

  18. Ablation of cereblon attenuates myocardial ischemia-reperfusion injury.

    Science.gov (United States)

    Kim, Jooyeon; Lee, Kwang Min; Park, Chul-Seung; Park, Woo Jin

    2014-05-16

    Cereblon (CRBN) was originally identified as a target protein for a mild type of mental retardation in humans. However, recent studies showed that CRBN acts as a negative regulator of AMP-activated protein kinase (AMPK) by binding directly to the AMPK catalytic subunit. Because AMPK is implicated in myocardial ischemia-reperfusion (I-R) injury, we reasoned that CRBN might play a role in the pathology of myocardial I-R through regulation of AMPK activity. To test this hypothesis, wild-type (WT) and crbn knockout (KO) mice were subjected to I-R (complete ligation of the coronary artery for 30 min followed by 24h of reperfusion). We found significantly smaller infarct sizes and less fibrosis in the hearts of KO mice than in those of WT mice. Apoptosis was also significantly reduced in the KO mice compared with that in WT mice, as shown by the reduced numbers of TUNEL-positive cells. In parallel, AMPK activity remained at normal levels in KO mice undergoing I-R, whereas it was significantly reduced in WT mice under the same conditions. In rat neonatal cardiomyocytes, overexpression of CRBN significantly reduced AMPK activity, as demonstrated by reductions in both phosphorylation levels of AMPK and the expression of its downstream target genes. Collectively, these data demonstrate that CRBN plays an important role in myocardial I-R injury through modulation of AMPK activity.

  19. Clinical presentation of CAD and myocardial ischemia in women.

    Science.gov (United States)

    Wenger, Nanette K

    2016-10-01

    Angina is the most frequent initial and subsequent manifestation of ischemic heart disease in women. Women with stable ischemic heart disease have a more diverse symptom presentation than men, with prominent anginal equivalents; symptoms are more often precipitated by emotional or mental stress. Women, especially at younger age, whose acute myocardial infarction presentation is without chest pain have higher mortality rates than men without chest pain.

  20. Angina and exertional myocardial ischemia in diabetic and nondiabetic patients: assessment by exercise thallium scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Nesto, R.W.; Phillips, R.T.; Kett, K.G.; Hill, T.; Perper, E.; Young, E.; Leland, O.S. Jr.

    1988-02-01

    Patients with diabetes mellitus and coronary artery disease are thought to have painless myocardial ischemia more often than patients without diabetes. We studied 50 consecutive patients with diabetes and 50 consecutive patients without diabetes, all with ischemia, on exercise thallium scintigraphy to show the reliability of angina as a marker for exertional ischemia. The two groups had similar clinical characteristics, treadmill test results, and extent of infarction and ischemia, but only 7 patients with diabetes compared with 17 patients without diabetes had angina during exertional ischemia. In diabetic patients the extent of retinopathy, nephropathy, or peripheral neuropathy was similar in patients with and without angina. Angina is an unreliable index of myocardial ischemia in diabetic patients with coronary artery disease. Given the increased cardiac morbidity and mortality in such patients, periodic objective assessments of the extent of ischemia are warranted.

  1. Detecting myocardial ischemia with 2-D CVIB imaging method--an in vivo animal experiment study

    Institute of Scientific and Technical Information of China (English)

    JIANG Yong; BAI Jing; YING Kui; CHENG Kezheng; YU Can

    2004-01-01

    A 2-D cyclic variation of integrated backscatter (CVIB) imaging method was established for detecting myocardial ischemia. To demonstrate the feasibility and validity of this method, animal experiments were conducted. Acute myocardial ischemia was induced by occluding left anterior descending coronary artery in 10 anesthetized open-chest dogs. While scanning the normal hearts and the ischemic hearts with a B scanner, digital radiofrequency data were acquired by a real-time acquisition system in synchronism. The offline analysis to the radio-frequency signal with the 2-D CVIB imaging method was performed to verify the consistency between the imaging result and the design of the experiment. In addition, 4 dogs in experiment were treated with the heart pacemaker in order to investigate the influence of changing in heart rate on the detection of ischemic myocardium with the proposed method. The experimental result showed that the 2-D CVIB imaging method succeeded in detecting the ischemic myocardium and is a new non-invasive way for the cardiologists to both quantitatively and visually evaluate the contractile performance of the myocardium.

  2. Purine Metabolism in Acute Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ye. V. Oreshnikov

    2008-01-01

    Full Text Available Objective: to study the specific features of purine metabolism in clinically significant acute cerebral ischemia. Subjects and materials. Three hundred and fifty patients with the acutest cerebral ischemic stroke were examined. The parameters of gas and electrolyte composition, acid-base balance, the levels of malonic dialdehyde, adenine, guanine, hypox-anthine, xanthine, and uric acid, and the activity of xanthine oxidase were determined in arterial and venous bloods and spinal fluid. Results. In ischemic stroke, hyperuricemia reflects the severity of cerebral metabolic disturbances, hemodynamic instability, hypercoagulation susceptiility, and the extent of neurological deficit. In ischemic stroke, hyperuri-corachia is accompanied by the higher spinal fluid levels of adenine, guanine, hypoxanthine, and xanthine and it is an indirect indicator of respiratory disorders of central genesis, systemic acidosis, hypercoagulation susceptibility, free radical oxidation activation, the intensity of a stressor response to cerebral ischemia, cerebral metabolic disturbances, the depth of reduced consciousness, and the severity of neurological deficit. Conclusion. The high venous blood activity of xanthine oxidase in ischemic stroke is associated with the better neurological parameters in all follow-up periods, the better early functional outcome, and lower mortality rates. Key words: hyperuricemia, stroke, xanthine oxidase, uric acid, cerebral ischemia.

  3. Bronchogenic Carcinoma with Cardiac Invasion Simulating Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Anirban Das

    2016-01-01

    Full Text Available Cardiac metastases in bronchogenic carcinoma may occur due to retrograde lymphatic spread or by hematogenous dissemination of tumour cells, but direct invasion of heart by adjacent malignant lung mass is very uncommon. Pericardium is frequently involved in direct cardiac invasion by adjacent lung cancer. Pericardial effusion, pericarditis, and tamponade are common and life threatening presentation in such cases. But direct invasion of myocardium and endocardium is very uncommon. Left atrial endocardium is most commonly involved in such cases due to anatomical contiguity with pulmonary hilum through pulmonary veins, and in most cases left atrial involvement is asymptomatic. But myocardial compression and invasion by adjacent lung mass may result in myocardial ischemia and may present with retrosternal, oppressive chest pain which clinically may simulate with the acute myocardial infarction (AMI. As a result, it leads to misdiagnosis and delayed diagnosis of lung cancer. Here we report a case of non-small-cell carcinoma of right lung which was presented with asymptomatic invasion in left atrium and retrosternal chest pain simulating AMI due to myocardial compression by adjacent lung mass, in a seventy-four-year-old male smoker.

  4. Value of Ischemia Modified Albumin in the Early Diagnosis of Acute Myocardial Infarction%缺血修饰白蛋白在急性心肌梗死早期诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    马春华; 秦笛; 史连义; 葛军

    2012-01-01

    Objective To investigate the value of ischemia modified albumin (IMA) in early diagnosis of acute myocardial infarction (AMI). Methods Eighty 9ix patients who visited CNPC Central Hosiptial for acute chest pain within 6 hours after onset during January and November 2010 were randomly selected. All patients were classified by discharge diagnoses, 32 patients classified into AMI group and 51 patients into non - AMI group, among which 33 patients had unstable angina pectoris (UAP group) and 18 patients had non - cardiac chest pain (NCCP group). Forty healthy adults were recruited as oontrol group. The plasma level of IMA was indirectly measured by albumin cobalt binding test (ACB). The effectiveness of IMA in diagnosing AMI patients was explored and was compared with that of the traditional cardiac markers such as MYO, CK - MB and cTnl. Results According to the ROC curve drawn by ACB values of AMI group and control group, the optimum cut - off point for IMA levels in the AMI diagnosis was found to be 67.08 U/ml. The sensitivity, specificity, negative predictive value and accuracy of IMA for AMI diagnosis within 6 hours after onset of chest pain were 81.25%, 47.06% , 80% and 60.24%, respectively. The sensitivity and negative predictive value was obviously higher than those of the traditional cardiac markers, MYO, CK - MB and cTnl. Conclusions IMA can contribute to early identification of AMI and it has better diagnosis and prediction value than the traditional cardiac injury markers.%目的 探讨缺血修饰白蛋白(IMA)在急性心肌梗死(AMI)早期诊断中的意义.方法 选择发病6h以内以急性胸痛就诊的患者83例,根据出院诊断分为AMI组32例,非AMI组51例,其中不稳定型心绞痛(UAP)者33例,非心源性胸痛18例,健康对照组40例.利用白蛋白-钴结合试验(albumin cobalt binding test,ACB)原理间接测定IMA含量.探讨IMA对急性心肌梗死的诊断效能,并与传统的心肌标志物MYO、CK

  5. 曲马多预先给药对急性心肌缺血大鼠心肌P物质的影响%Effects of tramadol pretreatment on expression of substance P in myocardium after acute myocardial ischemia in rats

    Institute of Scientific and Technical Information of China (English)

    张建文; 郭政

    2012-01-01

    目的 观察曲马多预先给药对急性心肌缺血大鼠心肌组织缺血区和非缺血区P物质(SP)表达的影响,探讨痛觉干预在缺血心肌保护中的作用. 方法 健康成年雄性SD大鼠18只,体重270 - 300 9,随机分为3组(各n=6):假手术组(S组)、单纯冠状动脉结扎组(I组)和曲马多干预冠状动脉结扎组(T组).S组大鼠开胸后在冠状动脉左前降支下穿线不结扎;I组大鼠开胸后结扎冠状动脉左前降支;T组大鼠经尾静脉注射曲马多12.5 mg/kg,15 min后结扎冠状动脉左前降支.各组在手术后计时3h.采用免疫组化、酶免疫试验和反转录-聚合酶链反应从蛋白和基因水平观察各组大鼠缺血区和非缺血区心肌SP的表达. 结果 I组大鼠缺血区与非缺血区心肌SP和SP mRNA的水平均较S组升高(P<0.05),T组低于I组(P<0.05),但仍高于S组(P<0.05). 结论 曲马多预先给药可降低急性心肌缺血大鼠心肌组织SP的表达,提示曲马多痛觉干预可能参与缺血心肌的保护.%Objective To investigate the effects of tramadol pretreatment on the expression of substance P(SP) in ischemia and non-ischemia myocardium following the acute myocardial ischemia. Methods Eighteen adult male Sprague-Dawley rats weighing 270 -300 g were randomly divided into 3 groups(n =6 in each group) :sham group,ischemia group and tramadol group. The left anterior descending branch of coronary artery was occluded for 3 h in ischemia group and tramadol group. In tramadol group,tramadol 12.5 mg/kg was additionally injected through caudal vein IS min before coronary artery occlusion (CAO). The hearts were removed at the end of 3 h for determining the SP protein expression by immunohistochemistry and enzyme immunometric assay and the expression of SP mRNA by RT-PCR in ischemia and non-ischemia myocardium. Results Compared with sham group,SP and SP mRNA levels were increased significantly in ischemia group and tramadol group in myocardium of

  6. Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction by Biomarkers

    Science.gov (United States)

    2016-01-25

    Acute Myocardial Infarction (AMI); Acute Coronary Syndrome (ACS); ST Elevation (STEMI) Myocardial Infarction; Ischemic Reperfusion Injury; Non-ST Elevation (NSTEMI) Myocardial Infarction; Angina, Unstable

  7. Protective effect of resveratrol on rats with acute myocardial ischemia%白藜芦醇对大鼠急性心肌缺血的保护作用

    Institute of Scientific and Technical Information of China (English)

    张妍; 杜鹃; 赵文晓; 潘振伟; 李宝馨; 杨宝峰

    2006-01-01

    BACKGROUND: Resveratrol is a naturally occurring phytoalexin present in grapes, peanut and some herbs. It has been demonstrated to produce a variety of biological actions, such as anticancer, antiinflammation. Accumulating line of evidence supported the view that resveratrol may exert protective effect on cardiovascular system. However, its protective mechanism is not completely understood.OBJECTIVE: To investigate the anti-ischemic effect and mechanism of resveratrol (Res) on acute myocardial infarction in rats.DESIGN: Randomly grouping paralleled control study.SETTING: Pharmacological Laboratory of Harbin Medical University, Biopharmaceutical Key Laboratory of Heilongjiang Province-Incubator of State Key Laboratory.MATERIALS: The experiment was carried out in Department of Pharmacology of Harbin Medical University from March 2005 to July 2005.Totally 80 male Wistar rats weighting 250-300 g were selected in this study. Among them, 60 rats after operation successful modeling were randomly grouped into 5 groups: sham operation group, blank control group,resveratrol 5 mg/kg, 15 mg/kg and 45 mg/kg groups with 12 in each group.METHODS: Acute myocardial infarction (AMI) model was induced by ligation of the anterior branch of the left coronary artery in rat, Sham operation group: The same suture was put through but not ligated. Resveratrol group: Rats were injected with 5, 15 and 45 resveratrol mg/kg provided by Hunan Huaguang Biological Products Company Limited (batch number: 20050221, purity ≥99%) and ligated after 10 minutes. Model group: The same volume saline was injected for 10 minutes and then rats were ligated. Observe and record ST segment of standard limb lead Ⅱ electrocardiogram (ECG)after 1, 5, 10, 15, 30 minutes after ligating the left anterior decendingcoronary artery. After 6-hour ischemia, the infarct size areas was identified with the myocardium by 2, 3, 5-triphenyltetrazolium chloride (TTC) stain; the activities of serum .creatine kinase (CK

  8. Timing of ischemic onset estimated from the electrocardiogram is better than historical timing for predicting outcome after reperfusion therapy for acute anterior myocardial infarction: a DANish trial in Acute Myocardial Infarction 2 (DANAMI-2) substudy

    DEFF Research Database (Denmark)

    Sejersten, Maria; Ripa, Rasmus S; Grande, Peer

    2007-01-01

    BACKGROUND: Acute treatment strategy and subsequently prognosis are influenced by the duration of ischemia in patients with ST-elevation acute myocardial infarction (AMI). However, timing of ischemia may be difficult to access by patient history (historical timing) alone. We hypothesized...... that an electrocardiographic acuteness score is better than historical timing for predicting myocardial salvage and prognosis in patients with anterior AMI treated with fibrinolysis or primary percutaneous coronary intervention. METHODS: One hundred seventy-five patients with anterior infarct without electrocardiogram (ECG...... the Aldrich score to determine the initially predicted myocardial infarct size and the Selvester score to determine the final QRS-estimated myocardial infarct size. RESULTS: The mean amount of myocardium salvage depended on ECG timing (43% [+/-38%] for "early" vs 1% [+/-56%] for "late"; P

  9. NADPH oxidase inhibitor apocynin attenuates ischemia/reperfusion induced myocardial injury in rats

    Institute of Scientific and Technical Information of China (English)

    罗秀菊

    2013-01-01

    Objective To explore the role of NADPH oxidase inhibitor apocynin on ischemia/reperfusion(I/R)-induced myocardial injury. Methods Male SD rat hearts were divided into the normal control group; sham group;I/R group(1 h ischemia followed by 3 h reperfusion); I/R+ apocynin group(50 mg/kg,administrated at 30 min

  10. 组织多普勒成像在急性心肌缺血心功能异常中的实验研究%Experimental study of Doppler tissue imaging on functional abnormality of the acute myocardial ischemia in pigs

    Institute of Scientific and Technical Information of China (English)

    田瑞霞; 左鲁生; 南苏红; 李熹; 朱先存; 张爱玲; 赵宝珍

    2001-01-01

    目的运用组织多普勒成像 (TDI)技术对急性心肌缺血区域和二尖瓣环侧壁处的运动速度、移动振幅进行检测,探讨TDI技术在急性心肌缺血、心肌梗死中的应用价值。方法 10只开胸猪结扎左冠状动脉前降支(LAD),通过TDI技术速度模式检测缺血区域和心尖四腔观二尖瓣环侧壁处的色泽变化及收缩、舒张期运动速度(VS,VE,VA)、移动振幅(MD,MDe,MDa)、等容收缩期时间,并与基础状态对照分析。结果 LAD结扎后,缺血区域和二尖瓣环处色泽暗淡,局部心肌色彩缺失。结扎15 s时收缩期、舒张早期运动速度、移动振幅显著降低,等容收缩期时间延长。结论 TDI技术能准确反映缺血梗死区域运动异常,精确测定局部收缩、舒张期运动速度、移动振幅,尤其二尖瓣环处的运动能反映整体心肌的运动,为临床早期评价局部心肌缺血及心功能异常提供了一种无创性的检查手段。%Objective To determine the motion velocity and mobile amplitude of acute myocardial ischemia(AMI), myocardial infarcted region and lateral wall of mitral annular using tissue Doppler imaging (TDI) and to study the available value of TDI on AMI and myocardial infarction.Methods Ligated descending anterior branch of left coronary artery(LAD) of 10 open-chest pigs, determined the color changes of ischemia region and view mitral annular apital four-chamber lateral wall and measwred the systotic and diastotic motion velocities (VS, VE, VA), displacement (MD, MDe, MDa) and isometric contraction time interval, and compared them with that of basal states.Results The colors of ischemia region and mitral annular were faint, local myocardial color lost after ligatured LAD. After having ligated for 15 s, the systolic and diastolic early motion velocities and mobile amplitude were decreased, time of isometric contraction was prolonged.Conclusions TDI can accurately reflect ischemia, infarcted

  11. Intraoperative myocardial ischemia during renal transplantation caused by anomalous origin of the right coronary artery

    Directory of Open Access Journals (Sweden)

    Arya Virendra

    2009-01-01

    Full Text Available Anomalous origin of the right coronary artery (AORCA is a rare congenital anomaly with an incidence of 0.92% during routine cardiac catheterization. Its presence raises an important concern to the anaesthesiologist because it can lead on to myocardial ischaemia manifesting as either angina pectoris or myocardial infarction, or sudden death in young patients with minimal exertion, even in the absence of atherosclerosis. Patients with AORCA may be intolerant to stress and the high cardiac output condition owing to volume loading. Such a therapeutic manoeuvre may be desirable during renal transplantation to enable better perfusion of the renal graft immediately after grafting the kidney, in order to improve its function. Hence, haemodynamic goals in renal transplant recipient with AORCA can be contradictory during surgery, thereby rendering anaesthetic management challenging. We report a case of acute myocardial ischemia precipitated by fluid loading conditions in a patient with AORCA during renal transplant that was successfully treated with emergent intra-aortic balloon pump therapy intraoperatively. Judicious intraoperative fluid replacement is recommended, and volume overload must be avoided in AORCA patients undergoing surgery.

  12. Exercise myocardial perfusion scintigraphy is useful for evaluating myocardial ischemia even in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Kurata, Chinori; Uehara, Akihiko; Sugi, Toshihiko; Yamazaki, Keisuke [Hamamatsu Univ. School of Medicine, Shizuoka (Japan); Tawarahara, Kei; Mikami, Tadashi; Matoh, Fumitaka; Odagiri, Keiichi

    2000-06-01

    Pharmacologic stress testing is recommended to elderly patients as a valuable alternative to exercise testing. We examined whether exercise testing is as useful for evaluating myocardial ischemia in the elderly as in the young. The consecutive 1,508 patients who underwent exercise {sup 201}Tl single-photon emission computed tomography (SPECT) were divided into six age groups: 6-29 years (n=56), 30-44 (n=143), 45-54 (n=311), 55-64 (n=498), 65-74 (n=402), and 75-88 (n=98). Both heart rate and rate-pressure product at peak exercise were significantly lower in patients aged 75-88 than in the other five groups. The frequency of ischemic ST depression was higher in patients aged 75-88 than in those aged 6-74, although the difference was not significant. Moreover, the frequency of {sup 201}Tl transient defect was significantly higher in patients aged 75-88 than in those aged 6-74. On the other hand, the sensitivity of ischemic ST depression for {sup 201}Tl transient defect was similar among the six groups, but the specificity was significantly lower in patients aged 75-88 than in those aged 6-74. In conclusion, exercise {sup 201}Tl SPECT is useful for evaluating myocardial ischemia even in the elderly, but exercise electrocardiography has limitations such as lower specificity in the elderly than {sup 201}Tl SPECT. (author)

  13. 速度向量成像技术评价犬心肌缺血与梗死状态下左心室节段性旋转特征%Assessment of regional rotation by velocity vector imaging in canine with myocardial ischemia and acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    张晓娟; 智光

    2011-01-01

    Objective To assess the regional rotation in canine with myocardial ischemia and acute myocardial infarction by velocity vector imaging( VVI ).Methods Myocardial ischemia and infarction model were successfully made by partly and fully ligating the left anterior descending coronary artery ( LAD ) in twelve mongrel dogs. The ventricle rotation and strain were measured by VVI. Results The results revealed: The LAD part ligation: rotation decreased in ventricular septal before LAD ligation status in LAD part ligation status( P <0. 05 ). The strain and strain rate has no significant difference. The LAD ful ligation: the rotation rate, rotation, circumferential strain and strain rate of the anterior septal, anterior wall and ventricular septal were significantly decreased in myocardial infarction status compared with those in the normal status, and were also significantly decreased compared with those in the myocardial ischemia status( P <0. 05 ). The strain and strain rate in the anterior septal,anterior wall and ventricular septal were significantly decreased in myocardial infarction status compared with those in the normal status( P <0. 05 ), but not significantly decreased compared with those in partly ligation status. Conclusion VVI can non-invasively and sensitively assess the left ventricular rotation and the results indicated the ventricular rotation is more sensitive than the strain and strain rate in evaluation of the ventricular systolic function.%目的 应用速度向量成像(VVI)技术评价心肌缺血及心肌梗死状态下犬心肌旋转运动特征.方法 选用杂种犬12只,在超声实时引导下结扎前降支定量制备前降支轻度狭窄(狭窄率:50%~75%)与完全闭塞模型,应用VVI技术分析前降支结扎前、轻度狭窄与完全闭塞状态下左心室旋转特征的改变.结果 12只杂种犬成功制备前降支轻度狭窄与完全闭塞模型,应用VVI技术对缺血与梗死状态下心肌旋

  14. Concordance between myocardial perfusion scan assessed by SPECT and fractional flow reserve findings for detection of significant ischemia

    Directory of Open Access Journals (Sweden)

    Morteza Safi

    2016-09-01

    Conclusion: FFR and MPI with SPECT techniques showed significant concordance for detection of myocardial ischemia, regardless of the type of diseased coronary arteries. In this context, SPECT has high sensitivity and NPV for detection of ischemia compared with FFR.

  15. Quality indicators for acute myocardial infarction

    DEFF Research Database (Denmark)

    Schiele, Francois; Gale, Chris P; Bonnefoy, Eric

    2016-01-01

    infarction (AMI), but no such indicators exist in Europe. In this context, the European Society of Cardiology (ESC) Acute Cardiovascular Care Association (ACCA) has reflected on the measurement of quality of care in the context of AMI (ST segment elevation myocardial infarction (STEMI) and non-ST segment...... be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial...... elevation myocardial infarction (NSTEMI)) and created a set of QIs, with a view to developing programmes to improve quality of care for the management of AMI across Europe. We present here the list of QIs defined by the ACCA, with explanations of the methodology used, scientific justification and reasons...

  16. Aeromedical transport after acute myocardial infarction

    DEFF Research Database (Denmark)

    Seidelin, Jakob B; Bruun, Niels Eske; Nielsen, Henrik

    2009-01-01

    BACKGROUND: No guidelines exist for the planning of aeromedical repatriation after acute myocardial infarction (AMI). In 2004, we employed a risk evaluation-based decision-making system for repatriation of patients after AMI. The objective was to evaluate the safety of transports during 2005...

  17. Thrombolytic therapy of acute myocardial infarction alters collagen metabolism

    DEFF Research Database (Denmark)

    Høst, N B; Hansen, S S; Jensen, L T

    1994-01-01

    infarction and receiving thrombolytic therapy. Regardless of whether acute myocardial infarction was confirmed or not, S-PIIINP increased (94-120%) 4 h after streptokinase therapy (p ....02). With confirmed acute myocardial infarction, S-PIIINP increased from 24 h towards a plateau reached at day 2-3 (p acute myocardial infarction had S-PICP above baseline at 1, 2, and 6 months (p ....05). A less pronounced S-PIIINP increase was noted with tissue-plasminogen activator than with streptokinase. Thrombolytic therapy induces collagen breakdown regardless of whether acute myocardial infarction is confirmed or not. With confirmed acute myocardial infarction collagen metabolism is altered...

  18. Myocardial Infarction Type 2 and Myocardial Injury

    DEFF Research Database (Denmark)

    Sandoval, Yader; Thygesen, Kristian

    2017-01-01

    BACKGROUND: The development and implementation of sensitive and high-sensitivity cardiac troponin assays has not only expedited the early ruling in and ruling out of acute myocardial infarction, but has also contributed to the identification of patients at risk for myocardial injury with necrosis......, as confirmed by the presence of cardiac troponin concentrations above the 99th percentile. Myocardial injury with necrosis may occur either in the presence of overt ischemia from myocardial infarction, or in the absence of overt ischemia from myocardial injury accompanying other conditions. Myocardial...... infarction type 2 (T2MI) has been a focus of attention; conceptually T2MI occurs in a clinical setting with overt myocardial ischemia where a condition other than an acute atherothrombotic event is the major contributor to a significant imbalance between myocardial oxygen supply and/or demand. Much debate...

  19. Assessment of hypotension during dialysis as a manifestation of myocardial ischemia in patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Randa Aly Soliman

    2014-04-01

    Conclusions: Patients with CKD and regular hemodialysis who experience moderate or severe intradialytic hypotension have significantly higher prevalence of myocardial ischemia and stress induced myocardial dysfunction, than those who experience no or mild intradialytic hypotension.

  20. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Seval İzdeş

    2011-08-01

    Full Text Available Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to discuss the approach to distinguish an acute coronary syndrome from myopericarditis. (Journal of the Turkish Society Intensive Care 2011; 9:68-70

  1. Myocardial Ischemia Induces SDF-1α Release in Cardiac Surgery Patients.

    Science.gov (United States)

    Kim, Bong-Sung; Jacobs, Denise; Emontzpohl, Christoph; Goetzenich, Andreas; Soppert, Josefin; Jarchow, Mareike; Schindler, Lisa; Averdunk, Luisa; Kraemer, Sandra; Marx, Gernot; Bernhagen, Jürgen; Pallua, Norbert; Schlemmer, Heinz-Peter; Simons, David; Stoppe, Christian

    2016-06-01

    In the present observational study, we measured serum levels of the chemokine stromal cell-derived factor-1α (SDF-1α) in 100 patients undergoing cardiac surgery with cardiopulmonary bypass at seven distinct time points including preoperative values, myocardial ischemia, reperfusion, and the postoperative course. Myocardial ischemia triggered a marked increase of SDF-1α serum levels whereas cardiac reperfusion had no significant influence. Perioperative SDF-1α serum levels were influenced by patients' characteristics (e.g., age, gender, aspirin intake). In an explorative analysis, we observed an inverse association between SDF-1α serum levels and the incidence of organ dysfunction. In conclusion, time of myocardial ischemia was identified as the key stimulus for a significant upregulation of SDF-1α, indicating its role as a marker of myocardial injury. The inverse association between SDF-1α levels and organ dysfunction association encourages further studies to evaluate its organoprotective properties in cardiac surgery patients.

  2. 高迁移率族蛋白B1对心肌缺血再灌注损伤保护作用的初步临床研究%Cardioprotective effect of high mobility group protein B1 against myocardial ischemia-reperfusion injury in acute myocardial infarction patients

    Institute of Scientific and Technical Information of China (English)

    刘宇; 曹清心; 张燕; 赵仙先

    2012-01-01

    目的 随着急性心肌梗死(acute myocardial infarction,AMI)发病率的不断增加,以及再灌注治疗的广泛开展,缺血再灌注损伤(ischemical reperfusion injury,IRI)已经引起了广泛关注,但尚未找到一种能有效减轻IRI的治疗方法.近年来,国内外基于动物模型的研究发现:高迁移率族蛋白B1(high mobility group box 1 protein,HMGB1)可能在IRI过程中发挥着中枢作用,并且目前有关AMI患者经经皮冠状动脉内介入术(percutaneous coronary intervention,PCI)血浆中HMGB1浓度变化及其机制的研究还鲜见报道.文中初步探讨HMGB1是否参与AMI患者PCI中心肌IRI过程,及其在此过程中产生的心肌保护作用和可能机制.方法 采用酶联免疫吸附法,分别测定17例经冠状动脉造影术(coronary arteriography,CAG)检查正常的健康志愿者(对照组),41例AMI经急诊PCI治疗患者(AMI手术组)术前即刻、术后24h和48h血浆中HMGB1和血管内皮生长因子(vascular endothelial growth factor,VEGF)变化水平,并记录AMI手术组梗死相关血管(infarction related artery,IRA)开通即刻出现的再灌注心律失常(reperfusion arrhythmia,RA)类型、术后24h脑钠肽(brain natriuretic peptide,BNP)水平、住院期间不良临床事件(心力衰竭、心源性猝死)及其他基本临床数据.结果 AMI手术组患者在IRA开通即刻均观察到RA;术后24h HMGB1水平明显高于术前即刻及术后48h(P<0.05),并且各时间点HMGB1水平与VEGF水平呈正相关(P<0.05);AMI手术组院内出现不良临床事件与无不良事件的患者相比较,各时间点HMGB1水平明显降低(P<0.05).结论 HMGB1参与了AMI患者行PCI手术中IRI的过程;HMGB1水平对于AMI患者的远期预后有一定预测作用;HMGB1可能通过促进VEGF的分泌而参与梗死后心肌的修复过程,并可能通过此作用对改善心功能、保护心肌细胞产生一定作用.%Objective With the increasing incidence of acute myocardial infarction

  3. ROLE OF EXERCISE STRESS TEST IN DETECTING UNDERLYING MYOCARDIAL ISCHEMIA

    Directory of Open Access Journals (Sweden)

    Sachin N.

    2014-07-01

    Full Text Available BACKGROUND: Ischemic heart disease (IHD is the leading cause of death and disability in industrialized countries. In India also there is increasing trends of death and disability due to IHD. The prevalence of IHD in India is 96.7/1000 in urban and 27.1/1000 in rural areas. Main risk factors for IHD are diabetes mellitus, hypertension, obesity, smoking and hyperlipidemia. AIM: The present study aims at early detection of IHD which can prevent death and disability in persons with risk factors. DESIGN: The present study is cross sectional observational study carried out in the govt. medical college of rural Indian set-up. MATERIALS AND METHODS: The present study was carried out on 70 asymptomatic patients of age group 30-70 years with any of the above mentioned risk factors for IHD. The treadmill test was performed in these patients. STATISTICAL ANALYSIS: The analysis was done using MS office excel 2007 software. RESULTS: 24.22% patients showed positive treadmill test. This means 24.22% of patients were having underlying IHD though they were asymptomatic. CONCLUSION: Thus treadmill test is a valuable, non-invasive tool for early detection of myocardial ischemia among the asymptomatic patients with risk factors for coronary artery disease.

  4. Humanized cobra venom factor decreases myocardial ischemia-reperfusion injury.

    Science.gov (United States)

    Gorsuch, W Brian; Guikema, Benjamin J; Fritzinger, David C; Vogel, Carl-Wilhelm; Stahl, Gregory L

    2009-12-01

    Cobra venom factor (CVF) is a complement activating protein in cobra venom, which functionally resembles C3b, and has been used for decades for decomplementation of serum to investigate the role of complement in many model systems of disease. The use of CVF for clinical practice is considered impractical because of immunogenicity issues. Humanization of CVF was recently demonstrated to yield a potent CVF-like molecule. In the present study, we demonstrate that mice treated with recombinant humanized CVF (HC3-1496) are protected from myocardial ischemia-reperfusion (MI/R) injuries with resultant preservation of cardiac function. Also, C3 deposition in the myocardium following MI/R was not observed following treatment with HC3-1496. HC3-1496 led to complement activation and depletion of C3, but preserved C5 titers. These data suggest, unlike CVF, HC3-1496 does not form a C5 convertase in the mouse, similar to recent studies in human sera/plasma. These results suggest that humanized CVF (HC3-1496) protects the ischemic myocardium from reperfusion injuries induced by complement activation and represents a novel anti-complement therapy for potential clinical use.

  5. Relationship between nonsustained ventricular tachycardia after non-ST-elevation acute coronary syndrome and sudden cardiac death: observations from the metabolic efficiency with ranolazine for less ischemia in non-ST-elevation acute coronary syndrome-thrombolysis in myocardial infarction 36 (MERLIN-TIMI 36) randomized controlled trial.

    NARCIS (Netherlands)

    Scirica, B.M.; Braunwald, E.; Belardinelli, L.; Hedgepeth, C.M.; Spinar, J.; Wang, W.; Qin, J.; Karwatowska-Prokopczuk, E.; Verheugt, F.W.A.; Morrow, D.A.

    2010-01-01

    BACKGROUND: Most studies examining the relationship between ventricular tachycardia (VT) after acute coronary syndrome and sudden cardiac death (SCD) were performed before widespread use of reperfusion, revascularization, or contemporary medical therapy and were limited to ST-elevation myocardial in

  6. Spontaneous coronary dissection associated with myocardial bridge causing acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    GE Jun-bo; HUANG Zhe-yong; LIU Xue-bo; QIAN Ju-ying

    2008-01-01

    @@ Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia, myocardial infarction and sudden cardiac death.1-10 This disease mainly occurs in young women with oral contraceptive or during the peripartum period,without risk factors for coronary artery disease.

  7. The immune system in atherosclerosis and in acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Antonio Barsotti

    2006-12-01

    Full Text Available Acute myocardial infarction (AMI occurs when the atheromatous process prevents total blood flow through the coronary artery. It was previously thought that progressive luminal narrowing from the continued growth of smooth muscle cells (SMCs in the plaque was the main cause of infarction, however, angiographic studies, have identified culprit lesions that do not cause marked stenosis. Is now evident that plaque activation, rather than stenosis, precipitates ischemia and infarction. Coronary spasm could be involved to some extent, but most cases of AMI are due to the formation of an occluding thrombus on the surface of the plaque; the two major causes of coronary thrombosis are plaque rupture and endothelial erosion. Plaque rupture is detectable in 60- 70% of cases and preferentially occurs when the fibrous cap is thin and partly destroyed. One of the major challenges in modern cardiology is the knowledge of the factors that induce a silent atherosclerotic plaque shifting from a stable to a vulnerable form.

  8. Combined postconditioning with ischemia and α7nAChR agonist produces an enhanced protection against rat myocardial ischemia reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    XIONG Jun; YUAN Yu-jing; XUE Fu-shan; WANG Qiang; LI Shan; LIAO Xu; LIU Jian-hua; CHEN Yi; LI Rui-ping

    2012-01-01

    Background Inflammation is one of important mechanisms for myocardial ischemia reperfusion injury (IRI).Ischemia postconditioning (IPOC) can protect the heart against IRI by inhibiting inflammation,but its cardioprotection is weaker than that of ischemia preconditioning.Recently,the α7 subunit-containing nicotinic acetylcholine receptor (α7nAChR) agonist has shown anti-infiammatory effects in many diseases related to inflammation.This randomized controlled experiment was designed to evaluate whether combined postconditioning with IPOC and the α7nAChR agonist could produce an enhanced cardioprotection in a rat in vivo model of acute myocardial IRI.Methods Fifty Sprague-Dawley rats were randomly divided into five equal groups:sham group,control group,IPOC group,α7nAChR agonist postconditioning group (APOC group) and combined postconditioning with IPOC and α7nAChR agonist group (combined group).Hemodynamic parameters were recorded during the periods of ischemia and reperfusion.Serum concentrations of troponin I (Tnl),tumor necrosis factor α (TNF-α) and high-mobility group box 1 (HMGB-1) at 180 minutes after reperfusion were assayed in all groups.At the end of the experiment,the infarct size was assessed from excised hearts by Evans blue and triphenyl tetrazolium chloride staining.Results As compared to the sham group,the infarct size in the other four groups was significantly increased,serum levels of Tnl,TNF-α and HMGB1 in the control group and TNF-α,HMGB1 in the IPOC group were significantly increased.The infarct size and serum concentrations of TNF-α,HMGB1 and Tnl in the IPOC,APOC and combined groups were significantly lower than those in the control group.As compared to the IPOC group,the infarct size in the combined group was significantly decreased,serum concentrations of Tnl,TNF-α and HMGB1 in the APOC and combined groups were significantly reduced.Although the infarct size was significantly smaller in the combined group than in the APOC group

  9. Macrophages mediate cardioprotective cellular postconditioning in acute myocardial infarction.

    Science.gov (United States)

    de Couto, Geoffrey; Liu, Weixin; Tseliou, Eleni; Sun, Baiming; Makkar, Nupur; Kanazawa, Hideaki; Arditi, Moshe; Marbán, Eduardo

    2015-08-03

    Ischemic injury in the heart induces an inflammatory cascade that both repairs damage and exacerbates scar tissue formation. Cardiosphere-derived cells (CDCs) are a stem-like population that is derived ex vivo from cardiac biopsies; they confer both cardioprotection and regeneration in acute myocardial infarction (MI). While the regenerative effects of CDCs in chronic settings have been studied extensively, little is known about how CDCs confer the cardioprotective process known as cellular postconditioning. Here, we used an in vivo rat model of ischemia/reperfusion (IR) injury-induced MI and in vitro coculture assays to investigate how CDCs protect stressed cardiomyocytes. Compared with control animals, animals that received CDCs 20 minutes after IR had reduced infarct size when measured at 48 hours. CDCs modified the myocardial leukocyte population after ischemic injury. Specifically, introduction of CDCs reduced the number of CD68+ macrophages, and these CDCs secreted factors that polarized macrophages toward a distinctive cardioprotective phenotype that was not M1 or M2. Systemic depletion of macrophages with clodronate abolished CDC-mediated cardioprotection. Using both in vitro coculture assays and a rat model of adoptive transfer after IR, we determined that CDC-conditioned macrophages attenuated cardiomyocyte apoptosis and reduced infarct size, thereby recapitulating the beneficial effects of CDC therapy. Together, our data indicate that CDCs limit acute injury by polarizing an effector macrophage population within the heart.

  10. Secondary prevention with calcium antagonists after acute myocardial infarction

    DEFF Research Database (Denmark)

    Hansen, J F

    1992-01-01

    Experimental studies have demonstrated that the 3 calcium antagonists nifedipine, diltiazem, and verapamil have a comparable effect in the prevention of myocardial damage during ischaemia. Secondary prevention trials after acute myocardial infarction, which aimed at improving survival...

  11. Polymeric electrospun scaffolds: neuregulin encapsulation and biocompatibility studies in a model of myocardial ischemia.

    Science.gov (United States)

    Simón-Yarza, Teresa; Rossi, Angela; Heffels, Karl-Heinz; Prósper, Felipe; Groll, Jürgen; Blanco-Prieto, Maria J

    2015-05-01

    Cardiovascular disease represents one of the major health challenges in modern times and is the number one cause of death globally. Thus, numerous studies are under way to identify effective cell- and/or growth factor (GF)-based therapies for repairing damaged cardiac tissue. In this regard, improving the engraftment or survival of regenerative cells and prolonging GF exposure have become fundamental goals in advancing these therapeutic approaches. Biomaterials have emerged as innovative scaffolds for the delivery of both cells and proteins in tissue engineering applications. In the present study, electrospinning was used to generate smooth homogenous polymeric fibers, which consisted of a poly(lactic-co-glycolic acid) (PLGA)/NCO-sP(EO-stat-PO) polymer blend encapsulating the cardioactive GF, Neuregulin-1 (Nrg). We evaluated the biocompatibility and degradation of this Nrg-containing biomaterial in a rat model of myocardial ischemia. Histological analysis revealed the presence of an initial acute inflammatory response after implantation, which was followed by a chronic inflammatory phase, characterized by the presence of giant cells. Notably, the scaffold remained in the heart after 3 months. Furthermore, an increase in the M2:M1 macrophage ratio following implantation suggested the induction of constructive tissue remodeling. Taken together, the combination of Nrg-encapsulating scaffolds with cells capable of inducing cardiac regeneration could represent an ambitious and promising therapeutic strategy for repairing diseased or damaged myocardial tissue.

  12. Angina pectoris during daily activities and exercise stress testing: The role of inducible myocardial ischemia and psychological distress.

    Science.gov (United States)

    Sullivan, Mark D; Ciechanowski, Paul S; Russo, Joan E; Spertus, John A; Soine, Laurie A; Jordan-Keith, Kier; Caldwell, James H

    2008-10-31

    Physicians often consider angina pectoris to be synonymous with myocardial ischemia. However, the relationship between angina and myocardial ischemia is highly variable and we have little insight into the sources of this variability. We investigated the relationship of inducible myocardial ischemia on SPECT stress perfusion imaging to angina reported with routine daily activities during the previous four weeks (N=788) and to angina reported during an exercise stress test (N=371) in individuals with confirmed or suspected coronary disease referred for clinical testing. We found that angina experienced during daily life is more strongly and consistently associated with psychological distress and the personal threat associated with angina than with inducible myocardial ischemia. In multivariable models, the presence of any angina during routine activities over the prior month was significantly associated with age, perceived risk of myocardial infarction, and anxiety when compared to those with no reported angina in the past month. Angina during daily life was not significantly associated with inducible myocardial ischemia on stress perfusion imaging in bivariate or multivariable models. In contrast, angina experienced during exercise stress testing was significantly related to image and ECG ischemia, though it was also significantly associated with anxiety. These results suggest that angina frequency over the previous four weeks is more strongly associated with personal threat and psychosocial distress than with inducible myocardial ischemia. These results lend support to angina treatment strategies that aim to reduce threat and distress as well as to reduce myocardial ischemia.

  13. Effect of regional myocardial ischemia on sympathetic nervous system as assessed by fluorine-18-metaraminol

    Energy Technology Data Exchange (ETDEWEB)

    Schwaiger, M.; Guibourg, H.; Rosenspire, K.; McClanahan, T.; Gallagher, K.; Hutchins, G.; Wieland, D.M. (Univ. of Michigan Medical Center, Ann Arbor (USA))

    1990-08-01

    With the introduction of radiolabeled catecholamine analogues, the noninvasive evaluation of the cardiac sympathetic nervous system has become possible. This study evaluated the effect of regional ischemia on myocardial retention of the new norepinephrine analogue 6-({sup 18}F) fluorometaraminol (FMR) in the open chest dog model. Six dogs were injected intravenously with FMR following 30-min occlusion of the left anterior descending artery. Six sham animals served as control group. Regional myocardial blood flow as determined by microspheres decreased 87% during ischemia (p less than 0.01), but was not significantly different from control myocardium following reperfusion. Regional myocardial 18F activity as determined postmortem was significantly reduced in reperfused myocardium (-34%), which paralleled an 18% reduction of tissue norepinephrine concentration. Thus, short time periods of coronary occlusion affect neuronal function indicating the sensitivity of the sympathetic nerve terminals to ischemia. FMR provides a new tracer approach for the characterization of neuronal integrity in postischemic myocardium.

  14. Regional myocardium function in rabbit with acute myocardial ischemia assessed by velocity vector imaging%速度向量成像技术评价兔急性心肌缺血局部心肌功能的研究

    Institute of Scientific and Technical Information of China (English)

    周佳; 周启昌; 蒲大容; 刘红雨; 丁正东; 田蕾琪; 周嘉炜; 肖永志

    2011-01-01

    目的 建立新西兰大白兔急性心肌缺血的动物模型,应用速度向量成像(VVI)技术分析急性心肌缺血状态下左心室长轴和短轴方向上各节段局部心肌收缩功能的变化特点.方法 新西兰大白兔30只,随机分为冠状动脉结扎组和假手术组,于术前和术后30 min内行超声心动图检查并采集动态图像,脱机行VVI分析,测量左心室心肌各节段长轴和短轴方向上的VVI参数:收缩期峰值运动速度(Vs)、收缩期峰值应变(Ss)、收缩期峰值应变率(SRs),行统计学分析.结果 心肌缺血后,分别与术前及与假手术组比较,长轴方向上,前间隔心尖段与后壁心尖段的Vs明显减低;前间隔中间段、心尖段与后壁心尖段Ss、SRs明显减低,差异均有统计学意义(P<0.05);短轴方向上,前壁、侧壁的基底段,前间隔、前壁、侧壁的中间段和心尖水平的各节段的Vs明显减低;前间隔、前壁、侧壁的基底段,前间隔、前壁、侧壁、后壁的中间段以及心尖水平各节段的Ss、SRs明显减低,差异均有统计学意义(P<0.05).结论 急性心肌缺血后左心室支供血节段及部分相邻节段的长轴及短轴局部心肌收缩功能减低.VVI技术能够客观、准确的检测实验兔心肌长轴和短轴方向上局部运动功能的微小变化,为急性心肌缺血的早期诊断提供了一种新的无创的、可靠的定量工具.%Objective To utilize velocity vector imaging ( VVI ) in analyzing regional myocardium function within 30 minutes before and after myocardial ischemia induced by occlusion of coronary artery in New Zealand white rabbits and to evaluate the changes of longitudinal and brachydiagonal segmental left ventricular( LV ) systolic function in rabbits with acute myocardial ischemia. Methods Thirty New Zealand white rabbits were divided into groups of myocardial ischemia and sham operation. All rabbits were performed by echocardiography before the operation and after

  15. Cholinergic anti-inflammatory pathway: a possible approach to protect against myocardial ischemia reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    XIONG Jun; XUE Fu-shan; YUAN Yu-jing; WANG Qiang; LIAO Xu; WANG Wei-li

    2010-01-01

    Objective A general review was made of studies involving: (1) the concept and mechanism of the cholinergic anti-inflammatory pathway (CAP), (2) the important role of inflammatory response in myocardial ischemia reperfusion (I/R)injury and (3) the evidence and mechanisms by which CAP may provide protection against myocardial I/R injury.Data sources The data used in this review were mainly from manuscripts listed in PubMed that were published in English from 1987 to 2009. The search terms were "vagal nerve stimulation", "myocardial ischemia reperfusion injury","nicotine acetylcholine receptor" and "inflammation".Study selection (1) Clinical and experimental evidence that the inflammatory response induced by reperfusion enhances myocardial I/R injury. (2) Clinical and laboratory evidence that the CAP inhibits the inflammation and provides protection against myocardial I/R injury.Results The myocardial I/R injury is really an inflammatory process characterized by recruitment of neutrophils into the ischemic myocardium and excessive production of pro-inflammatory cytokines. Because the CAP can modulate the inflammatory response by decreasing the production and release of pro-inflammatory cytokines, it can provide protection against myocardial I/R injury.Conclusions The CAP can inhibit the inflammatory response induced by reperfusion and protect against myocardial I/R injury. It represents an exciting opportunity to develop new and novel therapeutics to attenuate the myocardial I/R injury.

  16. Implications of myocardial reperfusion on survival in women versus men with acute myocardial infarction undergoing primary coronary intervention.

    Science.gov (United States)

    Meller, Stephanie M; Lansky, Alexandra J; Costa, Ricardo A; Soffler, Morgan; Costantini, Costantino O; Brodie, Bruce R; Cox, David A; Stuckey, Thomas D; Fahy, Martin; Grines, Cindy L; Stone, Gregg W

    2013-10-15

    We evaluated the effects of myocardial perfusion after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) on gender-based mortality rates. Research has demonstrated a gender-specific response of cardiomyocytes to ischemia and a potential increase in myocardial salvage in women compared with men. Myocardial blush grade (MBG), an angiographic surrogate of myocardial perfusion, is an independent predictor of early and late survival after AMI. Whether the incidence and prognosis of myocardial perfusion differs according to gender among patients with AMI undergoing PCI is unknown. MBG and short- and long-term mortality were evaluated in 1,301 patients (male = 935; female = 366) with AMI randomized to primary angioplasty ± abciximab versus stent ± abciximab. Following PCI, >96% of patients achieved final Thrombolysis In Myocardial Infarction 3 flow, of which MBG 2/3 was present in 58.3% of women versus 51.1% of men (p = 0.02). Worse MBG was an independent predictor of mortality in women at 30 days (7.4% for MBG 0/1 vs 2.4% for MBG 2/3, p = 0.04) and at 1-year (11.0% for MBG 0/1 vs 3.4% for MBG 2/3, p = 0.01); however, MBG was not associated with differences in mortality for men. In conclusion, impaired myocardial perfusion following PCI for AMI, indicated by worse MBG, is an independent predictor of early and late mortality in women but not in men. These findings imply an enhanced survival benefit from restoring myocardial perfusion for women compared with men during primary angioplasty and may have clinical implications for interventional strategies in women.

  17. The value of exercise tests after acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Nielsen, S L; Knudsen, F

    1992-01-01

    The aim of the present study was to relate the clinical course in patients after a first acute myocardial infarction with the response to exercise-tests performed one month after discharge. 90 consecutive patients who suffered an acute myocardial infarction for the first time were followed-up after...... (W) were predictive with respect to mortality, heart failure, and angina pectoris requiring drug treatment. Exercise tests following acute myocardial infarction could not predict the chances of returning to work....

  18. Molecular Characterization of Reactive Oxygen Species in Myocardial Ischemia-Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Tingyang Zhou

    2015-01-01

    Full Text Available Myocardial ischemia-reperfusion (I/R injury is experienced by individuals suffering from cardiovascular diseases such as coronary heart diseases and subsequently undergoing reperfusion treatments in order to manage the conditions. The occlusion of blood flow to the tissue, termed ischemia, can be especially detrimental to the heart due to its high energy demand. Several cellular alterations have been observed upon the onset of ischemia. The danger created by cardiac ischemia is somewhat paradoxical in that a return of blood to the tissue can result in further damage. Reactive oxygen species (ROS have been studied intensively to reveal their role in myocardial I/R injury. Under normal conditions, ROS function as a mediator in many cell signaling pathways. However, stressful environments significantly induce the generation of ROS which causes the level to exceed body’s antioxidant defense system. Such altered redox homeostasis is implicated in myocardial I/R injury. Despite the detrimental effects from ROS, low levels of ROS have been shown to exert a protective effect in the ischemic preconditioning. In this review, we will summarize the detrimental role of ROS in myocardial I/R injury, the protective mechanism induced by ROS, and potential treatments for ROS-related myocardial injury.

  19. Gender-specific issues in the management of patients with acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    SHEN Wei-feng

    2008-01-01

    @@ Acute coronary syndrome (ACS) represents a continuum of acute myocardial ischemia including non-ST-elevation myocardial infarction and unstable angina, synonymous with non-ST-elevation ACS (NSTE-ACS),and ST-elevation myocardial infarction (STEMI).

  20. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction.

    Science.gov (United States)

    Kumar, Andreas; Bagur, Rodrigo; Béliveau, Patrick; Potvin, Jean-Michel; Levesque, Pierre; Fillion, Nancy; Tremblay, Benoit; Larose, Eric; Gaudreault, Valérie

    2014-09-26

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause.

  1. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Andreas; Kumar; Rodrigo; Bagur; Patrick; Béliveau; Jean-Michel; Potvin; Pierre; Levesque; Nancy; Fillion; Benoit; Tremblay; éric; Larose; Valérie; Gaudreault

    2014-01-01

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause.

  2. Ischemia

    Science.gov (United States)

    Byeon, Suk Ho; Kim, Min; Kwon, Oh Woong

    "Ischemia" implies a tissue damage derived from perfusion insufficiency, not just an inadequate blood supply. Mild thickening and increased reflectivity of inner retina and prominent inner part of synaptic portion of outer plexiform layer are "acute retinal ischemic changes" visible on OCT. Over time, retina becomes thinner, especially in the inner portion. Choroidal perfusion supplies the outer portion of retina; thus, choroidal ischemia causes predominant change in the corresponding tissue.

  3. Treatment of acute hydrocephalus and cerebral ischemia after subarachnoid hemorrhage

    NARCIS (Netherlands)

    D. Hasan (Djo)

    1990-01-01

    textabstractOnly recently has acute hydrocephalus after subarachnoid hemorrhage been recognized as a clinical important problem. The mortality rate in patients with acute hydrocephalus after subarachnoid hemorrhage is higher than in those without, which is mainly caused by cerebral ischemia. An expl

  4. 99mTc-MIBI心肌显像评价参麦注射液对急性心肌梗死溶栓再灌注心肌的保护作用%Study on Effect of Shenmai Injection in Protecting Myocardium against Ischemia-Reperfusion Injury in Thrombolytic Therapy with Urokinase for Acute Myocardial Infarction Patients Evaluated by 99mTc-MIBI Myocardial Imaging

    Institute of Scientific and Technical Information of China (English)

    郭松鹏; 张言镇

    2001-01-01

    Objective: To evaluate the myocardial protecting effect ofShenmai injection (SMI) against ischemia/reperfusion injury in thrombolytic therapy with urokinase (UK) for acute myocardial infarction patients by 99m Tc-MIBI myocardial imaging (SPECT). Methods: Five hundred and thirty-seven patients were randomly divided into two groups. The SMI group (n=292) was treated with thrombolytic treatment plus SMI and the control group (n=245) with thrombolytic treatment only. Single photon emission computerized tomography (SPECT) was carried out on the 7th day after thrombolysis to determine the ischemic myocardial area (IMA) and ejection fraction (EF) in both groups and compared. Results: The reperfusion rate of infarction related area (IRA) in the two groups was not different significantly (72.26% vs 72.65%, P>0.05). The IMA in patients of the SMI group, no matter with or without reperfused IRA (211 cases and 81 cases) respectively, was significantly lower than that in the control group (178 cases and 67 cases) respectively, P<0.01 and P<0.05 respectively. The EF value in the SMI group was significantly higher than that in the control group (P<0.01). Conclusion: Using SMI in early stage of thrombolytic treatment in acute myocardial infarction could significantly reduce IMA and increase EF. SMI showed good protective effect against myocardial ischemia/reperfusion injury in thrombolytic treatment.%目的:用99m锝-甲氰基异丁基晴心肌灌注断层显像(SPECT),评价参麦注射液对急性心肌梗死(AMI)尿激酶(UK)溶栓治疗再灌注心肌保护作用的临床疗效。方法:537例AMI患者随机分为两组,参麦组(292例)采用UK溶栓疗法和参麦注射液治疗,对照组(245例)只使用UK溶栓疗法。于溶栓治疗后第7日进行SPECT检测。对两组心肌缺血面积(IMA)和左室射血分数(EF)的变化进行对比研究。结果:参麦组和对照组梗塞相关血管(IRA)再通率之间差异无显著性(分别为72.26%

  5. Mechanism of the protective effects of noninvasive limbs preconditioning on myocardial ischemia-reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Xiao-guang; WU Bin-yang; WANG Jun-ke; BAI Tao

    2005-01-01

    Background This study aimed at assessing the effect of noninvasive limb preconditioning on myocardial infarct size, and determining whether nitric oxide and neurogenic pathway play an important role in the mechanism of acute remote ischemic preconditioning (IPC).Methods Forty Wistar rats were randomly divided into four experimental groups. In Group Ⅰ, the rats underwent 30-minute occlusion of the left anterior descending coronary artery, and 120-minute reperfusion. In Group PL, the rats underwent four cycles of 5-minute occlusion and reperfusion of both hind limbs using a tourniquet before the experiment was continued as in Group Ⅰ. In Group PL-N and Group PL-H, we administered L-nitro-arginine methyl ester (L-NAME) 10 mg/kg or hexamethonium chloride 20 mg/kg intravenously, 10 minutes before IPC. Infarct size as a percentage of the area at risk was determined by triphenyltetrazolium chloride staining. Results There were no statistically significant differences in mean arterial pressure and heart rate among these groups at any time point during the experiment (P>0.05). The myocardial infarct size (IS) was decreased significantly in Group PL and Group PL-H compared with Group Ⅰ, and the IS/AAR was 34.5%±7.6%, 35.9%±8.6% and 58.5%±8.5%, respectively (P0.05).Conclusions Noninvasive limb IPC is effective in protecting the myocardium from ischemia reperfusion injury. Nitric oxide plays an important role in the mechanism of acute remote IPC, in which the neurogenic pathway is not involved.

  6. EXPERIMENTAL STUDY OF HOMIUM: YAG LASER TRANSMYOCARDIAL REVASCULARIZATION IN ACUTE ISCHEMIC SETFINGS WITH MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    王立清; 胡盛涛; 李澎; 谢峰; 吴清玉; 郭加强

    2000-01-01

    Objective. To study the mechanism and effects of blood perfusion to the acute ischemic region of myecardium through Ho-YAG laser channels with myocardial contrast echocardiography Methods. To produce the model of acute myocardial ischemia, we partially ligated the left anterior decending (IAD)coromry artery of canine hearts between 1st. and 2nd. diagonal branches and then performed transmyocardial revasmgafizafion in this region with Ho- YAG laser. Myocardial contrast echecardingmphy was made with a new gen-eration of ultrasound contrast agent and second harmonic imaging of this region before,after ischemia and after laser revascalarizafion. Pictures were taken with “R” wave trigger skill. Results. Acoustic demity derterming in the ischemia region (anterior wall)with MCE(myocardial contrast e-checardiography) was obviously decreased(5.40 ± 1.81) after the LAD was ligated,as compared with before( 11.69± 1.61, P 0.05). There were no dif-ferences in acoustic density in the lateral wall(as control)among these comprehensive three periods (P > 0.05). Con-trast in the laser region developed one cardiac cycle ahead of that in the non-iscbemic normal region. Conclusion. Acute ischemic myecardium can be perfused by oxygenated blood from the left ventricle through Ho-YAG laser channels. Evidenee of blood perfusion through laser channels during systolic phase was detected,and my-ocardial cormast ultrasonngtaphy using intravenous perfluorocarbon-exposed sonicated dextrose albumin may be regard-ed as a reliable method in the study of tranmlyecardial revasculariztion.

  7. Effect of Chinese Green Onion Extract Nanoemulsion Oral Spray on Electrocardiogram and Area of Myocardial Infarction in Rabbit Model With Acute Myocardial Ischemia%葱白提取物纳米乳口腔喷雾剂对急性心肌缺血兔心电图及心肌梗死面积的影响

    Institute of Scientific and Technical Information of China (English)

    何本鸿; 姜闪闪; 张介眉; 朱旭; 郝建军; 张耕; 柯于鹤; 杨祥良; 祝红达; 陈华兵

    2011-01-01

    目的:观察葱白提取物纳米乳口腔喷雾剂对急性心肌缺血兔心电图及心肌梗死(简称心梗)面积的影响.方法:日本大耳白兔56只,随机分为假手术组、空白模型组、硝酸甘油组、葱白提取物组、空白纳米组、葱白纳米乳组和葱白纳米乳原位凝胶组,每组8只.术后及时舌下给药,硝酸甘油组、葱白提取物组、空白纳米组、葱白纳米乳组和葱白纳米乳原位凝胶组给予相应的制剂5喷,假手术组和空白模型组给予同体积的生理盐水.记录给药前及用药后0、1、5、10、15、30、60、120和180 min的心电图,实验结束后处死动物,计算心梗面积.结果:①与模型组比较,各治疗组舌下给药后均可缩小兔冠脉结扎所致心肌梗死范围(P<0.05),葱白提取物及葱白提取物纳米制剂组减小心肌梗死面积的程度与硝酸甘油相当(P>0.005),葱白提取物纳米乳组和其纳米乳原位凝胶组与葱白提取物组未见明显差异(P>0.05);②对心电图的影响:与模型组比较,舌下给药后不同时间点各治疗组舌下给药后均可以使ST段显著降低(P<0.05);给药后1~5 min,葱白提取物纳米乳组与硝酸甘油组比较作用相当(P>0.05),优于葱白提取物组(P<0.05).葱白纳米乳原位凝胶起效时间为10~30 min,葱白提取物起效时间为5~10 min,葱白纳米乳组起效时间为0~5 min,葱白纳米乳优于葱白提取物和葱白纳米乳原位凝胶,与硝酸甘油起效时间相当.结论:葱白提取物纳米乳口腔喷雾剂对ST段和心肌梗死面积的作用优于葱白提取物和葱白纳米乳原位凝胶,与硝酸甘油起效时间相当.%Objective: To observe the effect of Chinese green onion (CGO) extract nanoemulsion oral spray on e-lectrocardiogram (ECG) and area of myocardial infarction in rabbits with acute myocardial ischemia. Methods: Fifty-six Japanese male white rabbits were randomly divided into sham operation group, blank

  8. Amphetamine Abuse Related Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Archana Sinha

    2016-01-01

    Full Text Available Amphetamine abuse is a global problem. The cardiotoxic manifestations like acute myocardial infarction (AMI, heart failure, or arrhythmia related to misuse of amphetamine and its synthetic derivatives have been documented but are rather rare. Amphetamine-related AMI is even rarer. We report two cases of men who came to emergency department (ED with chest pain, palpitation, or seizure and were subsequently found to have myocardial infarction associated with the use of amphetamines. It is crucial that, with increase in amphetamine abuse, clinicians are aware of this potentially dire complication. Patients with low to intermediate risk for coronary artery disease with atypical presentation may benefit from obtaining detailed substance abuse history and urine drug screen if deemed necessary.

  9. 急性心肌缺血激光心肌血管重建术与碱性成纤维生长因子联合应用对心脏功能及心肌存活性影响的实验研究%Effects of transmyocardial laser revascularization combined with basic fibroblast growth factor on myocardial viability and cardiac function in dog models with acute myocardial ischemia

    Institute of Scientific and Technical Information of China (English)

    谢明星; 王新房; 朱向明; 杨娅; 吕清; 陈立新; 聂绍平; 蒋桔泉; 曹林生

    2003-01-01

    AIM:To assess the effects of transmyocardial laser revascularization (TMLR) combined with basic fibroblast growth factor-fibrin glue (bFGF-FG) on the myocardial viability and the cardiac regional and global function in dog models with acute myocardial ischemia (AMI). METHODS: Eighteen crossbred dogs were randomized to three groups. (AMI, TMLR and bFGF-FG groups). The occlusion of the left anterior descending artery (LAD) of all animals was created in order to develop acute ischemic myocardium models. TMLR procedure was carried out 30 minutes after coronary ligation in both TMLR and bFGF-FG groups, and afterward bFGF-FG was planted in laser channels in bFGF-FG group. 15 dogs underwent conventional and pulsed Doppler tissue imaging dobutamine stress echocardiography two months after LAD occlusion (other 3 dogs for each group died 42, 56 and 60 days after operation, respectively). RESULTS: There was no difference in the diameter of left atrium and ventricle among three groups (P>0.05). The regional and globe function parameters of the left ventricle improved in the TMLR and bFGF-FG groups gradually by turns, compared to the AMI group, of which there were significant differences in some variables among three groups (P0.05). CONCLUSION: TMLR can improve the perfusion of acute ischemic myocardium, and TMLR combined with bFGF-FG can enhance improvement of myocardial perfusion to maintain the viability of ischemic myocardium and prevent the cardiac regional and global function from advancing impairment in acute myocardial ischemia.%目的:评价急性心肌缺血激光心肌血管重建术(TMLR)与碱性成纤维生长因子纤维蛋白胶(bFGF-FG)联合应用对缺血心肌存活性及心脏局部和整体功能的影响.方法:18只健康杂种犬随机分为3组,即急性心肌缺血组(AMI组)、激光打孔组(TMLR组)和碱性成纤维生长因子组(bFGF-FG组).所在实验犬均结扎冠状动脉左前降支,建立急性心肌缺血模型.结扎后30 minTMLR组和b

  10. Protection of Puerarin on Oxidative Stress Induced by Acute Myocardial Ischemia-Reperfusion Injury in Rats in Cardiopulmonary Bypass%葛根素对大鼠体外循环后心肌缺血再灌注损伤的保护作用及抗氧化应激机制的探讨

    Institute of Scientific and Technical Information of China (English)

    巩红岩; 秦元旭; 王更富; 王庆志

    2012-01-01

    目的:探讨葛根素对大鼠体外循环后心肌缺血再灌注损伤(myocardial ischemia-reperfusion injury,MIRI)的保护作用及抗氧化应激机制.方法:取健康雄性SD大鼠75只,随机分为5组:即假手术组(给予等体积的生理盐水)、MIRI模型组(给予等体积的生理盐水)、葛根素低、中、高剂量组(2,5,10 mg·kg-13个剂量).于再灌注开始时在储血槽内加入稀释葛根素10mL.在全麻手术下制造大鼠体外循环模型后,随即阻断大鼠升主动脉造成心肌缺血30 min然后开放升主动脉后再灌注180 min造成大鼠心肌缺血再灌注损伤模型(灌注24 h,用于测定心肌梗死面积).实验组和对照组分别给予葛根素和生理盐水.实验完成后留取大鼠心脏标本,观察大鼠心肌缺血区的心肌细胞凋亡情况;收集血清测定其抗氧化应激的指标:超氧化物歧化酶(SOD),丙二醛(MDA),谷胱甘肽(GSH),谷胱甘肽过氧化物酶(GSH-Px).结果:与模型组相比,葛根素的应用减少了MIRI大鼠的心肌细胞凋亡、心梗面积和血清中丙二醛的含量,增加了血清中超氧化物歧化酶、谷胱甘肽过氧化物酶的活性和谷胱甘肽的含量,并且随着剂量的增加保护效果尤为明显.结论:葛根素对MIRI大鼠具有抗氧化应激的作用,它能够剂量依赖性的减少心肌细胞凋亡,最终减少心肌梗死面积.%Objective: To investigate the protective mechanism of puerarin on acute myocardial ischemia -reperfusion injury( MIRI) in rats, and to explain the antioxidative mechanism involved. Method: Rat MIRI model was induced by ischemia for 30 min and reperfusion for 180 min. At the end of the 3 h reperfusion period (or 24 h for infarct. Size ), myocardial infarct size, myocardial apoptosis and the activity of antioxidative enzymes were measured. Result: Puerarin reduced infarct size, myocardial apoptosisand the serum level of malondialdehyde, increased the activity of superoxide dismutase and glutathione

  11. Glucagon-like peptide-1 (7-36) but not (9-36) augments cardiac output during myocardial ischemia via a Frank-Starling mechanism.

    Science.gov (United States)

    Goodwill, Adam G; Tune, Johnathan D; Noblet, Jillian N; Conteh, Abass M; Sassoon, Daniel; Casalini, Eli D; Mather, Kieren J

    2014-01-01

    This study examined the cardiovascular effects of GLP-1 (7-36) or (9-36) on myocardial oxygen consumption, function and systemic hemodynamics in vivo during normal perfusion and during acute, regional myocardial ischemia. Lean Ossabaw swine received systemic infusions of saline vehicle or GLP-1 (7-36 or 9-36) at 1.5, 3.0, and 10.0 pmol/kg/min in sequence for 30 min at each dose, followed by ligation of the left circumflex artery during continued infusion at 10.0 pmol/kg/min. Systemic GLP-1 (9-36) had no effect on coronary flow, blood pressure, heart rate or indices of cardiac function before or during regional myocardial ischemia. Systemic GLP-1 (7-36) exerted no cardiometabolic or hemodynamic effects prior to ischemia. During ischemia, GLP-1 (7-36) increased cardiac output by approximately 2 L/min relative to vehicle-controls (p = 0.003). This response was not diminished by treatment with the non-depolarizing ganglionic blocker hexamethonium. Left ventricular pressure-volume loops measured during steady-state conditions with graded occlusion of the inferior vena cava to assess load-independent contractility revealed that GLP-1 (7-36) produced marked increases in end-diastolic volume (74 ± 1 to 92 ± 5 ml; p = 0.03) and volume axis intercept (8 ± 2 to 26 ± 8; p = 0.05), without any change in the slope of the end-systolic pressure-volume relationship vs. vehicle during regional ischemia. GLP-1 (9-36) produced no changes in any of these parameters compared to vehicle. These findings indicate that short-term systemic treatment with GLP-1 (7-36) but not GLP-1 (9-36) significantly augments cardiac output during regional myocardial ischemia, via increases in ventricular preload without changes in cardiac inotropy.

  12. Induced coronary spasm without electrocardiographic signs or symptoms of myocardial ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Cipriano, P.R.

    1983-03-01

    Angiographic studies have shown that coronary artery spasm can be induced with ergonovine maleate. Coronary artery spasm induced by ergonovine maleate in these studies was nearly always accompanied by chest pain and electrocardiographic changes of myocardial ischemia. This report demonstrates that coronary artery spasm induced by ergonovine maleate may be diagnosed by angiography in the absence of these signs or symptoms.

  13. CT of Coronary Heart Disease : Part 1, CT of Myocardial Infarction, Ischemia, and Viability

    NARCIS (Netherlands)

    Vliegenthart, Rozemarijn; Henzler, Thomas; Moscariello, Antonio; Ruzsics, Balazs; Bastarrika, Gorka; Oudkerk, Matthijs; Schoepf, U. Joseph

    2012-01-01

    OBJECTIVE. This article reviews the CT-based approaches aimed at the assessment of myocardial infarction, ischemia, and viability described in the recent literature. CONCLUSION. Rapid advances in CT technology not only have improved visualization of coronary arteries but also increasingly enable non

  14. Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Oki, Glaucia Celeste Rossatto [Clinica Diagnoson and Hospital Aristides Maltez, Salvador, BA (Brazil). Servicos de Medicina Nuclear; Pavin, Elizabeth Joao; Parisi, Maria Candida R. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Endocrinology; Coelho, Otavio Rizzi; Almeida, Raitany C. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Cardiology; Etchebehere, Elba Cristina Sa de Camargo; Ramos, Celso Dario, E-mail: cdramos@unicamp.br [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Radiology. Service of Nuclear Medicine; Camargo, Edwaldo Eduardo [Hospital Sirio-Libanes, Campinas, SP (Brazil). Service of Nuclear Medicine

    2013-01-15

    Objective: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1) and type 2 diabetes mellitus (DM2) without previous diagnoses of coronary artery disease (CAD) or cerebral infarction. Materials and Methods: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2) underwent myocardial perfusion scintigraphy with {sup 99m}Tc-sestamibi (MPS). They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. Results: MPS was abnormal in 15 patients (25.4%): 12 (20.3%) with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0), peripheral neuropathy (p = 0.028; OR = 6.1), nephropathy (p = 0.031; OR = 5.6), and stress ECG positive for ischemia (p = 0.049; OR = 4.08). Conclusion: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia. (author)

  15. Availability of a baseline Electrocardiogram changes the application of the Sclarovsky-Birnbaum Myocardial Ischemia Grade

    DEFF Research Database (Denmark)

    Carlsen, Esben A; Bang, Lia E; Køber, Lars;

    2014-01-01

    BACKGROUND AND AIMS: The electrocardiogram (ECG) based Sclarovsky-Birnbaum Ischemia Grade may be used to determine the prognosis of patients with ST-elevation myocardial infarction (STEMI). However, application of the method is based on assumption of the baseline QRS morphology. Thus, the aims of...

  16. [Antioxidant and cardioprotective effects of N-tyrosol in myocardial ischemia with reperfusion in rats].

    Science.gov (United States)

    Smol'iakova, V I; Chernyshova, G A; Plotnikov, M B; Aliev, O I; Krasnov, E A

    2010-01-01

    We demonstrated in experiments on rats with left coronary artery occlusion that intravenous administration of 20 mg/kg n-tyrosol during ischemia limited manifestations of oxidative stress in myocardial tissue during early post reperfusion period: content of diene and triene conjugates lowered 16 and 20%, respectively. This was associated with higher preservation of cardiomyocytes and reduction of the infarction zone.

  17. Electrocardiologic and related methods of non-invasive detection and risk stratification in myocardial ischemia: state of the art and perspectives

    Directory of Open Access Journals (Sweden)

    Seeck, Andrea

    2010-01-01

    Full Text Available Background: Electrocardiographic methods still provide the bulk of cardiovascular diagnostics. Cardiac ischemia is associated with typical alterations in cardiac biosignals that have to be measured, analyzed by mathematical algorithms and allegorized for further clinical diagnostics. The fast growing fields of biomedical engineering and applied sciences are intensely focused on generating new approaches to cardiac biosignal analysis for diagnosis and risk stratification in myocardial ischemia. Objectives: To present and review the state of the art in and new approaches to electrocardiologic methods for non-invasive detection and risk stratification in coronary artery disease (CAD and myocardial ischemia; secondarily, to explore the future perspectives of these methods. Methods: In follow-up to the Expert Discussion at the 2008 Workshop on "Biosignal Analysis" of the German Society of Biomedical Engineering in Potsdam, Germany, we comprehensively searched the pertinent literature and databases and compiled the results into this review. Then, we categorized the state-of-the-art methods and selected new approaches based on their applications in detection and risk stratification of myocardial ischemia. Finally, we compared the pros and cons of the methods and explored their future potentials for cardiology. Results: Resting ECG, particularly suited for detecting ST-elevation myocardial infarctions, and exercise ECG, for the diagnosis of stable CAD, are state-of-the-art methods. New exercise-free methods for detecting stable CAD include cardiogoniometry (CGM; methods for detecting acute coronary syndrome without ST elevation are Body Surface Potential Mapping, functional imaging and CGM. Heart rate variability and blood pressure variability analyses, microvolt T-wave alternans and signal-averaged ECG mainly serve in detecting and stratifying the risk for lethal arrythmias in patients with myocardial ischemia or previous myocardial infarctions

  18. Cardioprotective Effect of the Aqueous Extract of Lavender Flower against Myocardial Ischemia/Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Dong Wang

    2014-01-01

    Full Text Available This study was conducted to evaluate the cardioprotective property of the aqueous extract of lavender flower (LFAE. The myocardial ischemia/reperfusion (I/R injury of rat was prepared by Langendorff retrograde perfusion technology. The heart was preperfused with K-H solution containing LFAE for 10 min before 20 minutes global ischemia, and then the reperfusion with K-H solution was conducted for 45 min. The left ventricular developed pressure (LVDP and the maximum up/downrate of left ventricular pressure (±dp/dtmax were recorded by physiological recorder as the myocardial function and the myocardial infarct size was detected by TTC staining. Lactate dehydrogenase (LDH and creatine kinase (CK activities in the effluent were measured to determine the myocardial injury degree. The superoxide anion dismutase (SOD and malondialdehyde (MDA in myocardial tissue were detected to determine the oxidative stress degree. The results showed that the pretreatment with LFAE significantly decreased the myocardial infarct size and also decreased the LDH, CK activities, and MDA level, while it increased the LVDP, ±dp/dtmax, SOD activities, and the coronary artery flow. Our findings indicated that LFAE could provide protection for heart against the I/R injury which may be related to the improvement of myocardial oxidative stress states.

  19. The prognostic importance of creatinine clearance after acute myocardial infarction

    DEFF Research Database (Denmark)

    Sørensen, C R; Brendorp, B; Rask-Madsen, C

    2002-01-01

    AIMS: The purpose of this study was to assess renal dysfunction as an independent predictor of mortality after acute myocardial infarction. METHODS: The study population was 6252 patients with a myocardial infarction admitted alive from 1990 to 1992. The mortality status was obtained after at least.......9-1.3) respectively. CONCLUSION: Renal dysfunction is an important risk factor after acute myocardial infarction. When the risk is adjusted for available competing risk factors only severely reduced renal function is associated with an important and independent risk of mortality after acute myocardial infarction...

  20. Speckle tracking imaging in evaluation of radial strain of subendocardial and epicardial myocardium in canine acute myocardial ischemia and reperfusion%斑点追踪技术评价犬急性心肌缺血及再灌注心内膜下心肌和心外膜下心肌径向应变

    Institute of Scientific and Technical Information of China (English)

    宋平梅; 任卫东; 马春燕; 王秀芹; 乔伟

    2013-01-01

    Objective To evaluate the radial strain function of subendocardial and epicardial myocardium in acute myocardial ischemia and reperfusion canine with speckle tracking imaging. Methods The first diagonal branch of left coronary artery of 20 adult healthy hybrid dogs were ligated. Radial strain of subendocardial and epicardial myocardium at basal, apical and papillary muscle level were compared by speckle tracking imaging before ligation, ligation immediately, 60,120, 180 min after ligation, reperfusion immediately, and 60, 120 min after reperfusion, respectively. Results Radial strain of basal level elevated by compensatory role in canine acute ischemic process. Radial strain of apical and papillary muscle level decreased obviously. Myocardial reverse movement was even found at apical level. In acute ischemia and reperfusion process, subendocardial myocardium was more sensitive to ischemia. After reperfusion, radial strain of subendocardial and epicardial myocardium at apical and papillary muscle level were still lower than that in basic status. Conclusion Speckle tracking imaging can objectively quantify regional and overall heart function and transmural extent of myocardial infarction in canine.%目的 应用斑点追踪技术检测犬急性心肌缺血及再灌注不同时间点心内膜下心肌和心外膜下心肌的径向应变.方法 选取20只健康成年杂种犬,结扎左冠状动脉第一对角支,分别对结扎前、结扎即刻、60、120和180 min及再灌注即刻、60和120 min基底水平、乳头肌水平和心尖水平心内膜下和心外膜下心肌的径向应变进行比较.结果 在急性缺血过程中,基底水平心肌起代偿作用,其径向应变上升;乳头肌水平和心尖水平心肌下降明显,心尖水平心肌甚至出现反向运动.在急性缺血及再灌注过程中,心内膜下心肌对缺血更加敏感.再灌注后,乳头肌水平和心尖水平心内膜下和心外膜下心肌及跨壁的径向应变

  1. Effects on Heart Rate Variability of Acute Myocardial Ischemia Rabbits with Electro-acupuncture at Different Primary Point%电针不同原穴对急性心肌缺血家兔心率变异性的影响

    Institute of Scientific and Technical Information of China (English)

    蔡荣林; 胡玲; 吴子建; 何璐; 彭传玉

    2013-01-01

    Objective To observe the treatment effects on heart rate variability of electro-acupuncture at different primary point with acute myocardial ischemia rabbits. To investigate the specificity effects of adjusting cardiac function after electro-acupuncturing (EA) on different primary acupoints. Methods 56 healthy rabbits are selected,8 are chosen randomly as normal group. The odd rabbits were developed acute myocardial ischemia models by intravenous administration posterior pituitrin into femoral vein,and AMI model rabbits were randomly divided into model group,EA on HT7 group,EA on KI3 group,EA on PC7 group,EA on LR3 group and EA on nonpoint group,8 in each group. The heart rate variability were analyzed by BIOPAC system and then analysis the signals with HRV&BRS 2.00 software. Results The HR,RRI,TV,LF/HF of EA on HT7 group,PC7 group and LR3 group have significant differences comparing with model group (P0.05). Conclusion HT7 and PC7 have the best effect on the adjusting heart rate variability of acute myocardial ischemia rabbits,while LR3 has certain adjustment effect and KI 3 has not obvious effect.%目的:观察电针不同原穴对急性心肌缺血家兔心率变异性的影响,探讨不同原穴针刺效应的特异性。方法56只家兔随机分为正常对照组、模型对照组、电针“神门”组、电针“太冲”组、电针“大陵”组、电针“太溪”组和电针非经穴组,每组8只;经股静脉一次性注射垂体后叶素复制急性心肌缺血家兔模型,采用Biopac 生物信号采集系统检测心电信号,分析各组家兔各时间段心率变异性参数。结果急性心肌缺血模型复制后家兔的心率明显下降、R-R间期(R-R interval,RRI)、总变异性(Total variability,TV)及低频/高频(Low frequency/high frequency,LF/HF)明显升高,与正常对照组家兔比较差异有统计学意义(P0.05)。结论神门和心包经原穴大陵对急性心肌缺血家兔心率变异

  2. Effect and mechanism of salvianolic acid B on the myocardial ischemia-reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Ling Xue; Zhen Wu; Xiao-Ping Ji; Xia-Qing Gao; Yan-Hua Guo

    2014-01-01

    Objective: To investigate the effect of salvianolic acid B on rats with myocardial ischemia-reperfusion injury. Methods: SD rats were randomly divided into five groups (n=10 in each group): A sham operation group, B ischemic reperfusion group model group, C low dose salvianolic acid B group, D median dose salvianolic acid B group, E high dose salvianolic acid B group. One hour after establishment of the myocardial ischemia-reperfusion model, the concentration and the apoptotic index of the plasma level of myocardial enzymes (CTnⅠ, CK-MB), SOD, MDA, NO, ET were measured. Heart tissues were obtained and micro-structural changes were observed. Results: Compared the model group, the plasma CTnⅠ, CK-MB, MDA and ET contents were significantly increased, NO, T-SOD contents were decreased in the treatment group (group C, D, and E) (P<0.05); compared with group E, the plasma CTnⅠ, CK-MB, MDA and ET levels were increased, the NO, T-SOD levels were decreased in groups C and D (P<0.05). Infarct size was significantly reduced, and the myocardial ultrastructural changes were improved significantly in treatment group. Conclusions: Salvianolic acid B has a significant protective effect on myocardial ischemia-reperfusion injury. It can alleviate oxidative stress, reduce calcium overload, improve endothelial function and so on.

  3. Myocardial perfusion abnormality and effects of Ca channel blockers on myocardial ischemia in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Yoko [Kyoto Prefectural Univ. of Medicine (Japan)

    1997-03-01

    The purpose of this study was to investigate the frequency of myocardial ischemia and characteristic regions of myocardial hypoperfusion during stress in patients with hypertrophic cardiomyopathy. Furthermore, the effects of Ca channel blocker (verapamil, diltiazem) on myocardial ischemia were studied. One hundred patients with hypertrophic cardiomyopathy underwent exercise {sup 201}Tl SPECT. Sixty-eight patients had one or more {sup 201}Tl abnormalities. Of the 68 patients with {sup 201}Tl abnormalities, 56 had reversible {sup 201}Tl abnormalities and 12 had fixed defect. {sup 201}Tl abnormalities were frequently distributed in the anterior and posterior areas of junction between the ventricular septum and the free wall and the apex. Of the 56 patients with reversible {sup 201}Tl abnormalities, 40 patients underwent one more exercise {sup 201}Tl SPECT after 8 weeks of oral administration of verapamil or diltiazem. The {sup 201}Tl defect was visually scored as the defect score. Transient dilation index was calculated as an index of subendocardial ischemia. The mean defect score decreased significantly from 9.80{+-}4.35 to 5.50{+-}4.63 after verapamil and from 9.90{+-}5.17 to 5.50{+-}4.89 after diltiazem. Mean transient dilation index decreased from 1.20{+-}0.12 to 1.08{+-}0.09 after treatment with verapamil and from 1.16{+-}0.10 to 1.02{+-}0.09 after treatment with diltiazem. (K.H.)

  4. Prognostic importance of complete atrioventricular block complicating acute myocardial infarction

    DEFF Research Database (Denmark)

    Aplin, Mark; Engstrøm, Thomas; Vejlstrup, Niels G

    2003-01-01

    Third-degree atrioventricular block after acute myocardial infarction is considered to have prognostic importance. However, its importance in conjunction with thrombolytic therapy and its relation to left ventricular function remains uncertain. This report also outlines an important distinction...... between atrioventricular block in the setting of anterior and inferior wall acute myocardial infarction, with profound clinical and prognostic implications....

  5. Nanog expression in heart tissues induced by acute myocardial infarction.

    Science.gov (United States)

    Luo, Huanhuan; Li, Qiong; Pramanik, Jogen; Luo, Jiankai; Guo, Zhikun

    2014-10-01

    Nanog is a potential stem cell marker and is considered a regeneration factor during tissue repair. In the present study, we investigated expression patterns of nanog in the rat heart after acute myocardial infarction by semi-quantitative RT-PCR, immunohistochemistry and Western blot analyses. Our results show that nanog at both mRNA and protein levels is positively expressed in myocardial cells, fibroblasts and small round cells in different myocardial zones at different stages after myocardial infarction, showing a spatio-temporal and dynamic change. After myocardial infarction, the nanog expression in fibroblasts and small round cells in the infarcted zone (IZ) is much stronger than that in the margin zone (MZ) and remote infarcted zone (RIZ). From day 7 after myocardial infarction, the fibroblasts and small cells strongly expressed nanog protein in the IZ, and a few myocardial cells in the MZ and the RIZ and the numbers of nanog-positive fibroblasts and small cells reached the highest peak at 21 days after myocardial infarction, but in this period the number of nanog-positive myocardial cells decreased gradually. At 28 days after myocardial infarction, the numbers of all nanog-positive cells decreased into a low level. Therefore, our data suggest that all myocardial cells, fibroblasts and small round cells are involved in myocardial reconstruction after cardiac infarction. The nanog-positive myocardial cells may respond to early myocardial repair, and the nanog-positive fibroblasts and small round cells are the main source for myocardial reconstruction after cardiac infarction.

  6. Multiple coronary arterial loops as a cause of myocardial ischemia

    Science.gov (United States)

    Bashour, Tali T.; Mansour, Nagi N.; Lee, Damon

    1993-01-01

    A case of long-standing angina with ischemia documented by exercise testing and thallium scintigraphy in a patient who had multiple proximal loops in all three major coronary arteries in the absence of luminal stenosis, is reported.

  7. Systemic inflammatory response following acute myocardial infarction.

    Science.gov (United States)

    Fang, Lu; Moore, Xiao-Lei; Dart, Anthony M; Wang, Le-Min

    2015-05-01

    Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Inflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction (AMI). Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes (such as death, recurrent myocardial infarction, and heart failure) in patients with AMI.

  8. Systemic inflammatory response following acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Lu FANG; Xiao-Lei Moore; Anthony M Dart; Le-Min WANG

    2015-01-01

    Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Inflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction (AMI). Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes (such as death, recurrent myocardial in-farction, and heart failure) in patients with AMI.

  9. Low dose metoprolol in acute myocardial infarction.

    Science.gov (United States)

    Kumar, K P; Krishnaswami, S; Prasad, N K; Rath, P C; Jose, J

    1989-01-01

    A study of the effects of low dose Metoprolol was undertaken in 37 patients with acute myocardial infarction. These patients were randomly divided into three groups depending on the dose of the drug per kg body weight. Group I, consisting of 18 patients, received 0.36 to 0.65 mg per kg per day, Group II (10 patients) received 0.66 to 0.99 mg/kg/day, and Group III (9 patients) 1 to 1.81 mg/kg/day. To assess the degree of beta blockade achieved, the parameters that were evaluated were the fall in blood pressure and heart rate. There was a fall in systolic blood pressure which ranged from 7 to 17%, and fall in heart rate of 6.6 to 12.8% in the 3 groups over the 48-hour study period. These observations were compared with the results obtained from the Goteberg Metoprolol trial and Metoprolol in acute myocardial infarction (MIAMI) trials wherein 200 mg of Metoprolol per day were used. Our preliminary observations suggest that Indian patients may not need such a high dose, and Metoprolol at 50-100 mg per day would probably be sufficient to get the desired effect.

  10. The usefulness of {sup 123}I-BMIPP myocardial SPECT in diagnosis for silent myocardial ischemia induced by vasospasm

    Energy Technology Data Exchange (ETDEWEB)

    Kawasaki, Tatsuya; Ito, Kazuki; Okano, Akira; Nagata, Kazuhiro; Yoneyama, Satoshi; Katoh, Shuji [Asahi Univ., Gifu (Japan). Murakami Memorial Hospital; Sugihara, Hiroki

    1999-01-01

    This study was designed to evaluate the clinical usefulness of {sup 123}I-BMIPP myocardial SPECT in patients with silent myocardial ischemia induced by vasospasm. Ultrasonic echocardiography (UCG), Holter electrocardiogram recording (Holter ECG), exercise {sup 201}Tl myocardial SPECT (EX-Tl) and rest {sup 123}I-BMIPP myocardial SPECT (BMIPP) were performed in 8 patients with asymptomatic vasospasm without history of myocardial infarction. The sensitivity of each modality in detecting coronary artery spasm was 37.5% (3 of 8 cases) for UCG, 37.5% (3 of 8 cases) in Holter ECG, 25.0% (2 of 8 cases) in Ex-Tl, 62.5% (5 of 8 cases) on initial BMIPP images and 75.0% (6 of 8 cases) on delayed BMIPP images. Severity of regional left ventricular wall motion abnormality in UCG correlated with the severity of regionally decreased tracer uptake in BMIPP. The washout rate of BMIPP was 18.7{+-}2.4 in normal controls, 32.4{+-}5.9 in asymptomatic vasospasm, and 38.2{+-}4.0 in asymptomatic vasospasm with abnormal left ventricular wall motion. It was suggested that {sup 123}I-BMIPP myocardial SPECT might be useful for assessing asymptomatic vasospasm. (author)

  11. Coxsackie and adenovirus receptor is a modifier of cardiac conduction and arrhythmia vulnerability in the setting of myocardial ischemia. : Coxsackie and adenovirus receptor is a modifier of cardiac conduction and arrhythmia vulnerability in the setting of myocardial ischemia.

    NARCIS (Netherlands)

    Marsman, Roos F; Bezzina, Connie R; Freiberg, Fabian; Verkerk, Arie O; Adriaens, Michiel E; Podliesna, Svitlana; Chen, Chen; Purfürst, Bettina; Spallek, Bastian; Koopmann, Tamara T; Baczko, Istvan; Dos Remedios, Cristobal G; George, Alfred L; Bishopric, Nanette H; Lodder, Elisabeth M; de Bakker, Jacques M; Fischer, Robert; Coronel, Ruben; Wilde, Arthur A; Gotthardt, Michael; Remme, Carol A

    2014-01-01

    The aim of this study was to investigate the modulatory effect of the coxsackie and adenovirus receptor (CAR) on ventricular conduction and arrhythmia vulnerability in the setting of myocardial ischemia.

  12. Protective Effects of L-Malate against Myocardial Ischemia/Reperfusion Injury in Rats

    Directory of Open Access Journals (Sweden)

    Shiao Ding

    2016-01-01

    Full Text Available Objective. To investigate the protective effects of L-malate against myocardial ischemia/reperfusion (I/R injury in rats. Methods. Male Sprague-Dawley rats were randomly assigned to the following groups: sham (sham, an ischemia/reperfusion (I/R model group (model, an DMF pretreated group (DMF, and 5 L-malate pretreated groups (15, 60, 120, 240, or 480 mg/kg, gavage before inducing myocardial ischemia. Plasma LDH, cTn-I, TNF-α, hs-CRP, SOD, and GSH-PX were measured 3 h later I/R. Areas of myocardial infarction were measured; hemodynamic parameters during I/R were recorded. Hearts were harvested and Western blot was used to quantify Nrf2, Keap1, HO-1, and NQO-1 expression in the myocardium. Results. L-malate significantly reduced LDH and cTn-I release, reduced myocardial infarct size, inhibited expression of inflammatory cytokines, and partially preserved heart function, as well as increasing antioxidant activity after myocardial I/R injury. Western blot confirmed that L-malate reduced Kelch-like ECH-associated protein 1 in ischemic myocardial tissue, upregulated expression of Nrf2 and Nrf2 nuclear translocation, and increased expression of heme oxygenase-1 and NAD(PH:quinone oxidoreductase 1, which are major targets of Nrf2. Conclusions. L-malate may protect against myocardial I/R injury in rats and this may be associated with activation of the Nrf2/Keap1 antioxidant pathway.

  13. Timing and duration of myocardial ischemia on Holter monitoring following percutaneous coronary intervention and their association with clinical outcomes (a PROTECT-TIMI 30 Substudy Analysis).

    Science.gov (United States)

    Gibson, C Michael; Pride, Yuri B; Buros, Jacqueline L; Ciaglo, Lauren N; Morrow, David A; Scirica, Benjamin M; Stone, Peter H

    2009-07-01

    In patients with unstable angina, evidence of myocardial ischemia on Holter monitoring is associated with an adverse prognosis. However, the association of duration and timing of ischemia on Holter monitoring with outcomes after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes (NSTEACSs) has not been systematically evaluated. PROTECT-TIMI 30 randomized 857 patients with NSTEACSs undergoing PCI to eptifibatide plus a heparin product or bivalirudin monotherapy. Patients underwent continuous Holter monitoring following PCI, and the association between ischemia and clinical outcomes was evaluated retrospectively. Forty-three patients (5.0%) had ischemia on Holter after PCI. Any ischemia was associated with a significant increase in the incidence of death or myocardial infarction (MI) within 48 hours (32.6% vs 6.1%, odds ratio 7.5, 95% confidence interval 3.70 to 15.10, p Holter monitoring is associated with an increased incidence of death or MI. Holter monitoring may be a useful surrogate end point in clinical trials.

  14. Nitroglycerine induced acute myocardial infarction in a patient with myocardial bridging

    DEFF Research Database (Denmark)

    Rujic, Dragana; Nielsen, Mette Lundgren; Veien, Karsten Tange

    2014-01-01

    Muscle overlying an intramyocardial segment of a coronary artery is termed a myocardial bridge. The intramyocardial segment, the tunneled artery, is compressed during systole. The condition is generally benign but may occasionally cause myocardial ischemia, infarction, arrhythmia, or sudden cardiac...... death. We present a case regarding a 52-year-old man with exercise-induced angina who was diagnosed with a myocardial bridge overlying the left anterior descending artery. He was initially treated with beta-blockers and later received coronary bypass graft surgery....

  15. Acute limb ischemia in cancer patients: should we surgically intervene?

    LENUS (Irish Health Repository)

    Tsang, Julian S

    2012-02-01

    BACKGROUND: Cancer patients have an increased risk of venous thromboembolic events. Certain chemotherapeutic agents have also been associated with the development of thrombosis. Reported cases of acute arterial ischemic episodes in cancer patients are rare. METHODS: Patients who underwent surgery for acute limb ischemia associated with malignancy in a university teaching hospital over a 10-year period were identified. Patient demographics, cancer type, chemotherapy use, site of thromboembolism, treatment and outcome were recorded. RESULTS: Four hundred nineteen patients underwent surgical intervention for acute arterial ischemia, 16 of these patients (3.8%) had associated cancer. Commonest cancer sites were the urogenital tract (n = 5) and the lungs (n = 5). Eight patients (50%) had been recently diagnosed with cancer, and four (25%) of these cancers were incidental findings after presentation with acute limb ischemia. Four patients (25%) developed acute ischemia during chemotherapy. The superficial femoral artery was the most frequent site of occlusion (50%), followed by the brachial (18%) and popliteal (12%) arteries. All patients underwent thromboembolectomy, but two (12%) patients subsequently required a bypass procedure. Six patients (37%) had limb loss, and in-patient mortality was 12%. Histology revealed that all occlusions were due to thromboembolism, with no tumor cells identified. At follow-up, 44% of patients were found to be alive after 1 year. CONCLUSION: Cancer and chemotherapy can predispose patients to acute arterial ischemia. Unlike other reports that view this finding as a preterminal event most appropriately treated by palliative measures, in this series, early diagnosis and surgical intervention enabled limb salvage and patient survival.

  16. MG132 Inhibits Myocardial Ischemia-reperfusion Injury by Regulating Apoptotic Pathway

    Institute of Scientific and Technical Information of China (English)

    Dai Cuilian; Luo Kailiang; Chen Zhangrong

    2007-01-01

    Objectives To administrated proteasome inhibitor-MG-132 prior to reperfusion in rat myocardial ischemia-reperfusion model to determine whether MG-132 could reduce myocytic apoptosis. Methods and results MG-132 (0.75 mg/kg in 2 ml DMSO) injection 5 min prior to reperfusion resulted significant reduction of myocardial reperfusion injury. This effect was accompanied by reduced polymorphonuclear neutrophils(PMN) infiltration in myocardial region surrounding the myocardial infarct, reduced apoptosis in cardiac myocytes, reduced NF-κB activation, as determined by electron microscopy, histology, immunohistochemistry, the terminal deoxynucleotidyl transferase-mediated nick endlabeling (TUNEL) method, reverse transcription-polymerase chain reaction. Functional effects of MG-132 on PMN accumulation, activation of nuclear factor kappa B(p65 mRNA and protein levels ), and apoptosis were characterized in rat myocardial tissue. MG132 time-dependently inhibited myocardial p65 mRNA expression and reduced myocardial apoptotic index (AI) after reperfusion for 2 h, 6 h and 24 h ( P<0.01 ). Moreover, MG-132 time-dependently decreased Bax protein levels, while increased Bcl-2 protein levels in ischemic and reperfused myocardium ( P<0.05 ), its effect peaked after reperfusion for 24 h. Conclusions Our results demonstrate that MG-132 reduced myocardial reperfusion injury by inhibiting myosytic apoptotic cell death and blocking activation of NF-κB, down-regulating Bax expression and up-regulating Bcl-2 expression as well as elevating Bcl-2/Bax ratio.

  17. Intestinal Ischemia

    Science.gov (United States)

    ... some generally recognized patterns. Symptoms of acute intestinal ischemia Signs and symptoms of acute intestinal ischemia typically ... confusion in older adults Symptoms of chronic intestinal ischemia Signs and symptoms of chronic intestinal ischemia can ...

  18. Protective Effects of Millettia Pulchra Flavonoids on Myocardial Ischemia In Vitro and In Vivo

    Directory of Open Access Journals (Sweden)

    Jianchun Huang

    2015-01-01

    Full Text Available Background: Previous studies have demonstrated that Millettia pulchra flavonoids (MPF exhibit protective effects on myocardial ischemia reperfusion injury (MI/RI in isolated rat hearts and show anti-oxidative, anti-hypoxic and anti-stress properties. Methods: In this study, the cardioprotective effects of MPF on myocardial ischemia and its underlying mechanisms were investigated by a hypoxia/ reoxygenation (H/R injury model in vitro and a rat MI/RI model in vivo. Results: We found that the lactate dehydrogenase (LDH and inducible nitric oxide synthase (iNOS activities were decreased in the MPF pretreatment group, whereas the activities of constructional nitric oxide synthase (cNOS, total nitric oxide synthase (tNOS, Na+-K+-ATPase and Ca2+-Mg2+-ATPase were significantly increased. In addition, the cardiocytes were denser in the MPF groups than in the control group. The mortality rate and apoptosis rate of cardiocytes were significantly decreased. Furthermore, pretreatment with MPF in vivo significantly improved the hemodynamics, decreased malondialdehyde (MDA abundance, increased the activities of plasma superoxide dismutase (SOD and glutathione peroxidase (GSH-Px and decreased the expression of the Bax protein and ratio Bax/Bc1-2 ration. Conclusions: These results suggest that MPF is an attractive protective substance in myocardial ischemia due to its negative effects on heart rate and ionotropy, reduction of myocardial oxidative damage and modulation of gene expression associated with apoptosis.

  19. Treatment of chronical myocardial ischemia by adenovirus-mediated hypatocyte growth factor gene transfer in minipigs

    Institute of Scientific and Technical Information of China (English)

    YUAN Biao; ZHANG YouRong; ZHAO Zhong; WU DanLi; YUAN LiZhen; WU Bin; WANG LiSheng; HUANG Jun

    2008-01-01

    Growth factor gene transfer-induced therapeutic angiogenesis has become a novel approach for the treatment of myocardial ischemia. In order to provide a basis for the clinical application of an adeno-virus with hepatocyte growth factor gene (Ad-HGF) in the treatment of myocardial ischemia, we estab-lished a minipig model of chronically ischemic myocardium in which an Ameroid constrictor was placed around the left circumflex branch of the coronary artery (LCX). A total of 18 minipigs were ran-domly divided into 3 groups: a surgery control group, a model group and an Ad-HGF treatment group implanted with Ameroid constrictor. Ad-HGF or the control agent was injected directly into the ischemic myocardium, and an improvement in heart function and blood supply were evaluated. The results showed that myocardial perfusion remarkably improved in the Ad-HGF group compared with that in both the control and model groups. Four weeks after the treatment, the density of newly formed blood vessels was higher and the number of collateral blood vessels was greater in the Ad-HGF group than in the model group. The area of myocardial ischemia reduced evidently and the left ventricular ejection fraction improved significantly in the Ad-HGF group. These results suggest that HGF gene therapy may become a novel approach in the treatment of chronically ischemic myocardium.

  20. Treatment of chronical myocardial ischemia by adenovirus-mediated hepatocyte growth factor gene transfer in minipigs

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Growth factor gene transfer-induced therapeutic angiogenesis has become a novel approach for the treatment of myocardial ischemia. In order to provide a basis for the clinical application of an adeno- virus with hepatocyte growth factor gene (Ad-HGF) in the treatment of myocardial ischemia, we estab- lished a minipig model of chronically ischemic myocardium in which an Ameroid constrictor was placed around the left circumflex branch of the coronary artery (LCX). A total of 18 minipigs were ran- domly divided into 3 groups: a surgery control group, a model group and an Ad-HGF treatment group implanted with Ameroid constrictor. Ad-HGF or the control agent was injected directly into the ischemic myocardium, and an improvement in heart function and blood supply were evaluated. The results showed that myocardial perfusion remarkably improved in the Ad-HGF group compared with that in both the control and model groups. Four weeks after the treatment, the density of newly formed blood vessels was higher and the number of collateral blood vessels was greater in the Ad-HGF group than in the model group. The area of myocardial ischemia reduced evidently and the left ventricular ejection fraction improved significantly in the Ad-HGF group. These results suggest that HGF gene therapy may become a novel approach in the treatment of chronically ischemic myocardium.

  1. Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H; Pless, P; Nielsen, J R

    1992-01-01

    In order to investigate whether thrombolysis affects residual myocardial ischaemia, we prospectively performed a predischarge maximal exercise test and early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men surviving a first acute myocardial infarction (AMI). Seventy...... less than 0.02). Thrombolysis resulted in a non-significant reduction in exercise-induced ST segment depression: prevalence 43% vs 62% in controls. However, during ambulatory monitoring the duration of transient myocardial ischaemia was significantly reduced in thrombolysed patients: 322 min vs 1144...... myocardial ischaemia. This may explain the improvement in myocardial function during physical activities, which was also observed in this study....

  2. The additional value of first pass myocardial perfusion imaging during peak dose of dobutamine stress cardiac MRI for the detection of myocardial ischemia

    NARCIS (Netherlands)

    Lubbers, Daniel D.; Janssen, Caroline H. C.; Kuijpers, Dirkjan; Van Dijkman, Paul R. M.; Overbosch, Jelle; Willems, Tineke P.; Oudkerk, Matthijs

    2008-01-01

    Purpose of this study was to assess the additional value of first pass myocardial perfusion imaging during peak dose of dobutamine stress Cardiac-MR (CMR). Dobutamine Stress CMR was performed in 115 patients with an inconclusive diagnosis of myocardial ischemia on a 1.5 T system (Magnetom Avanto, Si

  3. Nonuniform loss of regional flow reserve during myocardial ischemia in dogs.

    Science.gov (United States)

    Coggins, D L; Flynn, A E; Austin, R E; Aldea, G S; Muehrcke, D; Goto, M; Hoffman, J I

    1990-08-01

    To determine whether coronary vasodilator reserve that persists during myocardial ischemia is present in all left ventricular regions, we measured regional blood flow in 192 left ventricular pieces (mean weight, 201 mg) in each of eight dogs by using radioactive microspheres while perfusing the left main coronary artery at 70, 50, 40, and 30 mm Hg. Flows were measured before and during adenosine infusion to determine flow reserve. Perfusion at 40 and 30 mm Hg produced ischemia in all dogs. At 70 mm Hg, 100% of left ventricular regions had significant flow reserve, compared with 92%, 55%, and 8% during perfusion at 50, 40, and 30 mm Hg, respectively. A greater amount of flow reserve and a greater number of regions responded to adenosine in the subepicardium than in the subendocardium at 50, 40, and 30 mm Hg. We conclude that coronary flow reserve persists in only a subset of left ventricular regions during ischemia and that the number of regions with persistent flow reserve decreases with perfusion pressure. These findings may best be explained by a model in which regional ischemia is a maximal coronary vasodilator and persistent pharmacological vasodilator reserve seen when global markers indicate ischemia simply reflects persistent endogenous flow reserve in myocardial regions not yet ischemic.

  4. Glaucocalyxin A Ameliorates Myocardial Ischemia-Reperfusion Injury in Mice by Suppression of Microvascular Thrombosis

    Science.gov (United States)

    Liu, Xiaohui; Xu, Dongzhou; Wang, Yuxin; Chen, Ting; Wang, Qi; Zhang, Jian; You, Tao; Zhu, Li

    2016-01-01

    Background The aim of this study was to evaluate the cardio-protective roles of glaucocalyxin A (GLA) in myocardial ischemia-reperfusion injury and to explore the underlying mechanism. Material/Methods Myocardial ischemia-reperfusion in wild-type C57BL/6J mice was induced by transient ligation of the left anterior descending artery. GLA or vehicle (solvent) was administrated intraperitoneally to the mice before reperfusion started. After 24 h of myocardial reperfusion, ischemic size was revealed by Evans blue/TTC staining. Cardiac function was evaluated by echocardiography and microvascular thrombosis was assessed by immunofluorescence staining of affected heart tissue. We also measured the phosphorylation of AKT, ERK, P-GSK-3β, and cleaved caspase 3 in the myocardium. Results Compared to the solvent-treated control group, GLA administration significantly reduced infarct size (GLA 13.85±2.08% vs. Control 18.95±0.97%, p<0.05) and improved left ventricular ejection fraction (LVEF) (GLA 53.13±1.11% vs. Control 49.99±1.25%, p<0.05) and left ventricular fractional shortening (LVFS) (28.34±0.71% vs. Control 25.11±0.74%, p<0.05) in mice subjected to myocardial ischemia-reperfusion. GLA also attenuated microvascular thrombosis (P<0.05) and increased the phosphorylation of pro-survival kinase AKT (P<0.05) and GSK-3β (P<0.05) in the myocardium upon reperfusion injury. Conclusions Administration of GLA before reperfusion ameliorates myocardial ischemia-reperfusion injury in mice. The cardio-protective roles of GLA may be mediated through the attenuation of microvascular thrombosis. PMID:27716735

  5. Inhibition of Fas-associated death domain-containing protein (FADD protects against myocardial ischemia/reperfusion injury in a heart failure mouse model.

    Directory of Open Access Journals (Sweden)

    Qian Fan

    Full Text Available AIM: As technological interventions treating acute myocardial infarction (MI improve, post-ischemic heart failure increasingly threatens patient health. The aim of the current study was to test whether FADD could be a potential target of gene therapy in the treatment of heart failure. METHODS: Cardiomyocyte-specific FADD knockout mice along with non-transgenic littermates (NLC were subjected to 30 minutes myocardial ischemia followed by 7 days of reperfusion or 6 weeks of permanent myocardial ischemia via the ligation of left main descending coronary artery. Cardiac function were evaluated by echocardiography and left ventricular (LV catheterization and cardiomyocyte death was measured by Evans blue-TTC staining, TUNEL staining, and caspase-3, -8, and -9 activities. In vitro, H9C2 cells transfected with ether scramble siRNA or FADD siRNA were stressed with chelerythrin for 30 min and cleaved caspase-3 was assessed. RESULTS: FADD expression was significantly decreased in FADD knockout mice compared to NLC. Ischemia/reperfusion (I/R upregulated FADD expression in NLC mice, but not in FADD knockout mice at the early time. FADD deletion significantly attenuated I/R-induced cardiac dysfunction, decreased myocardial necrosis, and inhibited cardiomyocyte apoptosis. Furthermore, in 6 weeks long term permanent ischemia model, FADD deletion significantly reduced the infarct size (from 41.20 ± 3.90% in NLC to 26.83 ± 4.17% in FADD deletion, attenuated myocardial remodeling, improved cardiac function and improved survival. In vitro, FADD knockdown significantly reduced chelerythrin-induced the level of cleaved caspase-3. CONCLUSION: Taken together, our results suggest FADD plays a critical role in post-ischemic heart failure. Inhibition of FADD retards heart failure progression. Our data supports the further investigation of FADD as a potential target for genetic manipulation in the treatment of heart failure.

  6. Acute non-ST elevation myocardial infarction following paclitaxel administration for ovarian carcinoma: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Kajal Shah

    2012-01-01

    Full Text Available We report a case of an acute non-ST elevation myocardial infarction (AMI induced by paclitaxel in a patient with ovarian cancer. A 45-year-old premenopausal lady without any co-morbidity was started on the first cycle of neoadjuvant chemotherapy with paclitaxel-based regimen for advanced stage ovarian cancer. The patient developed chest pain 3 h after paclitaxel infusion with characteristic electrocardiographic changes of antero-apical myocardial infarction. The patient recovered on conservative medical management with reversion of electrocardiogram (ECG changes. Cardiac ischemia and myocardial infarction, possibly due to coronary vasospasm, are rare adverse effects of paclitaxel with reported incidence of 0.26%. We have reported a case of paclitaxel-induced myocardial infarction with reversible cardiac dysfunction. The possibility of myocardial infarction should be considered in patients who develop chest pain or other symptoms after paclitaxel infusion.

  7. [The effect of metformin on myocardial tolerance to ischemia in rats with diabetes mellitus type 2].

    Science.gov (United States)

    Kravchuk, E N; Grineva, E N; Galagudza, M M; Bairamov, A A

    2013-01-01

    The effect of metformin on myocardial sensitivity to ischemia in rats with neonatal streptozotocin T2DM was investigated using the model of global ischemia-reperfusion in the isolated perfused heart. Metformin administration had no effect on infarct size. At the same time, infarct size in T2DM was significantly lower than in controls, which is indicative of the phenomenon of metabolic preconditioning in T2DM. The protocol of metformin administration used in this study had not afforded a significant cardioprotective effect in animals with T2DM.

  8. Myocardial glucose transporters and glycolytic metabolism during ischemia in hyperglycemic diabetic swine.

    Science.gov (United States)

    Stanley, W C; Hall, J L; Smith, K R; Cartee, G D; Hacker, T A; Wisneski, J A

    1994-01-01

    We assessed the effects of 4 weeks of streptozocin-induced diabetes on regional myocardial glycolytic metabolism during ischemia in anesthetized open-chest domestic swine. Diabetic animals were hyperglycemic (12.0 +/- 2.1 v 6.6 +/- .5 mmol/L), and had lower fasting insulin levels (27 +/- 8 v 79 +/- 19 pmol/L). Myocardial glycolytic metabolism was studied with coronary flow controlled by an extracorporeal perfusion circuit. Left anterior descending coronary artery (LAD) flow was decreased by 50% for 45 minutes and left circumflex (CFX) flow was constant. Myocardial glucose uptake and extraction were measured with D-[6-3H]-2-deoxyglucose (DG) and myocardial blood flow was measured with microspheres. The rate of glucose conversion to lactate and lactate uptake and output were assessed with a continuous infusion of [6-14C]glucose and [U-13C]lactate into the coronary perfusion circuit. Both diabetic and nondiabetic animals had sharp decreases in subendocardial blood flow during ischemia (from 1.21 +/- .10 to 0.43 +/- .08 mL.g-1.min-1 in the nondiabetic group, and from 1.30 +/- .15 to 0.55 +/- .11 in the diabetic group). Diabetes had no significant effect on myocardial glucose uptake or glucose conversion to lactate under either well-perfused or ischemic conditions. Forty-five minutes of ischemia resulted in significant glycogen depletion in the subendocardium in both nondiabetic and diabetic animals, with no differences between the two groups. Glycolytic metabolism is not impaired in hyperglycemic diabetic swine after 1 month of the disease when compared with that in normoglycemic nondiabetic animals. The myocardial content of the insulin-regulatable glucose transporter (GLUT 4) was measured in left ventricular biopsies.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Copeptin Testing in Acute Myocardial Infarction: Ready for Routine Use?

    Directory of Open Access Journals (Sweden)

    Sebastian Johannes Reinstadler

    2015-01-01

    Full Text Available Suspected acute myocardial infarction is one of the leading causes of admission to emergency departments. In the last decade, biomarkers revolutionized the management of patients with suspected acute coronary syndromes. Besides their pivotal assistance in timely diagnosis, biomarkers provide additional information for risk stratification. Cardiac troponins I and T are the most sensitive and specific markers of acute myocardial injury. Nonetheless, in order to overcome the remaining limitations of these markers, novel candidate biomarkers sensitive to early stage of disease are being extensively investigated. Among them, copeptin, a stable peptide derived from the precursor of vasopressin, emerged as a promising biomarker for the evaluation of suspected acute myocardial infarction. In this review, we summarize the currently available evidence for the usefulness of copeptin in the diagnosis and risk stratification of patients with suspected acute myocardial infarction in comparison with routine biomarkers.

  10. Acute myocardial infarction in the obstetric patient.

    Science.gov (United States)

    Firoz, Tabassum; Magee, Laura A

    2012-06-01

    Acute myocardial infraction (AMI) in the obstetric patient is a rare event, although the incidence is rising due to advancing maternal age and pre-existing cardiac risk factors and medical co-morbidities. While atherosclerotic disease is the leading cause of AMI, coronary artery dissection is an important consideration in pregnancy and in the postpartum period. The physiological changes of pregnancy as well as pregnancy-specific risk factors can predispose the obstetric patient to AMI. Diagnosis of AMI can be challenging as symptoms may be atypical. Furthermore, diagnostic tests must be interpreted in the context of pregnancy. While the overall management of the obstetric patient with AMI is similar to that outside of pregnancy, drug therapy requires modification as some medications may be contraindicated in pregnancy and breastfeeding. There is limited information about prognosis and risk stratification but it is anticipated that future studies will address this issue.

  11. PET/CT Imaging in Mouse Models of Myocardial Ischemia

    Directory of Open Access Journals (Sweden)

    Sara Gargiulo

    2012-01-01

    Full Text Available Different species have been used to reproduce myocardial infarction models but in the last years mice became the animals of choice for the analysis of several diseases, due to their short life cycle and the possibility of genetic manipulation. Many techniques are currently used for cardiovascular imaging in mice, including X-ray computed tomography (CT, high-resolution ultrasound, magnetic resonance imaging, and nuclear medicine procedures. Cardiac positron emission tomography (PET allows to examine noninvasively, on a molecular level and with high sensitivity, regional changes in myocardial perfusion, metabolism, apoptosis, inflammation, and gene expression or to measure changes in anatomical and functional parameters in heart diseases. Currently hybrid PET/CT scanners for small laboratory animals are available, where CT adds high-resolution anatomical information. This paper reviews mouse models of myocardial infarction and discusses the applications of dedicated PET/CT systems technology, including animal preparation, anesthesia, radiotracers, and images postprocessing.

  12. Cardioprotection and pharmacological therapies in acute myocardial infarction: Challenges in the current era.

    Science.gov (United States)

    Dominguez-Rodriguez, Alberto; Abreu-Gonzalez, Pedro; Reiter, Russel J

    2014-03-26

    In patients with an acute ST-segment elevation myocardial infarction, timely myocardial reperfusion using primary percutaneous coronary intervention is the most effective therapy for limiting myocardial infarct size, preserving left-ventricular systolic function and reducing the onset of heart failure. Within minutes after the restoration of blood flow, however, reperfusion itself results in additional damage, also known as myocardial ischemia-reperfusion injury. An improved understanding of the pathophysiological mechanisms underlying reperfusion injury has resulted in the identification of several promising pharmacological (cyclosporin-A, exenatide, glucose-insulin-potassium, atrial natriuretic peptide, adenosine, abciximab, erythropoietin, metoprolol and melatonin) therapeutic strategies for reducing the severity of myocardial reperfusion injury. Many of these agents have shown promise in initial proof-of-principle clinical studies. In this article, we review the pathophysiology underlying myocardial reperfusion injury and highlight the potential pharmacological interventions which could be used in the future to prevent reperfusion injury and improve clinical outcomes in patients with coronary heart disease.

  13. Inhibition of ALDH2 by O-GlcNAcylation contributes to the hyperglycemic exacerbation of myocardial ischemia/reperfusion injury.

    Science.gov (United States)

    Liu, Baoshan; Wang, Jiali; Li, Minghua; Yuan, Qiuhuan; Xue, Mengyang; Xu, Feng; Chen, Yuguo

    2016-12-27

    Although hyperglycemia is causally related to adverse outcomes after myocardial ischemia/reperfusion (I/R), the underlying mechanisms are largely unknown. Here, we investigated whether excessive O-linked-N-acetylglucosamine (O-GlcNAc) modification of acetaldehyde dehydrogenase 2 (ALDH2), an important cardioprotective enzyme, was a mechanism for the hyperglycemic exacerbation of myocardial I/R injury. Both acute hyperglycemia (AHG) and diabetes (DM)-induced chronic hyperglycemia increased cardiac dysfunction, infarct size and apoptosis index compared with normal saline (NS)+I/R rats (PO-GlcNAc modification was increased whereas its activity was decreased in AHG+I/R and DM+I/R rats. High glucose (HG, 30mmol/L) markedly increased ALDH2 O-GlcNAc modification compared with Con group (5mmol/L) (PO-GlcNAc modification was increased by 62.9% in Con+PUGNAc group whereas it was decreased by 44.1% in Con+DON group compared with Con group (PO-GlcNAc modification and improved infarct size, apoptosis index and cardiac dysfunction induced by I/R combined with hyperglycemia. These findings demonstrate that ALDH2 O-GlcNAc modification is a key mechanism for the hyperglycemic exacerbation of myocardial I/R injury and Alda-1 has therapeutic potential for inducing cardioprotection.

  14. Nanoparticle-Mediated Delivery of Irbesartan Induces Cardioprotection from Myocardial Ischemia-Reperfusion Injury by Antagonizing Monocyte-Mediated Inflammation

    Science.gov (United States)

    Nakano, Yasuhiro; Matoba, Tetsuya; Tokutome, Masaki; Funamoto, Daiki; Katsuki, Shunsuke; Ikeda, Gentaro; Nagaoka, Kazuhiro; Ishikita, Ayako; Nakano, Kaku; Koga, Jun-Ichiro; Sunagawa, Kenji; Egashira, Kensuke

    2016-07-01

    Myocardial ischemia-reperfusion (IR) injury limits the therapeutic effect of early reperfusion therapy for acute myocardial infarction (AMI), in which the recruitment of inflammatory monocytes plays a causative role. Here we develop bioabsorbable poly-lactic/glycolic acid (PLGA) nanoparticles incorporating irbesartan, an angiotensin II type 1 receptor blocker with a peroxisome proliferator-activated receptor (PPAR)γ agonistic effect (irbesartan-NP). In a mouse model of IR injury, intravenous PLGA nanoparticles distribute to the IR myocardium and monocytes in the blood and in the IR heart. Single intravenous treatment at the time of reperfusion with irbesartan-NP (3.0 mg kg‑1 irbesartan), but not with control nanoparticles or irbesartan solution (3.0 mg kg‑1), inhibits the recruitment of inflammatory monocytes to the IR heart, and reduces the infarct size via PPARγ-dependent anti-inflammatory mechanisms, and ameliorates left ventricular remodeling 21 days after IR. Irbesartan-NP is a novel approach to treat myocardial IR injury in patients with AMI.

  15. Justification for intravenous magnesium therapy in acute myocardial infarction

    DEFF Research Database (Denmark)

    Rasmussen, H S

    1988-01-01

    Recent studies have shown that patients with acute myocardial infarction (AMI) are magnesium-deficient and develop an additional transient decrease in serum magnesium concentrations (S-Mg c) during the acute phase of the infarct. Animal experiments, as well as studies on humans, have indicated...... of routine practice for patients with acute myocardial infarction....... that the acute decrease in S-Mg c as well as a more chronic magnesium (Mg) deficiency state are harmful to the myocardium in the setting of acute ischaemia. This knowledge has led during the last couple of years to the performance of four double-blind placebo controlled studies in which the effect of i...

  16. Carvedilol versus metoprolol in the acute phase of myocardial infarction:.

    Science.gov (United States)

    Bonnemeier, Hendrik; Ortak, Jasmin; Tölg, Ralph; Witt, Maren; Schmidt, Jörg; Wiegand, Uwe K H; Bode, Frank; Schunkert, Heribert; Richardt, Gert

    2005-01-01

    Beta-adrenergic blockers provide significant cardioprotection during acute ischemia and reperfusion. To further explore the effects of additional alpha-1-adrenoceptor blockade on autonomic modulation in acute myocardial infarction (AMI), carvedilol was compared with metoprolol in the setting of primary percutaneous coronary interventions (PCI). In a prospective study, 100 consecutive patients (61.1 +/- 11 years; 23 females) undergoing primary PCI for AMI were randomly assigned to metoprolol 200 mg/day vs carvedilol 25 mg/day. The first oral dose of study drug was administered upon hospital admission, and a 24-hour ambulatory electrocardiogram was recorded. A total of 40 recordings of patients assigned to metoprolol and 39 of patients assigned to carvedilol were eligible for analysis of heart rate turbulence. Turbulence onset (TO), turbulence slope (TS), and turbulence timing were measured after ventricular premature beats (VPBs). The mean value of the 10 preceding RR intervals (mean RR) before VPBs was also measured. There were no significant differences in mean age, gender distributions, TIMI perfusion grades, left ventricular ejection fraction, site and size of infarction, duration of ischemia, and mean 24-hour heart rate between the two groups. Though the mean RR were not significantly different (metoprolol 863.1 +/- 157 ms; carvedilol 839.6 +/- 151 ms), there was a trend toward lower values of TO in the carvedilol group (-0.015 +/- 0.016 vs -0.012 +/- 0.023%; P = NS) and significantly higher values for TS in the metoprolol group (6.96 +/- 5.8 vs 5.6 +/- 4.22; P metoprolol 5.8 +/- 2.4 vs carvedilol 6.1 +/- 2.1). In patients undergoing direct PCI for AMI, treatment with carvedilol, in contrast to metoprolol, was associated with a higher early acceleration and a lower deceleration of heart rate after VPBs, indicating differing effects on baroreceptor response due to additional alpha-1-adrenoceptor blockade. These data offer new insights into effects of a broader

  17. Research on Traditional Chinese Medicine in Treaof the present myocardial ischemia-reperfusion injury%中医药对心肌缺血再灌注损伤的研究现状

    Institute of Scientific and Technical Information of China (English)

    赵珏; 吴少俊; 王卫星

    2014-01-01

    Acute coronary syndrome was coronary heart disease in acute onset , clinical types of acute myocardial ischemic injury .In recent years, with thrombolytic therapy and percutaneous coronary intervention technology the establishment and promotion of artery bypass surgery and other methods significantly reduced the myocardial cell death due to ischemia and the ischemia myocardium after restoring blood flow myocardial ischemia-reperfusion injury in a cause for concern .This article analyzed injury mechanism and clinical research mainly from medical intervention to myocardial ischemia reperfusion .%急性冠脉综合征是冠心病中急性发病的临床类型,造成心肌急性缺血性损伤。近年来,随着溶栓疗法、经皮冠状动脉介入技术( Percutaneous coronary intervention ,PCI)、动脉搭桥术等方法的建立和推广,明显的减少了心肌由于缺血导致的细胞坏死,但缺血心肌恢复血流后,出现的心肌缺血再灌注损伤已成关注重点。本文主要从中医药对心肌缺血再灌注损伤干预机制及相关的临床研究进行阐述。

  18. EXPERIMENTAL STUDY OF HOMIUM: YAG LASER TRANSMYOCARDIAL REVASCULARIZATION IN ACUTE ISCHEMIC SET TINGS WITH MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    王立清; 胡盛寿; 李澎; 谢峰; 吴清玉; 郭加强

    2000-01-01

    Objective. To study the mechanism and effects of blood perfusion to the acute ischemic region of myocardium through Ho-YAG laser channels with myocardial contrast echocardiography. Methods. To produce the model of acute myocardial ischemia, we partially ligated the left anterior decending (LAD)coronary artery of canine hearts between lst. and 2nd. diagonal branches and then performed transmyocardial revascularization in this region with Ho- YAG laser. Myocardial contrast echocardiography was made with a new gen eration of ultrasound contrast agent and second harmonic imaging of this region before, after ischemia and after laser revascularization. Pictures were taken with “R” wave trigger skill. Results. Acoustic density derterming in the ischemia region (anterior wall)with MCE (myocardial contrast e chocardiography )was obviously decreased( 5.40 ± 1.81) after the LAD was ligated, as compared with before( 11.69 ± 1.61, P < 0.01 ). It was increased remarkably after transmyocardial laser revascularizatuon (TMLR) ( 11.2 ± 2.01, P < 0. 01 )as compared with that when ischemia and approximated to that before ischemia(P > 0.05). There were no dif ferences in acoustic density in the lateral wall(as control)among these comprehensive three periods(P > 0.05). Con trast in the laser region developed one cardiac cycle ahead of that in the non-ischemic normal region. Conclusion. Acute ischemic myocardium can be peffused by oxygenated blood from the left ventricle through Ho YAG laser channels. Evidence of blood perfusion through laser channels during systolic phase was detected, and my ocardial contrast ultrasonography using intravenous perfluorocarbon-exposed sonicated dextrose albumin may be regard ed as a reliable method in the study of transmyocardial revascularization.

  19. Impairment of endothelial-myocardial interaction increases the susceptibility of cardiomyocytes to ischemia/reperfusion injury.

    Directory of Open Access Journals (Sweden)

    Thorsten M Leucker

    Full Text Available Endothelial-myocardial interactions may be critically important for ischemia/reperfusion injury. Tetrahydrobiopterin (BH4 is a required cofactor for nitric oxide (NO production by endothelial NO synthase (eNOS. Hyperglycemia (HG leads to significant increases in oxidative stress, oxidizing BH4 to enzymatically incompetent dihydrobiopterin. How alterations in endothelial BH4 content impact myocardial ischemia/reperfusion injury remains elusive. The aim of this study was to examine the effect of endothelial-myocardial interaction on ischemia/reperfusion injury, with an emphasis on the role of endothelial BH4 content. Langendorff-perfused mouse hearts were treated by triton X-100 to produce endothelial dysfunction and subsequently subjected to 30 min of ischemia followed by 2 h of reperfusion. The recovery of left ventricular systolic and diastolic function during reperfusion was impaired in triton X-100 treated hearts compared with vehicle-treated hearts. Cardiomyocytes (CMs were co-cultured with endothelial cells (ECs and subsequently subjected to 2 h of hypoxia followed by 2 h of reoxygenation. Addition of ECs to CMs at a ratio of 1∶3 significantly increased NO production and decreased lactate dehydrogenase activity compared with CMs alone. This EC-derived protection was abolished by HG. The addition of 100 µM sepiapterin (a BH4 precursor or overexpression of GTP cyclohydrolase 1 (the rate-limiting enzyme for BH4 biosynthesis in ECs by gene trasfer enhanced endothelial BH4 levels, the ratio of eNOS dimer/monomer, eNOS phosphorylation, and NO production and decreased lactate dehydrogenase activity in the presence of HG. These results demonstrate that increased BH4 content in ECs by either pharmacological or genetic approaches reduces myocardial damage during hypoxia/reoxygenation in the presence of HG. Maintaining sufficient endothelial BH4 is crucial for cardioprotection against hypoxia/reoxygenation injury.

  20. Effects of ischemic preconditioning and iloprost on myocardial ischemia-reperfusion damage in rats.

    Science.gov (United States)

    Ay, Yasin; Kara, Ibrahim; Aydin, Cemalettin; Ay, Nuray Kahraman; Teker, Melike Elif; Senol, Serkan; Inan, Bekir; Basel, Halil; Uysal, Omer; Zeybek, Rahmi

    2013-01-01

    This study investigates the effects of cardiac ischemic preconditioning and iloprost on reperfusion damage in rats with myocardial ischemia/reperfusion. 38 male Wistar Albino rats used in this study were divided into 5 groups. The control group (Group 1) (n=6), ischemia/reperfusion (IR) group (Group 2) (n=8), cardiac ischemic preconditioning (CIP) group (Group 3) (n=8), iloprost (ILO) group (Group 4) (n=8), and cardiac ischemic preconditioning + iloprost (CIP+ILO) group (Group 5) (n=8). Pre-ischemia, 15 minutes post-ischemia, 45 minutes post-reperfusion, mean blood pressure (MBP), and heart rates (HR) were recorded. The rate-pressure product (RPP) was calculated. Post-reperfusion plasma creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), troponin (cTn) vlaues, and infarct size/area at risk (IS/AAR) were calculated from myocardial tissue samples. Arrhythmia and ST segment elevations were evaluated during the ischemia and reperfusion stages. Although the MBP, HR, RPP values, biochemical parameters of CK-MB and LDH levels, IS/AAR rates, ST segment elevation values were found to be similar in CIP and CIP+ILO groups and the IR and ILO groups (p>0.05), CIP-containing group values had a positively meaningful difference (pILO group. While mild-moderate findings of damage were observed in Group 3 and Group 5, severely findings of damage were releaved in Group 2 and Group 4. The arrhythmia score of the ILO group was meaningfully lower (F: 41.4, p<0.001) than the IR group. We can conclude that the effects of myocardial reperfusion damage can be reduced by cardiac ischemic preconditioning, intravenous iloprost reduced the incidence of ventricular arrhythmia associated with reperfusion, and its use with CIP caused no additional changes.

  1. Cardioprotective proteins upregulated in the liver in response to experimental myocardial ischemia.

    Science.gov (United States)

    Liu, Shu Q; Tefft, Brandon J; Roberts, Derek T; Zhang, Li-Qun; Ren, Yupeng; Li, Yan Chun; Huang, Yong; Zhang, Di; Phillips, Harry R; Wu, Yu H

    2012-12-15

    Myocardial ischemia (MI) activates innate cardioprotective mechanisms, enhancing cardiomyocyte tolerance to ischemia. Here, we report a MI-activated liver-dependent mechanism for myocardial protection. In response to MI in the mouse, hepatocytes exhibited 6- to 19-fold upregulation of genes encoding secretory proteins, including α-1-acid glycoprotein (AGP)2, bone morphogenetic protein-binding endothelial regulator (BMPER), chemokine (C-X-C motif) ligand 13, fibroblast growth factor (FGF)21, neuregulin (NRG)4, proteoglycan 4, and trefoil factor (TFF)3. Five of these proteins, including AGP2, BMPER, FGF21, NRG4, and TFF3, were identified as cardioprotective proteins since administration of each protein significantly reduced the fraction of myocardial infarcts (37 ± 9%, 34 ± 7%, 32 ± 8%, 39 ± 6%, and 31 ± 7%, respectively, vs. 48 ± 7% for PBS at 24 h post-MI). The serum level of the five proteins elevated significantly in association with protein upregulation in hepatocytes post-MI. Suppression of a cardioprotective protein by small interfering (si)RNA-mediated gene silencing resulted in a significant increase in the fraction of myocardial infarcts, and suppression of all five cardioprotective proteins with siRNAs further intensified myocardial infarction. While administration of a single cardioprotective protein mitigated myocardial infarction, administration of all five proteins furthered the beneficial effect, reducing myocardial infarct fractions from PBS control values from 46 ± 6% (5 days), 41 ± 5% (10 days), and 34 ± 4% (30 days) to 35 ± 5%, 28 ± 5%, and 24 ± 4%, respectively. These observations suggest that the liver contributes to cardioprotection in MI by upregulating and releasing protective secretory proteins. These proteins may be used for the development of cardioprotective agents.

  2. 定量组织速度成像与应变率成像在急诊心肌缺血中的应用价值%Value of Quantitative Tissue Velocity and Strain Rate Imaging in the Acute Myocardial Ischemia of Emegency

    Institute of Scientific and Technical Information of China (English)

    彭继红

    2016-01-01

    Objective To observe myocardial velocity and strain rate characteristics in patients with acute myocardial ischemia(AMI) of emergency,and to evaluate the clinical value of quantitative tissue velocity imaging(QTVI)and strain rate imaging(SRI)in quanti-tative assessment of left ventricular(LV)region infarction myocardial function.Methods Thirty two patients with AMI of coronary heart disease(CHD),30 control subjects were enrol ed in the study.Longitudinal peak velocity,strain rate of LV anterior wal (AW) and anterior interventricular septum(AS)during systole,early diastole and atrium contraction(VS,VE,VA),(SRS,SRE,SRA) were measured at different levels(basal,middle and apical).QTVI and SRI data were compared with coronary angiography results. Results VS:different levels of LV infarction wal significantly decreased in CHD group.VE:al levels of LV infarction wal ,except for apex levels of AS,were significantly lower than those in control group.VA:different levels of AW and apex level of AS in CHD group were significantly lower than those in control group.SRS and SRE:al levels of LV infarction wal in CHD group were significantly low-er than those in control group.SRA:different levels of AW and base level of AS in CHD group were significantly lower than those in control group (P<0.05,P<0.01 respectively).Conclusion QTVI and SRI are sensitive and feasible in evaluating functions of congestive heart failure of myocardial ischemia of emergency.%目的:探讨定量组织速度成像(QTVI)及应变率成像(SRI)在急诊心肌缺血中的临床应用价值。方法应用QTVI及SRI对32例急诊心肌缺血病人和30例正常人节段纵向收缩期(S)、舒张早期(E)及收缩期(A)的峰值速度(VS、VE、VA)、峰值应变率(SRS、SRE、SRA)进行测定。结果 VS:心肌缺血组室壁的不同水平均较正常对照组显著性减低;VE:除前间隔的心尖水平外,室壁较正常对照组显著性减低;VA:前壁的不同水平及前间隔的心尖

  3. Value of the Doppler index of myocardial performance in the early phase of acute myocardial infarction

    DEFF Research Database (Denmark)

    Poulsen, S H; Jensen, S E; Tei, C

    2000-01-01

    Prospective assessment of a nongeometric Doppler-derived index of combined systolic and diastolic myocardial performance was performed in 64 patients with acute myocardial infarction (MI) within 1 hour after their arrival to the hospital and in 39 age-matched healthy subjects. The index is defined...

  4. Aldosterone blockade in post-acute myocardial infarction heart failure

    NARCIS (Netherlands)

    Pitt, Bertram; Ferrari, Roberto; Gheorghiade, Mihai; van Veldhuisen, Dirk J.; Krum, Henry; McMurray, John; Lopez-Sendon, Jose

    2006-01-01

    Development of heart failure (HF) or left ventricular systolic dysfunction (LVSD) significantly increases mortality post acute myocardial infarction (AMI). Aldosterone contributes to the development and progression of HF post AMI, and major guidelines now recommend aldosterone blockade in this setti

  5. Sleep impairment and prognosis of acute myocardial infarction

    DEFF Research Database (Denmark)

    Clark, Alice; Lange, Theis; Hallqvist, Johan

    2014-01-01

    fatality and subsequent cardiovascular events following first-time acute myocardial infarction (AMI). DESIGN: Prospective cohort study. SETTING: The Stockholm Heart Epidemiology Program, Sweden. PARTICIPANTS: There were 2,246 first-time AMI cases. MEASUREMENTS AND RESULTS: SLEEP IMPAIRMENT WAS ASSESSED...... assessment that could benefit secondary cardiovascular prevention. CITATION: Clark A, Lange T, Hallqvist J, Jennum P, Rod NH. Sleep impairment and prognosis of acute myocardial infarction: a prospective cohort study. SLEEP 2014;37(5):851-858....

  6. Effects and Mechanisms of Chinese Herbal Medicine in Ameliorating Myocardial Ischemia-Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Qing Liu

    2013-01-01

    Full Text Available Myocardial ischemia-reperfusion (MIR injury is a major contributor to the morbidity and mortality associated with coronary artery disease, which accounts for approximately 450,000 deaths a year in the United States alone. Chinese herbal medicine, especially combined herbal formulations, has been widely used in traditional Chinese medicine for the treatment of myocardial infarction for hundreds of years. While the efficacy of Chinese herbal medicine is well documented, the underlying molecular mechanisms remain elusive. In this review, we highlight recent studies which are focused on elucidating the cellular and molecular mechanisms using extracted compounds, single herbs, or herbal formulations in experimental settings. These studies represent recent efforts to bridge the gap between the enigma of ancient Chinese herbal medicine and the concepts of modern cell and molecular biology in the treatment of myocardial infarction.

  7. Limitations of spontaneous reperfusion and conventional medical therapy to afford myocardial protection through antecedent angina pectoris in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Akiyoshi; Nakata, Tomoaki; Wakabayashi, Takeru; Yuda, Satoshi; Eguchi, Mariko; Sasao, Hisataka; Tsuchihashi, Kazufumi; Shimamoto, Kazuaki [Sapporo Medical Univ. (Japan)

    1999-10-01

    Despite the cardioprotective effect of rapid coronary reperfusion, the effects of spontaneous recanalization on myocardial viability and metabolism are unknown. We studied whether preinfarction angina affords cardioprotection when spontaneous coronary reperfusion occurred in acute infarct patients. Myocardial tomographies with thallium and I-123-labeled-{beta}-methyl-p-iodophenyl penta-decanoic acid (BMIPP) were performed in 27 acute myocardial infarct patients treated medically: 15 patients had preexisting angina before infarction (group A) and 12 did not (group B). Thallium and BMIPP abnormalities and regional function were quantified by a polar map and contrast ventriculography, respectively. There was no significant difference between thallium and BMIPP in the severity index in groups A and B (89{+-}97 vs. 85{+-}68, 97{+-}28 vs. 95{+-}27, respectively), and no significant difference between the groups in the thallium or BMIPP severity index. The ratio of the thallium severity index to that of BMIPP and the regional wall-motion abnormality index were identical in groups A and B. Both patient groups were divided into 2 subgroups based on the presence or absence of spontaneous coronary reperfusion: subgroups A1 and A2, and subgroups B1 and B2, respectively. There were no significant differences among the 4 subgroups in severity indexes for both tracers, the thallium/BMIPP ratio, or the asynergy score. The BMIPP severity index correlated significantly with that of thallium in all subgroups, but no significant difference between the regression lines was found. It is therefore unlikely that spontaneous coronary recanalization affords beneficial effects through preservation of myocardial viability in an ischemia-related zone, suggesting that the cardioprotective effect of preinfarction angina is a limited phenomenon in patients undergoing rapid coronary reperfusion. (author)

  8. Cardiovascular risk evaluation and prevalence of silent myocardial ischemia in subjects with asymptomatic carotid artery disease

    Directory of Open Access Journals (Sweden)

    Ciccone M

    2011-03-01

    Full Text Available Marco Matteo Ciccone1, Artor Niccoli-Asabella2, Pietro Scicchitano1, Michele Gesualdo1, Antonio Notaristefano2, Domenico Chieppa1, Santa Carbonara1, Gabriella Ricci1, Marco Sassara1, Corinna Altini2, Giovanni Quistelli1, Mario Erminio Lepera1, Stefano Favale1, Giuseppe Rubini21Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO, 2Nuclear Medicine Unit, Department of Internal Medicine and of Public Medicine, University of Bari, Bari, ItalyIntroduction: Silent ischemia is an asymptomatic form of myocardial ischemia, not associated with angina or anginal equivalent symptoms, which can be demonstrated by changes in ECG, left ventricular function, myocardial perfusion, and metabolism. The aim of this study was to evaluate the prevalence of silent myocardial ischemia in a group of patients with asymptomatic carotid stenosis.Methods: A total of 37 patients with asymptomatic carotid plaques, without chest pain or dyspnea, was investigated. These patients were studied for age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of cardiac disease, and underwent technetium-99 m sestamibi myocardial stress-rest scintigraphy and echo-color Doppler examination of carotid arteries.Results: A statistically significant relationship (P = 0.023 was shown between positive responders and negative responders to scintigraphy test when both were tested for degree of stenosis. This relationship is surprising in view of the small number of patients in our sample. Individuals who had a positive scintigraphy test had a mean stenosis degree of 35% ± 7% compared with a mean of 44% ± 13% for those with a negative test. Specificity of our detection was 81%, with positive and negative predictive values of 60% and 63%, respectively.Conclusion: The present study confirms that carotid atherosclerosis is associated with coronary atherosclerosis and highlights the importance of screening for ischemic heart disease in

  9. Diffusion and Perfusion MRI in Acute Cerebral Ischemia

    Institute of Scientific and Technical Information of China (English)

    Tchoyoson CC Lim; Chong-Tin Tan

    2001-01-01

    Reeent advances in magnetic resonance imaging (MRI), in particular diffusion weighted imaging (DWI) and perfusion weighted imaging (PWI), have allowed clinicians to have the ability to differentiate between irreversible cerebral infarction and the potentially reversible ischemic penumbra. This article examines the principles and practice of DWI and PWI. With continued advances in thrombolysis and other therapy for acute cerebral ischemia, neuroimaging is poised to play an increasingly important role in decisionmaking in aeute stroke.

  10. Prevalence of Ischemia on Myocardial Perfusion Scintigraphy of Pre- and Postmenopausal Women

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniel Augusto Message dos, E-mail: danielmessage@cardiol.br; Navarro, Wendy Yasdin Sierraalta; Alexandre, Leonardo Machado; Cestari, Priscila Feitosa; Smanio, Paola Emanuela Poggio [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP (Brazil)

    2013-12-15

    In postmenopausal women, the presence of risk factors for coronary artery disease (CAD) increases. However, the difference in prevalence of ischemia between pre- and postmenopausal women with multiple risk factors for CAD has not been well established. To compare the prevalence of ischemia on Tc{sup 99m}-sestamibi myocardial perfusion scintigraphy (MPS) in pre-and postmenopausal women, and to evaluate whether menopause can be considered an independent risk predictor of ischemia in women with multiple risk factors for CAD. This study retrospectively assessed 500 MPS of pre- and postmenopausal women with multiple risk factors for CAD. Statistical analysis was performed by using Fisher exact test and univariate and multivariate analysis, a p value ≤ 0.05 being considered significant. Postmenopausal women represented 55.9% of the sample; 83.3% were hypertensive; 28.9%, diabetic; 32.1%, smokers; 25%, obese; 61.2% had high cholesterol levels; and 34.3% had known CAD. Postmenopausal women were more often hypertensive, diabetic and dyslipidemic, and had lower functional capacity on exercise testing (p = < 0.005). The presence of ischemia on MPS did not significantly differ between the pre- and postmenopausal groups (p = 0.395). The only variable associated with ischemia on MPS was known CAD (p = 0.004). The results suggest that, in women with multiple risk factors for CAD, menopause was not an independent predictor of ischemia on MPS. Those data support the idea that the investigation of ischemia via MPS in women with multiple risk factors for CAD should begin prior to menopause.

  11. Protective effect and mechanism of lithium chloride pretreatment on myocardial ischemia-reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Fang-Jiang Li; Tao Hsu; Hui-Xian Li; Jin-Zheng Shi; Mei-Ling Du; Xiao-Yuan Wang; Wen-Ting Zhang

    2014-01-01

    Objective:To investigate the protective effect and mechanism of lithium chloride pretreatment on myocardial ischemia-reperfusion injury(I-RI) in rats.Methods:A total of60SD rats were randomly divided into control group, model group, lithium chloride intervention group and L-arginine methyl ester+ lithium chloride intervention group with15 in each.TheI-RI model was established in model group, the lithium chloride intervention group andL-arginine methyl ester+ lithium chloride intervention group by method of seaming along left anterior descending coronary artery myocardial, control group was only opened the chest without seaming,ST-elevation within2 min was regarded as modeling success.Model group did not adopted any intervention, lithium chloride intervention group was treated with lithium chloride injection 15 mg/kg by jugular venipuncture preoperatively,L-arginine methyl ester+ lithium chloride intervention group was treated with intraperitoneal injection of30 mg•kg-1•d-1L-arginine methyl ester7 d before the test, and intravenous catheter of15 mg/kg lithium chloride preoperatively. The hydroxybutyric acid dehydrogenase(HBDH), creatine kinase isoenzyme(CK-MB), superoxide dismutase(SOD), malondialdehyde(MDA) level and nitric oxide synthase(NOS) activites were tested.Each large area of myocardial ischemia tissue was extracted for determination of the MDA content,SOD activity in tissue and serum, and morphological changes of myocardial tissue.Results:SOD activity was highest in lithium chloride intervention group, followed by L-arginine methyl ester+ lithium chloride intervention group, control group and model group (P0.05);HBDH andCK-MB of plasma were highest in model group, followed byL-arginine methyl ester+ lithium chloride intervention group, lithium chloride intervention group and control group(P<0.05).A significantly lighter myocardial damage was observed microscopically in lithium chloride intervention group than that inL-arginine methyl ester+ lithium

  12. 45. Ezetimibe and statins yields on silent holter ambulatory myocardial ischemia

    Directory of Open Access Journals (Sweden)

    W. Kadro

    2016-07-01

    Full Text Available Further cholestrol lowering may affect silent ischemia detected on holter monitoring. Cholesterol lowering is associated with a reduction in cardiovascular morbidity and mortality. Statins are the main drugs for cholesterol lowering. Ezetimibe when added to statins gives further reduction in cholesterol but its long-term effect on cardiovascular morbidity and mortality and ischemic events is not known. This study sought to determine whether further cholesterol lowering with ezitimibe will also results in a reduction of myocardial ischemia during daily life. We enrolled 50 patients with proven stable coronary artery disease (CAD and at least one episode of ST-segment depression on ambulatory ECG monitoring. All of them were receiving optimal therapy for CAD including statin therapy for cholesterol reduction. 25 patients were randomized to continue their statin therapy (Statin only group and 25 to recieve statin plus ezitimibe 10 mg/day (ezitimibe group. Serum cholesterol and LDL cholesterol levels and ambulatory monitoring were repeated after 4–6 months of therapy. The two groups were comparable with respect to baseline characteristics, number of episodes of ST-segment depression, and baseline serum cholesterol levels. The ezitimibe group had lower mean total and LDL cholesterol levels at study end and experienced a significant reduction in the number of episodes of ST-segment depression compared with the statin only group. ST-segment depression was completely resolved in 13 of 25 patients (52% in the ezitimibe group versus 3 of 25 (12% in the statin only group. The ezitimibe group exhibited a highly significant reduction in ambulatory ischemia (P < .001. By logistic regression, treatment with ezitimibe was an independent predictor of ischemia resolution. Further cholesterol lowering with ezitimibe can result in reduction or resolution of myocardial ischemia recorded as episodes of ST-segment depression in ambulatory monitoring of the ECG.

  13. Differential effects of heptanoate and hexanoate on myocardial citric acid cycle intermediates following ischemia-reperfusion.

    Science.gov (United States)

    Okere, Isidore C; McElfresh, Tracy A; Brunengraber, Daniel Z; Martini, Wenjun; Sterk, Joseph P; Huang, Hazel; Chandler, Margaret P; Brunengraber, Henri; Stanley, William C

    2006-01-01

    In the normal heart, there is loss of citric acid cycle (CAC) intermediates that is matched by the entry of intermediates from outside the cycle, a process termed anaplerosis. Previous in vitro studies suggest that supplementation with anaplerotic substrates improves cardiac function during myocardial ischemia and/or reperfusion. The present investigation assessed whether treatment with the anaplerotic medium-chain fatty acid heptanoate improves contractile function during ischemia and reperfusion. The left anterior descending coronary artery of anesthetized pigs was subjected to 60 min of 60% flow reduction and 30 min of reperfusion. Three treatment groups were studied: saline control, heptanoate (0.4 mM), or hexanoate as a negative control (0.4 mM). Treatment was initiated after 30 min of ischemia and continued through reperfusion. Myocardial CAC intermediate content was not affected by ischemia-reperfusion; however, treatment with heptanoate resulted in a more than twofold increase in fumarate and malate, with no change in citrate and succinate, while treatment with hexanoate did not increase fumarate or malate but increased succinate by 1.8-fold. There were no differences among groups in lactate exchange, glucose oxidation, oxygen consumption, and contractile power. In conclusion, despite a significant increase in the content of carbon-4 CAC intermediates, treatment with heptanoate did not result in improved mechanical function of the heart in this model of reversible ischemia-reperfusion. This suggests that reduced anaplerosis and CAC dysfunction do not play a major role in contractile and metabolic derangements observed with a 60% decrease in coronary flow followed by reperfusion.

  14. 心肌“缺血记忆”分子影像诊断研究进展%Progress of molecular imaging in myocardial "ischemia memory"

    Institute of Scientific and Technical Information of China (English)

    郑娜; 苏芙蓉; 张国建; 王城; 李剑波; 邬心爱; 王涛; 王雪梅

    2016-01-01

    急性心肌缺血的识别通常是基于心电图的改变、超声心动图发现的室壁运动异常和血清生物标志物的升高等.以“胸痛”为首发症状就诊的患者日益增多,一些急性胸痛者往往其心电图、血清标志物甚至CAG阴性而导致漏诊误诊.急性心肌缺血可引起一系列病理生理学现象,如心肌灌注减低、脂肪酸和葡萄糖代谢异常及神经功能异常等.急性心肌缺血在缺血再灌注后,代谢异常和神经功能损伤还会持续,即“代谢顿抑”或“缺血记忆”.笔者在概述心肌缺血的病理生理基础上,总结近年来分子影像学手段诊断心肌“缺血记忆”的研究进展.%Acute myocardial ischemia is usually identified based on electrocardiography changes,wall motion abnormalities found on echocardiography,elevated serum biomarkers,etc.In recent years,the number of patients with chest pain as the first symptom has been increasing.However,in some patients with acute chest pain,electrocardiography changes may be non-diagnostic and without serum biomarkers elevation,which leads to misdiagnosis.Acute myocardial ischemia may cause a series of pathophysiological phenomena,such as myocardial perfusion reduction,abnormal metabolism of fatty acid and glucose as well as malfunction of cardiac nerve system.Myocardial perfusion may be normal shortly after restoration of coronary blood flow.However,the changes of metabolic and nervous function may persist longer.The remained changes in metabolism and nervous function after ischemia event were named as metabolic stunning or ischemic memory.This review focuses on the research progress of molecular imaging in the evaluation of myocardial "ischemia memory".

  15. Prognostic significance of sinus deceleration during dobutamine stress echocardiography test following acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Šalinger Sonja

    2006-01-01

    Full Text Available Background/Aim. Chronotropic incompetence during exercise stress testing after acute myocardial infarction is an indicator of ischemia or impaired left ventricular function. On the other side, infusion of dobutamine leads to a typical dose-dependent increase in heart rate. The aim of this study was to evaluate of paradoxical sinus deceleration during dobutamine stress echocardiography (DSE, as the sign of ischemia and impaired left ventricular function, or the consequence of infarction localization, and the estimation of prognostic significance after acute myocardial infarction. Methods. Our investigation comprised 81 patients hospitalized because of the acute myocardial infarction, and all of them had uncomplicated infarction. Fifty five patients were treated with thrombolytic therapy (67.9%; 53 patients (65.4% had anterior myocardial infarction, and 28 patients (34.6% had inferoposterior localization of myocardial infarction. After 10-12 days all of them underwent dobutamine stress echocardiography examination. During the next 3-6 months, the patients underwent coronary angiography. The average follow-up period was 36±22 months. Results. A decrease in heart rate occurred at the dobutamine doses increasing from 15-40mcg/kg/min in 9 (11.1% of the patients, in 1 patient with an anterior localization and in 8 patients with an inferoposterior localization. The decrease was sudden in 4 (44.4%, and gradual in 5 (55.6% of the patients. In 3 patients (33.3% junction rhythm was developed, and in 2 patients (22.2% AV block II-III. Only in 2 of them, there was a worsening of regional function during a high dose dobutamine infusion, but 7 of them showed an improvement during a low dose. In 7 (77.8% of the patients there was a simultaneous decrease in blood pressure. Coronary angiographic examination showed that in 4 (44.4% of the patients there was a significant coronary artery disease and they underwent the revascularization procedure. During the follow

  16. Effects of chlorthalidone and diltiazem on myocardial ischemia in elderly patients with hypertension and coronary artery disease

    Directory of Open Access Journals (Sweden)

    Serro-Azul João Batista

    2001-01-01

    Full Text Available OBJETIVE: Antihypertensive therapy with thiazides decreases coronary events in elderly patients. However, the influence of diuretics on myocardial ischemia has not been fully investigated. The aim of this study was to compare the effect of chlorthalidone and diltiazem on myocardial ischemia. METHODS: Following a randomized, double-blind, crossover protocol, we studied 15 elderly hypertensive patients aged 73.6±4.6 years with myocardial ischemia. All patients had angiographically documented coronary artery disease. We measured patients using 48- hour ambulatory electrocardiogram monitoring and exercise testing. After a 2-week period using placebo, patients received chlorthalidone or diltiazem for 4 weeks. RESULTS: Both treatments lowered systolic and diastolic blood pressures. The number of ischemic episodes on ambulatory electrocardiogram recordings was reduced with the use of chlorthalidone (2.5±3.8 and diltiazem (3.2±4.2 when compared with placebo (7.9±8.8; p<0.05. The total duration of ischemic episodes was reduced in both treatments when compared with placebo (chlorthalidone: 19.2±31.9min; diltiazem: 19.3±29.6min; placebo: 46.1±55.3min; p<0.05. CONCLUSION: In elderly hypertensive patients with coronary artery disease, chlorthalidone reduced myocardial ischemia similarly to diltiazem. This result is consistent with epidemiological studies and suggests that reduction of arterial blood pressure with thiazide therapy plays an important role in decreasing myocardial ischemia.

  17. A Biomimic Reconstituted High Density Lipoprotein Nanosystem for Enhanced VEGF Gene Therapy of Myocardial Ischemia

    Directory of Open Access Journals (Sweden)

    Xiaotian Sun

    2015-01-01

    Full Text Available A biomimic reconstituted high density lipoprotein (rHDL based system, rHDL/Stearic-PEI/VEGF complexes, was fabricated as an advanced nanovector for delivering VEGF plasmid. Here, Stearic-PEI was utilized to effectively condense VEGF plasmid and to incorporate the plasmid into rHDL. The rHDL/Stearic-PEI/VEGF complexes with diameter under 100 nm and neutral surface charge demonstrated enhanced stability under the presence of bovine serum albumin. Moreover, in vitro cytotoxicity and transfection assays on H9C2 cells further revealed their superiority, as they displayed lower cytotoxicity with much higher transfection efficiency when compared to PEI 10K/VEGF and Lipos/Stearic-PEI/VEGF complexes. In addition, in vivo investigation on ischemia/reperfusion rat model implied that rHDL/Stearic-PEI/VEGF complexes possessed high transgene capacity and strong therapeutic activity. These findings indicated that rHDL/Stearic-PEI/VEGF complexes could be an ideal gene delivery system for enhanced VEGF gene therapy of myocardial ischemia, which might be a new promising strategy for effective myocardial ischemia treatment.

  18. Left ventricular global longitudinal strain in acute myocardial infarction

    DEFF Research Database (Denmark)

    Ersbøll, Mads

    Systolic dysfunction, clinical heart failure and elevated levels of neurohormonal peptides are major predictors of adverse outcome after acute myocardial infarction (MI). In the present thesis we evaluated global longitudinal strain (GLS) in patients with acute MI in relation to neurohormonal...

  19. Myocardial metabolic abnormalities in hypertrophic cardiomyopathy assessed by iodine-123-labeled beta-methyl-branched fatty acid myocardial scintigraphy and its relation to exercise-induced ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Matsuo, Shinro; Nakamura, Yasuyuki; Takahashi, Masayuki; Mitsunami, Kenichi; Kinoshita, Masahiko [Shiga Univ. of Medical Science, Otsu (Japan)

    1998-03-01

    Reversible thallium-201 ({sup 201}Tl) abnormalities during exercise stress have been used as markers of myocardial ischemia in hypertrophic cardiomyopathy (HCM) and are most likely to identify relatively underperfused myocardium. Although metabolic abnormalities in HCM were reported, the relationship between impaired energy metabolism and exercise-induced ischemia has not been fully elucidated as yet. To assess the relationship between myocardial perfusion abnormalities and fatty acid metabolic abnormalities, 28 patients with HCM underwent exercise {sup 201}Tl and rest {sup 123}I-15-(p-iodophenyl)-3-methyl pentadecanoic acid (BMIPP) scintigraphy. Perfusion abnormalities were observed by exercise {sup 201}Tl in 19/28 patients with HCM. {sup 123}I-BMIPP uptake was decreased compared with delayed {sup 201}Tl in 106/364 (29%) of the total myocardial segments (p<0.01, McNemar symmetry test). Such disparity between {sup 123}I-BMIPP and {sup 201}Tl was observed more often in the 49/75 (65%) segments with reversible exercise {sup 201}Tl defects (p<0.001). Our results indicate that exercise-induced myocardial ischemia exists in HCM, resulting in metabolic abnormalities. The combination of {sup 123}I-BMIPP and {sup 201}Tl suggests that myocardial ischemia may play an important role in metabolic abnormalities in HCM. (author)

  20. Dang Gui Bu Xue Tang ameliorates coronary artery ligation-induced myocardial ischemia in rats.

    Science.gov (United States)

    Chunhua, Ma; Hongyan, Long; Weina, Zhu; Xiaoli, He; Yajie, Zhang; Jie, Ruan

    2017-01-28

    Dang The present study was designed to investigate cardioprotective effects of Dang Gui Bu Xue Tang (DGBUT) on coronary artery ligation-induced myocardial ischemia. Myocardial ischemia (MI) model was induced in SD rats by surgical ligation of the left anterior descending coronary artery. ST segment elevation of Electrocardiograph (ECG) infarct size, levels of lactate dehydrogenase (LDH), creatine kinase (CK), glutathione (GSH) and catalase (CAT), catalase (SOD), malondialdehyde (MDA), and inflammatory cytokines and phosphorylation of extracellular signal-regulated kinase (ERK) 1/2, p38, c-Jun NH2 terminal kinases (JNK), nuclear factor (NF)-κBp65, inhibitory kappa B (IκB) α, IκB kinase (IKK) α and IKKβ were evaluated in rats treated with or without DGBUT. DGBUT treatment significantly reduced the elevation of the ST segment of ECG, the myocardial infarct size of MI. The level of LDH, CK and MDA were suppressed, the contents of SOD, GSH and CAT were enhanced with DGBUT. The elevated concentration of inflammatory cytokines tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and IL-6 in MI rats were effectively reversed by the DGBUT administration. Also, highly expressed p-JNK, p-ERK, p-p38, p-NF-κBp65, p-IκBα, p-IKKα and p-IKKβ in MI rats were restored respectively by DGBUT treatment. The protective effect of DGBUT against MI injury might be associated with MAPK/NF-кB pathway.

  1. Amelioration of ischemia/reperfusion-induced myocardial infarction by the 2-alkynyladenosine derivative 2-octynyladenosine (YT-146).

    Science.gov (United States)

    Sasamori, Jun; Aihara, Kazuyuki; Yoneyama, Fumiya; Sato, Isamu; Kogi, Kentaro; Takeo, Satoshi

    2006-04-01

    The present study was aimed at determining whether the novel adenosine A2-agonist YT-146 may have cardioprotective effects against ischemia-reperfusion injury. Anesthetized open-chest dogs underwent 90-min occlusion of the left anterior descending artery and subsequent 300-min reperfusion. The animals were randomly assigned to receive vehicle, 3, or 10 microg/kg YT-146 or ischemic preconditioning (4 episodes of 5 min occlusion followed by 5 min of reperfusion). Blood pressure, heart rate, and regional myocardial blood flow throughout the experiment were measured, as was the myocardial infarct size after reperfusion. The infarct size of the vehicle-treated dog was 56.2% +/- 2.7% (n = 5), whereas that of 3 or 10 microg/kg YT-146-treated dog was smaller (ie, 29.5% +/- 8.7% or 20.2% +/- 7.0%, respectively; n = 5). The infarct size of the dog treated with 10 microg/kg YT-146 was reduced to a degree similar to that of the ischemic preconditioning (19.2% +/- 6.3%, n = 5). YT-146 at both doses elicited a dose-dependent increase in acute hyperemic coronary flow immediately after reperfusion. The cardioprotective effect may be attributed to the limitation of the infarct size, probably via A2-receptor-mediated coronary artery dilatation during the early period of reperfusion.

  2. Nonlinear Dynamic Theory of Acute Cell Injuries and Brain Ischemia

    Science.gov (United States)

    Taha, Doaa; Anggraini, Fika; Degracia, Donald; Huang, Zhi-Feng

    2015-03-01

    Cerebral ischemia in the form of stroke and cardiac arrest brain damage affect over 1 million people per year in the USA alone. In spite of close to 200 clinical trials and decades of research, there are no treatments to stop post-ischemic neuron death. We have argued that a major weakness of current brain ischemia research is lack of a deductive theoretical framework of acute cell injury to guide empirical studies. A previously published autonomous model based on the concept of nonlinear dynamic network was shown to capture important facets of cell injury, linking the concept of therapeutic to bistable dynamics. Here we present an improved, non-autonomous formulation of the nonlinear dynamic model of cell injury that allows multiple acute injuries over time, thereby allowing simulations of both therapeutic treatment and preconditioning. Our results are connected to the experimental data of gene expression and proteomics of neuron cells. Importantly, this new model may be construed as a novel approach to pharmacodynamics of acute cell injury. The model makes explicit that any pro-survival therapy is always a form of sub-lethal injury. This insight is expected to widely influence treatment of acute injury conditions that have defied successful treatment to date. This work is supported by NIH NINDS (NS081347) and Wayne State University President's Research Enhancement Award.

  3. [Efficiency of mildronate in rats of different age with experimental-induced myocardial ischemia].

    Science.gov (United States)

    Kukes, V G; Zhernakova, N I; Gorbach, T V; Romashchenko, O V; Rumbesht, V V

    2013-01-01

    Under experimental myocardial ischemia in rats of 10 months treatment with mildronate resulted in essential changes in metabolism of cardiomyocites. This includes stimulation of aerobic and anaerobic ways of power supply of heart cells: activation of glycolysis, oxidative phosphorylation and oxidative pyruvate decarboxylation with restoration of adenosine triphosphate pool to intact rats level in myocardium, serum and erythrocytes with signs of stabilization of cardiomyocytes membranes and essential decrease of tissue hypoxia. Introduction of mildronate to old rats (24 months) with an experimental myocardium ischemia was accompanied by lesser expressed changes of metabolism: activation of glycolysis and oxidative pyruvate decarboxylation without stimulation of Crebs' cycle enzymes. This became sufficient for restoration of adenosine triphosphate pool in myocardium without change of its quantity in serum and erythrocytes with signs of stabilization of cardiomyocytes membranes and moderate reduction of tissue hypoxia degree.

  4. Protective effects of emulsified isoflurane after myocardial ischemia-reperfusion injury and its mechanism in rabbits

    Institute of Scientific and Technical Information of China (English)

    RAO Yan; WANG Yan-lin; CHEN Yong-quan; ZHANG Wen-sheng; LIU Jin

    2009-01-01

    Objective: To evaluate the protective effects of 8% emulsified isoflurane after myocardial ischemia-reperfusion injury and its mechanism in rabbits.Methods: Twenty-four male adult New Zealand white rabbits were anesthetized with intravenous injection of 30 mg/kg pentobarbital followed by 5 mg·kg-1·h-1 infusion. All rabbits were subjected to 30 minutes of left anterior de-scending coronary artery (LAD) occlusion and 3 hours of subsequent reperfusion. Before LAD occlusion, the rabbits were randomly allocated into three groups for precondi-tioning treatment (eight for each group). The control group (C group) received intravenously 0.9% NaCl for 30 minutes. The emulsified isoflurane group (EI group) received 8% emulsified isoflurane intravenously till 0.64% end-tidal con-centration for 30 minutes that was followed by a 15-minute washout period. The Intralipid group (IN group) received 30% Intralipid for 30 minutes. The infarcted area, plasma malondialdehyde (MDA) content, superoxide dismutase activity (SOD) and nitrite concentration after 3-hour myo-cardial perfusion were recorded simultaneously.Results: For the myocardial ischemia-reperfusion in-jury animals, the infarcted size in the EI group was signifi-cantly reduced (91.9%±8%) as compared with control group (39%±6%,t=5.19, P<0.01). The plasma SOD activity and nitrite concentration in EI group were significantly higher than those in control group (t=2.82, t=8.46, P<0.05), but MDA content was lower in EI group than that in control group (t=2.56, P<0.05).Conclusions: The results indicate that emulsified isoflurane has a cardioprotection effect against ischemia-reperfusion injury. This beneficial effect of emulsified isoflurane is probably through NO release and consequently by increase in autioxidation of myocardium.

  5. Assessment of myocardial viability using multidetector computed tomography in patients with reperfused acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, T. [Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Choi, B.J. [Department of Cardiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Kang, D.K., E-mail: kdklsm@ajou.ac.kr [Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Sun, J.S. [Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of)

    2012-08-15

    Aim: To assess the prognostic value of 64-section multidetector computed tomography (MDCT) to predict follow-up myocardial dysfunction and functional recovery after reperfusion therapy in patients with acute myocardial infarction (MI) as defined by echocardiography. Materials and methods: After reperfusion therapy for acute MI, 71 patients underwent two-phase contrast-enhanced MDCT and follow-up echocardiography. MDCT findings were compared with echocardiographic findings using kappa statistics. The areas under the receiver operating characteristic curves (AUCs) and the odds ratios (ORs) of early perfusion defects (EPD), delayed enhancement (DE), and residual perfusion defects (RPD) for predicting follow-up myocardial dysfunction and functional recovery were calculated on a segmental basis. Results: The presence of transmural EPD (EPD{sub TM}) or RPD showed good agreement (k = 0.611 and 0.658, respectively) with follow-up myocardial dysfunction, while subendocardial EPD (EPD{sub sub}) or subendocardial DE (DE{sub sub}) showed fair agreement with follow-up myocardial dysfunction (k = 0.235 and 0.234, respectively). The AUC of RPD (0.796) was superior (p < 0.001 and 0.031, respectively) to those of EPD{sub TM} (0.761) and DE{sub TM} (0.771). The presence of EPD{sub TM}, DE{sub TM}, and RPD were significant, independent positive predictors of follow-up myocardial dysfunction (OR = 6.4, 1.9, and 9.8, respectively). EPD{sub TM} was a significant, independent negative predictor of myocardial functional recovery (OR = 0.13). Conclusion: Abnormal myocardial attenuation on two-phase MDCT after reperfusion therapy may provide promising information regarding myocardial viability in patients with acute MI.

  6. Late sodium current and intracellular ionic homeostasis in acute ischemia.

    Science.gov (United States)

    Ronchi, Carlotta; Torre, Eleonora; Rizzetto, Riccardo; Bernardi, Joyce; Rocchetti, Marcella; Zaza, Antonio

    2017-03-01

    Blockade of the late Na(+) current (I NaL) protects from ischemia/reperfusion damage; nevertheless, information on changes in I NaL during acute ischemia and their effect on intracellular milieu is missing. I NaL, cytosolic Na(+) and Ca(2+) activities (Nacyt, Cacyt) were measured in isolated rat ventricular myocytes during 7 min of simulated ischemia (ISC); in all the conditions tested, effects consistently exerted by ranolazine (RAN) and tetrodotoxin (TTX) were interpreted as due to I NaL blockade. The results indicate that I NaL was enhanced during ISC in spite of changes in action potential (AP) contour; I NaL significantly contributed to Nacyt rise, but only marginally to Cacyt rise. The impact of I NaL on Cacyt was markedly enhanced by blockade of the sarcolemmal(s) Na(+)/Ca(2+) exchanger (NCX) and was due to the presence of (Na(+)-sensitive) Ca(2+) efflux through mitochondrial NCX (mNCX). sNCX blockade increased Cacyt and decreased Nacyt, thus indicating that, throughout ISC, sNCX operated in the forward mode, in spite of the substantial Nacyt increment. Thus, a robust Ca(2+) source, other than sNCX and including mitochondria, contributed to Cacyt during ISC. Most, but not all, of RAN effects were shared by TTX. (1) The paradigm that attributes Cacyt accumulation during acute ischemia to decrease/reversal of sNCX transport may not be of general applicability; (2) I NaL is enhanced during ISC, when the effect of Nacyt on mitochondrial Ca(2+) transport may substantially contribute to I NaL impact on Cacyt; (3) RAN may act mostly, but not exclusively, through I NaL blockade during ISC.

  7. Synthesis and Myocardial Ischemia Protective Effect of Ocotillol-Type Derivatives

    Directory of Open Access Journals (Sweden)

    Bi Yi

    2012-03-01

    Full Text Available A series of ocotillol-type derivatives bearing a glycosyl moiety were synthesized. Among them, compound 3a and 3b led to a reduction in the increased CK, LDH, MDA activity and attenuate the decrease of SOD, GSH-PX and T-AOC compared with the iso group. In the heart section, compound 3a and 3b group showed nearly normal myofibrillar structure nearly without neutrophil granulocytes infiltration in the iso group. These results indicated that ocotillol-type derivatives may be the good lead compounds with protective property of myocardial ischemia.

  8. The Role of Oxidative Stress in Myocardial Ischemia and Reperfusion Injury and Remodeling: Revisited

    Directory of Open Access Journals (Sweden)

    Gino A. Kurian

    2016-01-01

    Full Text Available Oxidative and reductive stress are dual dynamic phases experienced by the cells undergoing adaptation towards endogenous or exogenous noxious stimulus. The former arises due to the imbalance between the reactive oxygen species production and antioxidant defenses, while the latter is due to the aberrant increase in the reducing equivalents. Mitochondrial malfunction is the common denominator arising from the aberrant functioning of the rheostat that maintains the homeostasis between oxidative and reductive stress. Recent experimental evidences suggest that the maladaptation during oxidative stress could play a pivotal role in the pathophysiology of major cardiovascular diseases such as myocardial infraction, atherosclerosis, and diabetic cardiovascular complications. In this review we have discussed the role of oxidative and reductive stress pathways in the pathogenesis of myocardial ischemia/reperfusion injury and diabetic cardiomyopathy (DCM. Furthermore, we have provided impetus for the development of subcellular organelle targeted antioxidant drug therapy for thwarting the deterioration of the failing myocardium in the aforementioned cardiovascular conditions.

  9. Therapeutic angiogenesis induced by human hepatocyte growth factor (HGF) gene in rat myocardial ischemia models

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    In order to investigate the feasibility of myocardial ischemia gene therapy, we cloned human hepatocyte growth factor gene from human placenta cDNA library by the RT-PCR method. Recombination adenovirus Ad-HGF was constructed by the method of co-transfection and homologous recombination of plasmids in 293 cells. Ad-HGF was amplified in 293 cells and purified through CsCl density gradient centrifugation. Ad-HGF could be expressed in rat primary myocardial cells and HGF secreted into the culture media, which was tested by ELISA. The distribution and persistence of adenovirus in rat were investigated by green fluorescence protein as a report gene. In vivo we found that intramyocardial administration of Ad-HGF could induce angiogenesis in rat myocardium after ligation of coronary artery. The results suggested that Ad-HGF was effective in vitro and in vivo, and the data for designing human trial of gene therapy-- mediated cardiac angiogenesis were provided.

  10. Mechanism of Total Polyphenols Extracted from Toona sinensis Roem on Acute Inflammation during Myocardial Ischemia-reperfusion in Rats%基于炎症反应的香椿子总多酚抗大鼠心肌缺血再灌注损伤的机制研究

    Institute of Scientific and Technical Information of China (English)

    李红月; 陈超

    2012-01-01

    目的:观察香椿子总多酚对大鼠心肌缺血再灌注急性炎症的影响.方法:50只SD大鼠随机分成假手术组(冠脉下穿线不结扎+0.5%羧甲基纤维素钠)、模型组(冠脉结扎+0.5%羧甲基纤维素钠)、香椿子总多酚低剂量(XD,50 mg· kg-1+冠脉结扎)、中剂量(XZ,100 mg·kg-1+冠脉结扎)、高剂量(XG,200 mg· kg-1+冠脉结扎)组,各组均ig给药.采用左冠状动脉前降支结扎30 min再灌120 min的方法复制大鼠心肌缺血再灌注损伤模型.以ST抬高作为结扎成功的标志,以ST段逐渐回落、梗死性Q波出现作为再灌注成功的标志.再灌结束后行腹主动脉取血,分离血清,测定血清中白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)含量.取左心室缺血区组织10 mg用RT-PCR测定核因子kB (NF-kB)p65 mRNA的表达水平,其余心肌组织做病理切片,并在光镜下观察左心室心肌组织的形态学变化.结果:模型组大鼠血清IL-6含量为(638.88±188.94) ng·L-1,XD,XZ,XG组与模型组相比,血清IL-6含量显著下降,分别为(491.58±142.59),(306.85±80.60),(246.11 ±71.64) ng·L-1.模型组大鼠血清TNF-α含量为(216.23 ±58.67) ng·L-1,XD,XZ,XG组大鼠血清TNF-α水平与之相比显著降低,分别为(148.24 -±36.30),(157.62 ±52.06),(144.10 ±36.64) ng·L-1.模型组大鼠心肌组织中NF-kBp65/β-actin为0.61 ±0.05,香椿子总多酚给药组大鼠NF-kB p65/β-actin与之相比显著降低,分别为0.53 ±0.08,0.45 ±0.13,0.38 ±0.11.香椿子总多酚组与模型组相比,大鼠心肌细胞的形态学损伤较轻.结论:香椿子总多酚能够减轻大鼠心肌缺血再灌注急性炎症,对其产生一定的保护作用.%Objective: To investigate effects of total polyphenols extracted from Toona sinensis Roem on acute inflammation in injury induced by myocardial ischemia-reperfusion in rats. Method: Fifty SD rats were randomly divided into 5 groups: sham operation group, model group and total polyphenols extracted from T

  11. Regularity of hypoxia inducible factor 1 alpha expression in acute myocardial ischaemia in rats

    Institute of Scientific and Technical Information of China (English)

    LI Zhi-gang; WANG Jiang-feng; CHENG Jian-ding; LIU Yan-wei; XING Hao-wei; WANG Yong; CHEN Yu-chuan

    2007-01-01

    @@ Acute myocardial ischaemia is a common acute disease and a common cause of sudden death. However, it is difficult to diagnose in patients who died within 6 hours after the onset of myocardial ischaemia.

  12. N-Acetylcysteine Attenuates Diabetic Myocardial Ischemia Reperfusion Injury through Inhibiting Excessive Autophagy

    Science.gov (United States)

    Wang, Sheng; Yan, Fuxia; Wang, Tingting; He, Yi

    2017-01-01

    Background. Excessive autophagy is a major mechanism of myocardial ischemia reperfusion injury (I/RI) in diabetes with enhanced oxidative stress. Antioxidant N-acetylcysteine (NAC) reduces myocardial I/RI. It is unknown if inhibition of autophagy may represent a mechanism whereby NAC confers cardioprotection in diabetes. Methods and Results. Diabetes was induced in Sprague-Dawley rats with streptozotocin and they were treated without or with NAC (1.5 g/kg/day) for four weeks before being subjected to 30-minute coronary occlusion and 2-hour reperfusion. The results showed that cardiac levels of 15-F2t-Isoprostane were increased and that autophagy was evidenced as increases in ratio of LC3 II/I and protein P62 and AMPK and mTOR expressions were significantly increased in diabetic compared to nondiabetic rats, concomitant with increased postischemic myocardial infarct size and CK-MB release but decreased Akt and eNOS activation. Diabetes was also associated with increased postischemic apoptotic cell death manifested as increases in TUNEL positive cells, cleaved-caspase-3, and ratio of Bax/Bcl-2 protein expression. NAC significantly attenuated I/RI-induced increases in oxidative stress and cardiac apoptosis, prevented postischemic autophagy formation in diabetes, and reduced postischemic myocardial infarction (all p < 0.05). Conclusions. NAC confers cardioprotection against diabetic heart I/RI primarily through inhibiting excessive autophagy which might be a major mechanism why diabetic hearts are less tolerant to I/RI. PMID:28265179

  13. Systemic Atherosclerotic Inflammation Following Acute Myocardial Infarction: Myocardial Infarction Begets Myocardial Infarction

    Science.gov (United States)

    Joshi, Nikhil V; Toor, Iqbal; Shah, Anoop S V; Carruthers, Kathryn; Vesey, Alex T; Alam, Shirjel R; Sills, Andrew; Hoo, Teng Y; Melville, Adam J; Langlands, Sarah P; Jenkins, William S A; Uren, Neal G; Mills, Nicholas L; Fletcher, Alison M; van Beek, Edwin J R; Rudd, James H F; Fox, Keith A A; Dweck, Marc R; Newby, David E

    2015-01-01

    Background Preclinical data suggest that an acute inflammatory response following myocardial infarction (MI) accelerates systemic atherosclerosis. Using combined positron emission and computed tomography, we investigated whether this phenomenon occurs in humans. Methods and Results Overall, 40 patients with MI and 40 with stable angina underwent thoracic 18F-fluorodeoxyglucose combined positron emission and computed tomography scan. Radiotracer uptake was measured in aortic atheroma and nonvascular tissue (paraspinal muscle). In 1003 patients enrolled in the Global Registry of Acute Coronary Events, we assessed whether infarct size predicted early (≤30 days) and late (>30 days) recurrent coronary events. Compared with patients with stable angina, patients with MI had higher aortic 18F-fluorodeoxyglucose uptake (tissue-to-background ratio 2.15±0.30 versus 1.84±0.18, P50 000] versus 3800 [1000 to 9200] ng/L, P<0.0001) and greater aortic 18F-fluorodeoxyglucose uptake (2.24±0.32 versus 2.02±0.21, P=0.03) than those with non–ST-segment elevation MI. Peak plasma troponin concentrations correlated with aortic 18F-fluorodeoxyglucose uptake (r=0.43, P=0.01) and, on multivariate analysis, independently predicted early (tertile 3 versus tertile 1: relative risk 4.40 [95% CI 1.90 to 10.19], P=0.001), but not late, recurrent MI. Conclusions The presence and extent of MI is associated with increased aortic atherosclerotic inflammation and early recurrent MI. This finding supports the hypothesis that acute MI exacerbates systemic atherosclerotic inflammation and remote plaque destabilization: MI begets MI. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT01749254. PMID:26316523

  14. The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Simon L. Bacon

    2012-01-01

    Full Text Available Impaired endothelial function has been shown to limit exercise in coronary artery disease (CAD patients and has been implicated in myocardial ischemia. However, the association of endothelial function and ischemia on peak exercise oxygen consumption (VO2 has not been previously reported. A total of 116 CAD patients underwent standard exercise stress testing, during which VO2 was measured. On a separate day, endothelial-dependent and -independent function were assessed by ultrasound using flow-mediated arterial vasodilation (FMD and sublingual glyceryl trinitrate administration (GTNMD of the brachial artery. Patients with exercise-induced myocardial ischemia had lower FMD than nonischemic patients (3.64±0.57 versus 4.98±0.36, P=.050, but there was no difference in GTNMD (14.11±0.99 versus 15.47±0.63, P=.249. Analyses revealed that both FMD (P=.006 and GTNMD (P=.019 were related to peak VO2. However, neither the presence of ischemia (P=.860 nor the interaction of ischemia with FMD (P=.382 and GTNMD (P=.151 was related to peak VO2. These data suggest that poor endothelial function, potentially via impaired NO production and smooth muscle dysfunction, may be an important determinant of exercise capacity in patients with CAD, independent of myocardial ischemia.

  15. Ginkgolide B Reduces the Degradation of Membrane Phospholipids to Prevent Ischemia/Reperfusion Myocardial Injury in Rats.

    Science.gov (United States)

    Pei, Hong-Xia; Hua, Rong; Guan, Cha-Xiang; Fang, Xiang

    2015-01-01

    Platelet-activating factor (PAF), a bioactive phospholipid, plays an important role in the integrity of the cellular membrane structure, and is involved in the pathogenesis of myocardial ischemia/reperfusion (IR) injuries. In this study, we tested the hypothesis that blockage of PAF receptor by BN 52021 (Ginkgolide B) can prevent IR-induced degradation of the myocardial membrane phospholipid, and deterioration of the cardiac function. Rat hearts in situ were subjected to 5 min ischemia and followed by 10 min reperfusion. Cardiac performances during periods of ischemia and reperfusion were monitored, and the amount of membrane phospholipids was analyzed. Myocardial total phospholipids, phosphatidylcholine, and phosphatidylethanolamine were decreased significantly in ischemia-reperfusion rat hearts compared with those of sham-operated rat hearts. Degradation of the membrane phospholipid was accompanied by the deterioration of cardiac functions and increase in serum lactate dehydrogenase (LDH) activity. BN 52021 (15 mg/kg), given by intravenous infusion 10 min prior to the left anterior descending coronary artery occlusion, reduced IR-related degradation of the myocardial phospholipids, the activity of serum LDH, and was concomitant with improvement of cardiac function. Furthermore, we demonstrated that the production of PAF was increased and BN 52021 decreased cellular damage in cultured anoxic cardiomyocytes. These results indicated that PAF antagonist BN 52021 has a protective effect against IR-induced myocardial dysfunction and degradation of the membrane phospholipids.

  16. Ginsenoside Rb1 Preconditioning Enhances eNOS Expression and Attenuates Myocardial Ischemia/Reperfusion Injury in Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Rui Xia

    2011-01-01

    Full Text Available Diabetes mellitus is associated with decreased NO bioavailability in the myocardium. Ginsenoside Rb1 has been shown to confer cardioprotection against ischemia reperfusion injury. The aim of this study was to investigate whether Ginsenoside Rb1 exerts cardioprotective effects during myocardial ischemia-reperfusion in diabetic rats and whether this effect is related to increase the production of NO via enhancing eNOS expression in the myocardium. The myocardial I/R injury were induced by occluding the left anterior descending artery for 30 min followed by 120 min reperfusion. An eNOS inhibitor L-NAME or Rb1 were respectively administered 25 min or 10 min before inducing ischemia. Ginsenoside Rb1 preconditioning reduced myocardial infarct size when compared with I/R group. Ginsenoside Rb1 induced myocardial protection was accompanied with increased eNOS expression and NO concentration and reduced plasma CK and LDH (P<0.05. Moreover, the myocardial oxidative stress and tissue histological damage was attenuated by Ginsenoside Rb1 (P<0.05. L-NAME abolished the protective effects of Ginsenoside Rb1. It is concluded that Ginsenoside Rb1 protects against myocardium ischemia/reperfusion injury in diabetic rat by enhancing the expression of eNOS and increasing the content of NO as well as inhibiting oxidative stress.

  17. Kaempferol Attenuates Myocardial Ischemic Injury via Inhibition of MAPK Signaling Pathway in Experimental Model of Myocardial Ischemia-Reperfusion Injury

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    Kapil Suchal

    2016-01-01

    Full Text Available Kaempferol (KMP, a dietary flavonoid, has antioxidant, anti-inflammatory, and antiapoptotic effects. Hence, we investigated the effect of KMP in ischemia-reperfusion (IR model of myocardial injury in rats. We studied male albino Wistar rats that were divided into sham, IR-control, KMP-20 + IR, and KMP 20 per se groups. KMP (20 mg/kg; i.p. was administered daily to rats for the period of 15 days, and, on the 15th day, ischemia was produced by one-stage ligation of left anterior descending coronary artery for 45 min followed by reperfusion for 60 min. After completion of surgery, rats were sacrificed; heart was removed and processed for biochemical, morphological, and molecular studies. KMP pretreatment significantly ameliorated IR injury by maintaining cardiac function, normalizing oxidative stress, and preserving morphological alterations. Furthermore, there was a decrease in the level of inflammatory markers (TNF-α, IL-6, and NFκB, inhibition of active JNK and p38 proteins, and activation of ERK1/ERK2, a prosurvival kinase. Additionally, it also attenuated apoptosis by reducing the expression of proapoptotic proteins (Bax and Caspase-3, TUNEL positive cells, and increased level of antiapoptotic proteins (Bcl-2. In conclusion, KMP protected against IR injury by attenuating inflammation and apoptosis through the modulation of MAPK pathway.

  18. Computational modeling of acute myocardial infarction.

    Science.gov (United States)

    Sáez, P; Kuhl, E

    2016-01-01

    Myocardial infarction, commonly known as heart attack, is caused by reduced blood supply and damages the heart muscle because of a lack of oxygen. Myocardial infarction initiates a cascade of biochemical and mechanical events. In the early stages, cardiomyocytes death, wall thinning, collagen degradation, and ventricular dilation are the immediate consequences of myocardial infarction. In the later stages, collagenous scar formation in the infarcted zone and hypertrophy of the non-infarcted zone are auto-regulatory mechanisms to partly correct for these events. Here we propose a computational model for the short-term adaptation after myocardial infarction using the continuum theory of multiplicative growth. Our model captures the effects of cell death initiating wall thinning, and collagen degradation initiating ventricular dilation. Our simulations agree well with clinical observations in early myocardial infarction. They represent a first step toward simulating the progression of myocardial infarction with the ultimate goal to predict the propensity toward heart failure as a function of infarct intensity, location, and size.

  19. [Acute myocardial infarction in the postoperative period following pneumonectomy].

    Science.gov (United States)

    López Alvarez, S; Bonome González, C; Izquierdo Villarroya, B; Barbeito Vilariño, M J; Etxainz Alvarez, A; Alvarez Refojo, F

    2002-11-01

    A 72-year-old man, smoker, with insuline-dependent diabetes and dislipemia underwent left pneumonectomy. Several episodes of intraoperative hemodynamic instability associated with electrocardiographic ST segment alterations were attributed to surgical manipulation; ischemia was not suspected. Cardiorespiratory failure, related to extensive anterior infarction, developed a few minutes after admission to the postoperative intensive care unit (PICU). Cardiopulmonary resuscitation and mechanical ventilation were required. The patient responded to treatment with beta blockers, platelet antiaggregants and statins. Tube was removed a few hours later and the patient was discharged from the PICU on the fifth day. Pneumonectomy has a high rate of morbidity and mortality, with complications mainly arising in the lung and heart. Risk from anesthesia is considered to be great in this procedure, and for that reason it is essential to identify intraoperative myocardial ischemia so that it can be treated aggressively. In patients at high cardiovascular risk who undergo lung resection, intraoperative episodes of myocardial ischemia are associated with a high incidence of postoperative miocardial infarction. Therefore, careful postoperative monitoring is needed and measures should be taken to prevent angina. Early extubation should be avoided.

  20. Prognostic significance of silent myocardial ischemia on a thallium stress test

    Energy Technology Data Exchange (ETDEWEB)

    Heller, L.I.; Tresgallo, M.; Sciacca, R.R.; Blood, D.K.; Seldin, D.W.; Johnson, L.L. (Columbia Univ., College of Physicians and Surgeons, New York, NY (USA))

    1990-03-15

    The clinical significance of silent ischemia is not fully known. The purpose of this study was to determine whether the presence or absence of angina during a thallium stress test positive for ischemia was independently predictive of an adverse outcome. Two hundred thirty-four consecutive patients with ischemia on a thallium stress test were identified. Ischemia was defined as the presence of defect(s) on the immediate postexercise scans not in the distribution of prior infarctions that redistributed on 4-hour scans. During the test 129 patients had angina, defined as characteristic neck, jaw, arm, back or chest discomfort, while the remaining 105 patients had no angina. Follow-up ranged from 2 to 8.2 years (mean 5.2 +/- 2.1) and was successfully obtained in 156 patients. Eighty-two of the 156 patients had angina (group A) and 74 had silent ischemia (group S). Group A patients were significantly older (62 +/- 8 vs 59 +/- 8 years, p less than 0.05). There was no significant difference between the 2 groups in terms of sex, history of prior infarction or presence of left main/3-vessel disease. A larger percentage of patients in group A were receiving beta blockers (60 vs 41%, p less than 0.05) and nitrates (52 vs 36%, 0.05 less than p less than 0.10). There was a large number of cardiac events (myocardial infarction, revascularization and death) in both groups (37 of 82 (45%) in group A; 28 of 72 (38%) in group S) but no statistically significant difference between the groups. Similarly, life-table analysis revealed no difference in mortality between the 2 groups.

  1. ST-elevation acute myocardial infarction in pregnancy: 2016 update.

    Science.gov (United States)

    Ismail, Sahar; Wong, Cynthia; Rajan, Priya; Vidovich, Mladen I

    2017-02-13

    Acute myocardial infarction (AMI) during pregnancy or the early postpartum period is rare, but can be devastating for both the mother and the fetus. There have been major advances in the diagnosis and treatment of acute coronary syndromes in the general population, but there is little consensus on the approach to diagnosis and treatment of pregnant women. This article reviews the literature relating to the pathophysiology of AMI in pregnant patients and the challenges in diagnosis and treatment of ST-elevation myocardial infarction (STEMI) in this unique population. From a cardiologist, maternal-fetal medicine specialist, and anesthesiologist's perspective, we provide recommendations for the diagnosis and management of STEMI occurring during pregnancy.

  2. Acute anteroseptal myocardial infarction in a patient with dextrocardia.

    Science.gov (United States)

    Alzand, Becker S N; Dennert, Robert; Kalkman, Robert; Gorgels, Anton P M

    2009-01-01

    Dextrocardia with situs inversus is an uncommon congenital condition in which the major visceral organs are reversed. The clinical diagnosis and electrocardiographic localization of myocardial infarctions in these patients remain a great challenge. We report a case of a 64-year-old man known with dextrocardia and situs inversus totalis presenting with acute chest pain irradiating to the right arm. The admission and reversed "normalized" electrocardiogram are presented, allowing for correct diagnosis of an acute anteroseptal myocardial infarction. The present case emphasizes the importance of performing a reversed electrocardiogram in patients with dextrocardia.

  3. Attenuated NOx responses and myocardial ischemia, a possible risk for structural vascular disease in African men: the SABPA study.

    Science.gov (United States)

    Uys, A S; Malan, L; van Rooyen, J M; Steyn, H S; Reimann, M; Ziemssen, T

    2014-07-01

    Chronically elevated blood pressure has been associated with impaired NO-mediated vasodilation and structural vascular disease risk. This study aimed to determine whether significant associations exist regarding NO metabolite (NOx) responses, cardiovascular function and structural vascular disease in a cohort of African and Caucasian men. The study included 81 African and 94 Caucasian male teachers stratified via median splits into low and high NOx ethnic groups. Ambulatory blood pressure, electrocardiogram monitoring and ultrasound carotid intima-media thickness (CIMT) images were obtained. Cardiovascular measurements and fasting blood for NOx responses were measured during rest and on challenging the cardiovascular system with the Stroop colour-word conflict test. African men displayed significantly higher resting NOx as well as higher number of 24 h silent ischemic events than their Caucasian counterparts. Low NOx African men displayed enhanced α-adrenergic and ECG ST segment depression acute mental stress responses as well as 24 h silent ischemic events associated with CIMT (adjusted R(2) = 0.47; β = 0.25; confidence interval (CI) = 0.13, 0.41). African men demonstrated a vulnerable cardiovascular profile. Novel findings revealed α-adrenergic-driven blood pressure responses and less NO bioavailability during acute stress. The association between myocardial ischemia and CIMT in this group emphasized their risk for future coronary artery disease and cerebrovascular events.

  4. Markers of Myocardial Ischemia in Patients with Obstructive Sleep Apnea and Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Misa Valo

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA is characterized by intermittent hypoxia during sleep. We tested the hypothesis that nocturnal myocardial ischemia is detectable by ST segment depression and elevation of high sensitive troponin T (hsTrop T and B-type natriuretic peptide (NT-proBNP in patients with OSA and coexisting coronary artery disease (CAD. Twenty-one patients with OSA and CAD and 20 patients with OSA alone underwent in-hospital polysomnography. Blood samples for hsTrop T and NT-proBNP measurements were drawn before and after sleep. ST segment depression was measured at the time of maximum oxygen desaturation during sleep. The apnea-hypopnea-index (AHI, oxygen saturation nadir, and time in bed with oxygen saturation of ≤80% were similar in both groups. Levels of hsTrop T and NT-proBNP did not differ significantly before and after sleep but NT-proBNP levels were significantly higher in patients suffering from OSA and CAD compared to patients with OSA alone. No significant ST depression was found at the time of oxygen saturation nadir in either group. Despite the fact that patients with untreated OSA and coexisting CAD experienced severe nocturnal hypoxemia, we were unable to detect myocardial ischemia or myocyte necrosis based on significant ST segment depression or elevation of hsTrop T and NT-proBNP, respectively.

  5. Myocardial contrast echocardiography to assess perfusion in a mouse model of ischemia/reperfusion injury

    Science.gov (United States)

    Hossack, John A.; Li, Yinbo; Christensen, Jonathan P.; Yang, Zequan; French, Brent A.

    2004-04-01

    Noninvasive approaches for measuring anatomical and physiological changes resulting from myocardial ischemia / reperfusion injury in the mouse heart have significant value since the mouse provides a practical, low-cost model for modeling human heart disease. In this work, perfusion was assessed before, during and after an induced closed- chest, coronary ischemic event. Ultrasound contrast agent, similar to MP1950, in a saline suspension, was injected via cannulated carotid artery as a bolus and imaged using a Siemens Sequoia 512 scanner and a 15L8 intraoperative transducer operating in second harmonic imaging mode. Image sequences were transferred from the scanner to a PC for analysis. Regions of interest were defined in septal and anterior segments of the myocardium. During the ischemic event, when perfusion was diminished in the anterior segment, mean video intensity in the affected segment was reduced by one half. Furthermore, following reperfusion, hyperemia (enhanced blood flow) was observed in the anterior segment. Specifically, the mean video intensity in the affected segment was increased by approximately 50% over the original baseline level prior to ischemia. Following the approach of Kaul et al., [1], gamma variate curves were fitted to the time varying level of mean video intensity. This foundation suggests the possibility of quantifying myocardial blood flow in ischemic regions of a mouse heart using automated analysis of contrast image data sets. An improved approach to perfusion assessment using the destruction-reperfusion approach [2] is also presented.

  6. Hyperbaric oxygen associated therapy on 398 youth myocardial ischemia%高压氧辅助治疗青年人心肌缺血398例

    Institute of Scientific and Technical Information of China (English)

    袁宝先; 王国枝

    2002-01-01

    @@ Background: Main causes of youth myocardial ischemia are smoking and hypercholesterolemia, which leads to disorder of collateral circulation, increase of cardiac accidence and coronary atherosclerosis. Hypoxia is easy to happen because thick of sclerotic vessels wall nearly reaches the maximal diffuse distance in this tissue. CO in cigarettes can lead to hypoxia and myocardial ischemia. After use of hyperbaric oxygen, blood fat decrease, incidence of coronary atherosclerosis decreases apparently. And it promotes myocardial hypoxia and metabolism, increases myocardial contraction and promotes heart function, thereby decrease incidence of angina, myocardial infarction and sudden death.

  7. Assessment of Myocardial Ischemia in Obese Individuals Undergoing Physical Stress Echocardiography (PSE

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    Mara Graziele Maciel Silveira

    2015-05-01

    Full Text Available Background: Physical stress echocardiography is an established methodology for diagnosis and risk stratification of coronary artery disease in patients with physical capacity. In obese (body mass index ≥ 30 kg/m2 the usefulness of pharmacological stress echocardiography has been demonstrated; however, has not been reported the use of physical stress echocardiography in this growing population group. Objective: To assess the frequency of myocardial ischemia in obese and non-obese patients undergoing physical stress echocardiography and compare their clinical and echocardiographic differences. Methods: 4,050 patients who underwent treadmill physical stress echocardiography were studied according to the Bruce protocol, divided into two groups: obese (n = 945; 23.3% and non-obese (n = 3,105; 76.6%. Results: There was no difference regarding gender. Obese patients were younger (55.4 ± 10.9 vs. 57.56 ± 11.67 and had a higher frequency of hypertension (75.2% vs. 57, 2%; p < 0.0001, diabetis mellitus (15.2% vs. 10.9%; p < 0.0001, dyslipidemia (59.5% vs 51.9%; p < 0.0001, family history of coronary artery disease (59.3% vs. 55.1%; p = 0.023 and physical inactivity (71.4% vs. 52.9%, p < 0.0001. The obese had greater aortic dimensions (3.27 vs. 3.14 cm; p < 0.0001, left atrium (3.97 vs. 3.72 cm; p < 0.0001 and the relative thickness of the ventricule (33.7 vs. 32.8 cm; p < 0.0001. Regarding the presence of myocardial ischemia, there was no difference between groups (19% vs. 17.9%; p = 0.41. In adjusted logistic regression, the presence of myocardial ischemia remained independently associated with age, female gender, diabetes and hypertension. Conclusion: Obesity did not behave as a predictor of the presence of ischemia and the physical stress echocardiography. The application of this assessment tool in large scale sample demonstrates the feasibility of the methodology, also in obese.

  8. Assessment of Myocardial Ischemia in Obese Individuals Undergoing Physical Stress Echocardiography (PSE)

    Science.gov (United States)

    Silveira, Mara Graziele Maciel; Sousa, Antônio Carlos Sobral; Santos, Marcos Antônio Almeida; Tavares, Irlaneide da Silva; Andrade, Stephanie Macedo; Melo, Luiza Dantas; de Andrade, Loren Suyane Oliveira; Santos, Emmanuel Lima Almeida; Oliveira, Joselina Luzia Menezes

    2015-01-01

    Background Physical stress echocardiography is an established methodology for diagnosis and risk stratification of coronary artery disease in patients with physical capacity. In obese (body mass index ≥ 30 kg/m2) the usefulness of pharmacological stress echocardiography has been demonstrated; however, has not been reported the use of physical stress echocardiography in this growing population group. Objective To assess the frequency of myocardial ischemia in obese and non-obese patients undergoing physical stress echocardiography and compare their clinical and echocardiographic differences. Methods 4,050 patients who underwent treadmill physical stress echocardiography were studied according to the Bruce protocol, divided into two groups: obese (n = 945; 23.3%) and non-obese (n = 3,105; 76.6%). Results There was no difference regarding gender. Obese patients were younger (55.4 ± 10.9 vs. 57.56 ± 11.67) and had a higher frequency of hypertension (75.2% vs. 57, 2%; p < 0.0001), diabetis mellitus (15.2% vs. 10.9%; p < 0.0001), dyslipidemia (59.5% vs 51.9%; p < 0.0001), family history of coronary artery disease (59.3% vs. 55.1%; p = 0.023) and physical inactivity (71.4% vs. 52.9%, p < 0.0001). The obese had greater aortic dimensions (3.27 vs. 3.14 cm; p < 0.0001), left atrium (3.97 vs. 3.72 cm; p < 0.0001) and the relative thickness of the ventricule (33.7 vs. 32.8 cm; p < 0.0001). Regarding the presence of myocardial ischemia, there was no difference between groups (19% vs. 17.9%; p = 0.41). In adjusted logistic regression, the presence of myocardial ischemia remained independently associated with age, female gender, diabetes and hypertension. Conclusion Obesity did not behave as a predictor of the presence of ischemia and the physical stress echocardiography. The application of this assessment tool in large scale sample demonstrates the feasibility of the methodology, also in obese. PMID:25714197

  9. In Silico Investigation into Cellular Mechanisms of Cardiac Alternans in Myocardial Ischemia

    Directory of Open Access Journals (Sweden)

    Jiaqi Liu

    2016-01-01

    Full Text Available Myocardial ischemia is associated with pathophysiological conditions such as hyperkalemia, acidosis, and hypoxia. These physiological disorders may lead to changes on the functions of ionic channels, which in turn form the basis for cardiac alternans. In this paper, we investigated the roles of hyperkalemia and calcium handling components played in the genesis of alternans in ischemia at the cellular level by using computational simulations. The results show that hyperkalemic reduced cell excitability and delayed recovery from inactivation of depolarization currents. The inactivation time constant τf of L-type calcium current (ICaL increased obviously in hyperkalemia. One cycle length was not enough for ICaL to recover completely. Alternans developed as a result of ICaL responding to stimulation every other beat. Sarcoplasmic reticulum calcium-ATPase (SERCA2a function decreased in ischemia. This change resulted in intracellular Ca (Cai alternans of small magnitude. A strong Na+-Ca2+ exchange current (INCX increased the magnitude of Cai alternans, leading to APD alternans through excitation-contraction coupling. Some alternated repolarization currents contributed to this repolarization alternans.

  10. In Silico Investigation into Cellular Mechanisms of Cardiac Alternans in Myocardial Ischemia

    Science.gov (United States)

    Liu, Jiaqi; Zhao, Xiaopeng

    2016-01-01

    Myocardial ischemia is associated with pathophysiological conditions such as hyperkalemia, acidosis, and hypoxia. These physiological disorders may lead to changes on the functions of ionic channels, which in turn form the basis for cardiac alternans. In this paper, we investigated the roles of hyperkalemia and calcium handling components played in the genesis of alternans in ischemia at the cellular level by using computational simulations. The results show that hyperkalemic reduced cell excitability and delayed recovery from inactivation of depolarization currents. The inactivation time constant τf of L-type calcium current (ICaL) increased obviously in hyperkalemia. One cycle length was not enough for ICaL to recover completely. Alternans developed as a result of ICaL responding to stimulation every other beat. Sarcoplasmic reticulum calcium-ATPase (SERCA2a) function decreased in ischemia. This change resulted in intracellular Ca (Cai) alternans of small magnitude. A strong Na+-Ca2+ exchange current (INCX) increased the magnitude of Cai alternans, leading to APD alternans through excitation-contraction coupling. Some alternated repolarization currents contributed to this repolarization alternans. PMID:28070211

  11. Reduced myocardial blood flow in acute and chronic digitalization.

    Science.gov (United States)

    Steiness, E; Bille-Brahe, N E; Hansen, J F; Lomholt, N; Ring-Larsen, H

    1978-07-01

    The myocardial blood flow was measured by the 133Xenon disappearance curve from the left ventricular wall following an injection of 133Xenon in the left coronary artery in 8 dogs without digoxin pretreatment and in 8 chronically digitalized dogs. The myocardial blood flow was significantly less (30%) in the digitalized dogs than in the dogs without pretreatment. In the digitalized dogs as well as in those without pretreatment an intravenous injection of digoxin resulted in a further significant decrease of the myocardial blood flow of about 20% and a significant increase of the coronary vascular resistance. The reduced myocardial blood flow both during acute and chronic digitalization is beleived to be of clinical importance.

  12. Intracoronary and systemic melatonin to patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Halladin, Natalie L; Busch, Sarah Ekeløf; Jensen, Svend Eggert

    2014-01-01

    INTRODUCTION: Ischaemia-reperfusion injury following acute myocardial infarctions (AMI) is an unavoidable consequence of the primary percutaneous coronary intervention (pPCI) procedure. A pivotal mechanism in ischaemia-reperfusion injury is the production of reactive oxygen species following...... following pPCI in patients with AMI. MATERIAL AND METHODS: The IMPACT trial is a multicentre, randomised, double-blinded, placebo-controlled study. We wish to include 2 × 20 patients with ST-elevation myocardial infarctions undergoing pPCI within six hours from symptom onset. The primary end......-point is the Myocardial Salvage Index assessed by cardiovascular magnetic resonance imaging on day 4 (± 1) after pPCI. The secondary end-points are high-sensitivity troponin, creatinekinase myocardial band and clinical events. CONCLUSION: The aim of the IMPACT trial is to evaluate the effect of melatonin on reperfusion...

  13. Management of cardiogenic shock complicating acute myocardial infarction.

    Science.gov (United States)

    Van Herck, Jozef L; Claeys, Marc J; De Paep, Rudi; Van Herck, Paul L; Vrints, Christiaan J; Jorens, Philippe G

    2015-06-01

    Cardiogenic shock complicates approximately 5-10% of cases with acute myocardial infarction and carries a poor prognosis. Early revascularization remains the cornerstone treatment of cardiogenic shock complicating myocardial infarction. Inotropic and/or vasopressor agents can be used for haemodynamic stabilization, although this comes at the expense of increased myocardial oxygen consumption and extended myocardial ischaemia. In recent years, the use of mechanical circulatory support has significantly increased. However, there is only limited data available from randomized trials evaluating the different percutaneous support systems. This review summarizes the available literature concerning the management of cardiogenic shock and gives an overview of the recommendations of the European and German-Austrian guidelines on cardiogenic shock.

  14. Myocardial autophagy variation during acute myocardial infarction in rats: the effects of carvedilol

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jing-lan; LU Jia-kai; CHEN Dong; CAI Qing; LI Tong-xun; WU Li-song; WU Xue-si

    2009-01-01

    Background The loss of cardiac myocytes is one of the mechanisms involved in acute myocardial infarction (AMI)-related heart failure. Autophagy is a common biological process in eukaryote cells. The relationship between cardiac myocyte loss and autophagy after AMI is still unclear. Carvedilol, a non-selective α1- and β-receptor blocker, also suppresses cardiac myocyte necrosis and apoptosis induced by ischemia. However, the association between the therapeutic effects of carvedilol and autophagy is still not well understood. The aim of the present study was to establish a rat model of AMI and observe changes in autophagy in different zones of the myocardium and the effects of carvedilol on autophagy in AMI rats.Methods The animals were randomly assigned to a sham group, an AMI group, a chloroquine intervention group and a carvedilol group. The AMI rat model was established by ligating the left anterior descending coronary artery. The hearts were harvested at 40 minutes, 2 hours, 24 hours and 2 weeks after ligation in the AMI group, at 40 minutes in the chloroquine intervention group and at 2 weeks in other groups. Presence of autophagic vacuoles (AV) in the myocytes was observed by electron microscopy. The expression of autophagy-, anti-apoptotic- and apoptotic-related proteins, MAPLC-3, Beclin-1, Bcl-xl and Bax, were detected by immunohistochemical staining and Western blotting. Results Avs were not observed in necrotic regions of the myocardium 40 minutes after ligation of the coronary artery. A large number of Avs were found in the region bordering the infarction. Compared with the infarction region and the normal region, the formation of AV was significantly increased in the region bordering the infarction (P <0.05). The expression of autophagy- and anti-apoptotic-related proteins was significantly increased in the region bordering the infarction. Meanwhile, the expression of apoptotic-related proteins was significantly increased in the infarction region. In

  15. Myocardial oedema in acute myocarditis detected by echocardiographic 2D myocardial deformation analysis

    DEFF Research Database (Denmark)

    Løgstrup, Brian Bridal; Nielsen, Jan Møller; Kim, W Y;

    2015-01-01

    AIMS: The clinical diagnosis of acute myocarditis is based on symptoms, electrocardiography, elevated myocardial necrosis biomarkers, and echocardiography. Often, conventional echocardiography reveals no obvious changes in global cardiac function and therefore has limited diagnostic value....... Myocardial deformation imaging by echocardiography is an evolving method used to characterize quantitatively longitudinal systolic function, which may be affected in acute myocarditis. The aim of our study was to assess the utility of echocardiographic deformation imaging of the left ventricle in patients...... with diagnosed acute myocarditis in whom cardiovascular magnetic resonance (CMR) evaluation was performed. METHODS AND RESULTS: We included 28 consecutive patients (mean age 32 ± 13 years) with CMR-verified diagnosis of acute myocarditis according to the Lake Louise criteria. Cardiac function was evaluated...

  16. Suv39h1 Protects from Myocardial Ischemia-Reperfusion Injury in Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Bo Yang

    2014-04-01

    Full Text Available Background: Patients with diabetes are at increased risk of ischemic events. Suv39h1 is a histone methyltransferase that catalyzes the methylation of histone 3 lysine 9, which is associated with the suppression of inflammatory genes in diabetes. However, the role of Suv39h1 in myocardial ischemia/reperfusion (I/R injury under diabetic condition has not been evaluated. Methods: To generate diabetic model, male SD rats were fed with 60% fat diet followed by intraperitoneal injection with 40mg/kg streptozotocin. Adenovirus encoding Suv39h1 gene was used for Suv39h1 overexpression. Each rat received injections of adenovirus at five myocardial sites. Three days after gene transfection, each rat was subjected to left main coronary artery occlusion and reperfusion. After 30 min ischemia and reperfusion for 4 h, the rats were euthanized for real-time PCR, Western blot, immunohistochemical staining, and morphometric analysis. Results: Delivery of Ad-Suv39h1 into the hearts of diabetic rats could markedly increase Suv39h1 expression. Up-regulation of Suv39h1 significantly reduced infarct size and tissue damage after I/R injury, which was associated with protection from apoptosis of cardiac myocytes and reduction of inflammatory response. In addition, compared with injury group, Ad-Suv39h1 led to a decreased activity of mitogen-activated protein kinase family and its down-steam transcriptional factor NF-κB. Conclusion: Overexpression of Suv39h1 results in the de-activation of proinflammatory pathways and reduced apoptosis and myocardial injury. Therefore, Suv39h1 might represent a novel therapeutic strategy to reduce I/R injury under diabetic condition.

  17. Acute myocardial infarction and subclinical hyperthyroidism without significant coronary stenoses.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Di Bella, Gianluca; Turiano, Giuseppe

    2009-05-29

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. It has been also reported an acute myocardial infarction with normal coronary arteries associated with iatrogenic hyperthyroidism and with a myocardial bridge too. Moreover, it has been reported that simply measuring maximum P wave duration and P wave dispersion values, may help to determine the patients with subclinical hyperthyroidism and high risk for the development of atrial fibrillation. We present a case of an acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  18. Critical finger ischemia and myocardial fibrosis development after sudden interruption of sildenafil treatment in a systemic sclerosis patient.

    Science.gov (United States)

    Bruni, C; Bellando-Randone, S; Gargani, L; Picano, E; Pingitore, A; Matucci-Cerinic, M; Guiducci, S

    2016-01-01

    Systemic sclerosis (SSc) is a connective tissue disease frequently associated with Raynaud's Phenomenon (RP). Among possible pharmacological treatments, phosphodiesterase 5 inhibitors are considered in cases of severe non -responsive RP. We present the case of a male SSc patient wh presented with critical finger ischemia and concomitant appearance of myocardial fibrosis after sudden interruption of sildenafil treatment.

  19. Relevance of tissue Doppler in the quantification of stress echocardiography for the detection of myocardial ischemia in clinical practice

    Directory of Open Access Journals (Sweden)

    Sicari Rosa

    2005-01-01

    Full Text Available Abstract In the present article we review the main published data on the application of Tissue Doppler Imaging (TDI to stress echocardiography for the detection of myocardial ischemia. TDI has been applied to stress echocardiography in order to overcome the limitations of visual analysis for myocardial ischemia. The introduction of a new technology for clinical routine use should pass through the different phases of scientific assessment from feasibility studies to large multicenter studies, from efficacy to effectiveness studies. Nonetheless the pro-technology bias plays a major role in medicine and expensive and sophisticated techniques are accepted before their real usefulness and incremental value to the available ones is assessed. Apparently, TDI is not exempted by this approach : its applications are not substantiated by strong and sound results. Nonetheless, conventional stress echocardiography for myocardial ischemia detection is heavily criticized on the basis of its subjectivity. Stress echocardiography has a long lasting history and the evidence collected over 20 years positioned it as an established tool for the detection and prognostication of coronary artery disease. The quantitative assessment of myocardial ischemia remains a scientific challenge and a clinical goal but time has not come for these newer ultrasonographic techniques which should be restricted to research laboratories.

  20. Reduction of transient myocardial ischemia with pravastatin in addition to the conventional treatment in patients with angina pectoris

    NARCIS (Netherlands)

    vanBoven, AJ; Jukema, JW; Zwinderman, AH; Crijns, HJGM; Lie, KI; Bruschke, AVG

    1996-01-01

    Background Lipid-lowering therapy reduces cardiac mor bidity and mortality. Le Methods and Results In a 2-year prospective randomized placebo-controlled study, the effect of pravastatin 40 mg on transient myocardial ischemia was assessed. Forty-eight-hour ambulatory ECGs with continuous ST-segment a

  1. Occurrence of Myocardial Ischemia in Patients Undergoing Pharmacologic Stress Echocardiography: The Impact of Type-D Personality

    Directory of Open Access Journals (Sweden)

    Rafael Borsoi

    2014-01-01

    Full Text Available Background: Type-D personality has been identified as a risk factor for general and cardiac mortality in patients with coronary artery disease (CAD. Dobutamine-atropine stress echocardiography (DASE is an established method for non-invasive evaluation of myocardial ischemia in patients with CAD. The objective of this study was to evaluate the prevalence of type-D personality and its association with the occurrence of myocardial ischemia as assessed by DASE. Methods: This case-control study enrolled 306 patients (61 ± 9.6 years, 57.8% female who were referred by physicians to assessment of myocardial ischemia. Before undergoing DASE, the patients answered the type-D scale, which identifies type-D personality. Results: Type-D personality was identified in 106 patients (34.6%. DASE was positive for myocardial ischemia in 32.4% (99 of 306 participants there was no significant association between type-D personality and ischemic changes on DASE (P = 0.941; odds ratio: 0.98; confidence interval 95%: 0.57-1.69. Chest pain was the only clinical variable with statistically significant prevalence in type-D personality patients (77.4% vs. 57.0%; P < 0.001. Conclusions: Type-D personality was not a significant risk factor for the presence of ischemic changes on DASE. Patients with type-D personality tended to complain more frequently of chest pain than non-type-D patients.

  2. History of Depression and Survival After Acute Myocardial Infarction

    NARCIS (Netherlands)

    Carney, Robert M.; Freedland, Kenneth E.; Steinmeyer, Brian; Blumenthal, James A.; de Jonge, Peter; Davidson, Karina W.; Czajkowski, Susan M.; Jaffe, Allan S.

    2009-01-01

    Objective: To compare survival in post-myocardial (MI) participants from the Enhancing Recovery In Coronary Heart Disease (ENRICHD) clinical trial with a first episode of major depression (MD) and those with recurrent MID, which is a risk factor for mortality after acute MI. Recent reports suggest t

  3. Myocardial stress in patients with acute cerebrovascular events

    DEFF Research Database (Denmark)

    Jespersen, Christian M; Fischer Hansen, Jørgen

    2008-01-01

    Signs of myocardial involvement are common in patients with acute cerebrovascular events. ST segment deviations, abnormal left ventricular function, increased N-terminal pro-brain natriuretic peptide (NT-proBNP), prolonged QT interval, and/or raised troponins are observed in up to one third...

  4. Mortality after acute myocardial infarction according to income and education

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe Nørgaard; Rasmussen, Søren; Gislason, Gunnar H

    2006-01-01

    OBJECTIVE: To study how income and educational level influence mortality after acute myocardial infarction (AMI). DESIGN AND SETTING: Prospective analysis using individual level linkage of registries in Denmark. PARTICIPANTS: All patients 30-74 years old hospitalised for the first time with AMI...

  5. Depressed natural killer cell activity in acute myocardial infarction

    DEFF Research Database (Denmark)

    Klarlund, K; Pedersen, B K; Theander, T G

    1987-01-01

    Natural killer (NK) cell activity against K562 target cells was measured in patients within 24 h of acute myocardial infarction (AMI) and regularly thereafter for 6 weeks. NK cell activity was suppressed on days 1, 3, and 7 (P less than 0.01), day 14 (P less than 0.05) and at 6 weeks (P = 0...

  6. Early changes in left atrial volume after acute myocardial infarction

    DEFF Research Database (Denmark)

    Bakkestrom, R.; Andersen, Mads J; Ersboll, M.

    2016-01-01

    Background: Dilatation of left atrium (LA) reflects chronic LA pressure or volume overload that possesses considerable prognostic information. Little is known regarding the interaction between LA remodeling after acute myocardial infarction (MI) and left atrial pressure at rest and during exercise...

  7. Prehospital thrombolysis for acute st-segment elevation myocardial infarction

    NARCIS (Netherlands)

    Lamfers, Evert Jan Pieter

    2003-01-01

    Early treatment of acute ST elevation myocardial infarction is associated with a good prognosis and a low incidence of complications. Prehospital administration of thrombolytic treatment is one of the ways of starting treatment early after onset of symptoms. Fifteen years of experience in prehospita

  8. Acute myocardial infarction in a young man using anabolic steroids.

    Science.gov (United States)

    Wysoczanski, Mariusz; Rachko, Maurice; Bergmann, Steven R

    2008-01-01

    Anabolic-androgenic steroids are used worldwide to help athletes gain muscle mass and strength. Their use and abuse is associated with numerous side effects, including acute myocardial infarction (MI). We report a case of MI in a young 31-year-old bodybuilder. Because of the serious cardiovascular complications of anabolic steroids, physicians should be aware of their abuse and consequences.

  9. Thrombolytic therapy preserves vagal activity early after acute myocardial infarction

    DEFF Research Database (Denmark)

    Lind, P; Hintze, U; Møller, M

    2001-01-01

    OBJECTIVE: The purpose of this study was to evaluate the effects of thrombolytic therapy on vagal tone after acute myocardial infarction (AMI). DESIGN: Holter monitoring for 24 h was performed at hospital discharge and 6 weeks after AMI in 74 consecutive male survivors of a first AMI, who fulfill...

  10. The inflammatory response in myocarditis and acute myocardial infarction

    NARCIS (Netherlands)

    Emmens, R.W.

    2016-01-01

    This thesis is about myocarditis and acute myocardial infarction (AMI). These are two cardiac diseases in which inflammation of the cardiac muscle occurs. In myocarditis, inflammation results in the elimination of a viral infection of the heart. During AMI, one of the coronary arteries is occluded,

  11. Regulation of Content of Malondialdehyde by Siqi Decoction via Increasing Activity of Superoxide Dismutase in Blood Serum of Rats with Myocardial Ischemia

    Institute of Scientific and Technical Information of China (English)

    SU Yan-bin; JIANG Yi-zhong; LU Ming; CHENG Ying-kun; SU Yan-wen; ZHANG Fen-rong; LI Zheng-qiang

    2009-01-01

    Effect of Siqi decoction on myocardial ischemia is to prevent cardiac myocyte membrane from damage associated with oxygen free radicals related to NO. To research the regulatoin of the content of malondialdehyde by Siqi decoction, an index of lipid peroxidation, via increasing activity of superoxide dismutase in blood serum of rats with Myocardial Ischemia, the model of myocardium ischemia was made in Wistar rats with posterior pituitary injection through vein in tail. Siqi decoction, Diaoxinxuekang(DK) and Fufangdanshenpian(FD), the latter two drugs of which are effective TCM drugs of anti-myocardial ischemia at present, were administrated to the rats with myocardium ischemia for 5 days to compare the effect of them on myocardium ischemia as reference drugs via measuring the changes of the content of malondialdehyde and the activity of superoxide dismutase in the rat blood serum with myocardial ischemia. There were a remarkable increase in the activity of superoxide dismutase and a decrease in the content of malondialdehyde in the serum of the rats administered Siqi decoction compared with those of the rats in control group, p<0.05. The contents of MDA in the serum of the prevention group rats in the experiments are lower than those of the cure group rats. Anti-Myocardium Ischemia mechanism of Siqi decoction is the regulation of the content of malondialdehyde via increasing activity of superoxide dismutase in the serum of Rats with myocardial ischemia and stimulating the activity of NOS in serum so as to increase NO concentration.

  12. Blockage of transient receptor potential vanilloid 4 alleviates myocardial ischemia/reperfusion injury in mice

    Science.gov (United States)

    Dong, Qian; Li, Jing; Wu, Qiong-feng; Zhao, Ning; Qian, Cheng; Ding, Dan; Wang, Bin-bin; Chen, Lei; Guo, Ke-Fang; Fu, Dehao; Han, Bing; Liao, Yu-Hua; Du, Yi-Mei

    2017-01-01

    Transient receptor potential vanilloid 4 (TRPV4) is a Ca2+-permeable nonselective cation channel and can be activated during ischemia/reperfusion (I/R). This study tested whether blockade of TRPV4 can alleviate myocardial I/R injury in mice. TRPV4 expression began to increase at 1 h, reached statistically at 4 h, and peaked at 24–72 h. Treatment with the selective TRPV4 antagonist HC-067047 or TRPV4 knockout markedly ameliorated myocardial I/R injury as demonstrated by reduced infarct size, decreased troponin T levels and improved cardiac function at 24 h after reperfusion. Importantly, the therapeutic window for HC-067047 lasts for at least 12 h following reperfusion. Furthermore, treatment with HC-067047 reduced apoptosis, as evidenced by the decrease in TUNEL-positive myocytes, Bax/Bcl-2 ratio, and caspase-3 activation. Meanwhile, treatment with HC-067047 attenuated the decrease in the activation of reperfusion injury salvage kinase (RISK) pathway (phosphorylation of Akt, ERK1/2, and GSK-3β), while the activation of survival activating factor enhancement (SAFE) pathway (phosphorylation of STAT3) remained unchanged. In addition, the anti-apoptotic effects of HC-067047 were abolished by the RISK pathway inhibitors. We conclude that blockade of TRPV4 reduces apoptosis via the activation of RISK pathway, and therefore might be a promising strategy to prevent myocardial I/R injury. PMID:28205608

  13. Effect of myocardial ischemia and nitroglycerin on systolic time intervals in the segmental myocardium

    Directory of Open Access Journals (Sweden)

    Haraoka,Shoichi

    1978-04-01

    Full Text Available Effects of ischemia and nitroglycerin on systolic time intervals in the segmental myocardial length were studied in anesthetized open-chest dogs. Two strain-gauges were sutured on the surface of the left ventricular wall; one was in the central area perfused by the left circumflex coronary artery (LCX and the other was in the area perfused by the left anterior descending coronary artery. LCX was partially occluded with a screw type constrictor to the degree at which reactive hyperemia after the transient total coronary occlusion almost disappeared. After the hemodynamics stabilized nitroglycerin (20 microgram/kg was injected into the femoral vein. In the ischemic area, contraction time was shortened and precontraction time was prolonged in association with an elongation of end-systolic and early systolic segment-length, respectively. The systolic time intervals in the ischemic segment were improved as a result of the recovery in the segment-length toward the control. The results suggest the usefulness of analyzing the segmental myocardial systolic time intervals for verifying the asynchronous contraction of the ventricle and the favourable effects of nitroglycerin on segmental myocardial function in the ischemic area.

  14. Impaired autophagy contributes to adverse cardiac remodeling in acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Xiaoqian Wu

    Full Text Available OBJECTIVE: Autophagy is activated in ischemic heart diseases, but its dynamics and functional roles remain unclear and controversial. In this study, we investigated the dynamics and role of autophagy and the mechanism(s, if any, during postinfarction cardiac remodeling. METHODS AND RESULTS: Acute myocardial infarction (AMI was induced by ligating left anterior descending (LAD coronary artery. Autophagy was found to be induced sharply 12-24 hours after surgery by testing LC3 modification and Electron microscopy. P62 degradation in the infarct border zone was increased from day 0.5 to day 3, and however, decreased from day 5 until day 21 after LAD ligation. These results indicated that autophagy was induced in the acute phase of AMI, and however, impaired in the latter phase of AMI. To investigate the significance of the impaired autophagy in the latter phase of AMI, we treated the mice with Rapamycin (an autophagy enhancer, 2.0 mg/kg/day or 3-methyladenine (3MA, an autophagy inhibitor, 15 mg/kg/day one day after LAD ligation until the end of experiment. The results showed that Rapamycin attenuated, while 3MA exacerbated, postinfarction cardiac remodeling and dysfunction respectively. In addition, Rapamycin protected the H9C2 cells against oxygen glucose deprivation in vitro. Specifically, we found that Rapamycin attenuated NFκB activation after LAD ligation. And the inflammatory response in the acute stage of AMI was significantly restrained with Rapamycin treatment. In vitro, inhibition of NFκB restored autophagy in a negative reflex. CONCLUSION: Sustained myocardial ischemia impairs cardiomyocyte autophagy, which is an essential mechanism that protects against adverse cardiac remodeling. Augmenting autophagy could be a therapeutic strategy for acute myocardial infarction.

  15. Myocardial capillary permeability after regional ischemia and reperfusion in the in vivo canine heart. Effect of superoxide dismutase

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Bjerrum, P J; Haunsø, S

    1991-01-01

    This study assesses the effect of the superoxide anion scavenger superoxide dismutase on myocardial capillary permeability-surface area (PS) products for small hydrophilic molecules after ischemia and reperfusion. Open-chest dogs underwent a 20-minute occlusion of the left anterior descending...... the start of reperfusion. In 13 dogs, no scavenger treatment was given (nonprotected control group), whereas eight dogs were treated systemically with 15,000 units/kg superoxide dismutase during 1 hour, starting 20 minutes before ischemia. In the control group, three dogs developed reperfusion ventricular...... fibrillation in contrast to none in the superoxide dismutase group. Before ischemia, plasma flow rate, myocardial capillary extraction fraction, and PS values were similar in the two groups. Five minutes after the start of reperfusion, plasma flow rate increased significantly (p less than 0.01) in both groups...

  16. Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Ruzsics, Balazs; Costello, Philip [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Lee, Heon [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Seoul Medical Center, Department of Radiology, Seoul (Korea); Zwerner, Peter L.; Schoepf, U.J. [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Charleston, SC (United States); Gebregziabher, Mulugeta [Medical University of South Carolina, Department of Biostatistics, Bioinformatics, and Epidemiology, Charleston, SC (United States)

    2008-11-15

    We aimed to evaluate the feasibility of diagnosing coronary stenosis and myocardial ischemia with a single dual-energy CT (DECT) acquisition. Thirty-five patients underwent contrast-enhanced, ECG-gated DECT of the heart while independently operating the two tubes of a dual-source CT system at high- and low-energy X-ray spectra. From the same raw data, coronary CTA (cCTA) studies were reconstructed for stenosis detection, and the myocardial blood-pool was analyzed by determining the tissue iodine content. Two independent observers analyzed all studies for stenosis and myocardial blood-pool deficits. Results were correlated with SPECT, coronary catheterization and cCTA on a segmental basis. cCTA had 98% sensitivity, 88% specificity and 92% accuracy for detection of >50% stenosis. DECT detected myocardial ischemia with 84% sensitivity, 94% specificity and 92% accuracy. Our initial experience may warrant further exploration of DECT as a possibly feasible single imaging investigation for the comprehensive diagnosis of coronary stenosis and myocardial ischemia. (orig.)

  17. Ethyl pyruvate reduces myocardial ischemia and reperfusion injury by inhibiting high mobility group box 1 protein in rats.

    Science.gov (United States)

    Hu, Xiaorong; Cui, Bo; Zhou, Xiaoya; Xu, Changwu; Lu, Zhibing; Jiang, Hong

    2012-01-01

    High mobility group box 1 protein (HMGB1) plays an important role in myocardial ischemia and reperfusion (I/R) injury. Ethyl pyruvate (EP), a potent reactive oxygen species scavenger, has been reported to inhibit myocardial apoptosis and reduce myocardial I/R injury. The aim of this study was to investigate the mechanism by which EP reduces myocardial I/R injury in rats. Anesthetized male rats were once treated with EP (50 mg/kg, i.p.) before ischemia, and then subjected to ischemia for 30 min followed by reperfusion for 4 h. Lactate dehydrogenase (LDH), creatine kinase (CK), malondialdehyde (MDA), superoxide dismutase (SOD) activity and infarct size were measured. HMGB1 expression was assessed by immunoblotting. The results showed that pretreatment of EP (50 mg/kg) could significantly reduce the infarct size and the levels of LDH and CK after 4 h reperfusion (all PR. The present study suggested that ethyl pyruvate could attenuate myocardial I/R injury by inhibiting HMGB1 expression.

  18. Protective Effects of Elaeagnus angustifolia Leaf Extract against Myocardial Ischemia/Reperfusion Injury in Isolated Rat Heart

    Directory of Open Access Journals (Sweden)

    Binsheng Wang

    2014-01-01

    Full Text Available The purpose of this study is to clarify the cardioprotective property of the aqueous extract of Elaeagnus angustifolia L. leaf (EA against myocardial ischemia/reperfusion injury in isolated rat heart. The myocardial ischemia/reperfusion (I/R injury model of isolated rat heart was set up by the use of improved Langendorff retrograde perfusion technology. Compared with the ischemia/reperfusion (I/R group, the aqueous extract of Elaeagnus angustifolia L. leaf (0.5 mg/mL, 1.0 mg/mL pretreatment markedly improved the coronary flow (CF and raised left ventricular developed pressure (LVDP and maximum rise/down velocity (±dp/dtmax. The infarct size of the EA-treated hearts was smaller than that of I/R group. After treatment with EA, the superoxide dismutase (SOD activity increased; malondialdehyde (MDA and protein carbonyl content reduced more obviously (P<0.01 than that of I/R injury myocardial tissue. Conclusion. Results from the present study showed that the aqueous extract of Elaeagnus angustifolia L. leaf has obvious protective effects on myocardial I/R injury, which may be related to the improvement of myocardial oxidative stress states.

  19. Myocardial Ischemia

    Science.gov (United States)

    ... blood pressure and high blood cholesterol levels. Waist circumference. A waist measurement of more than 35 inches (89 centimeters) for women and 40 inches (102 cm) in men increases the risk of high blood pressure and heart disease. Lack ...

  20. Protective effects of pinacidil hyperpolarizing cardioplegia on myocardial ischemia reperfusion injury by mitochondrial KATP channels

    Institute of Scientific and Technical Information of China (English)

    YU Tian; FU Xiao-yun; LIU Xing-kui; YU Zhi-hao

    2011-01-01

    Background Many studies have indicated that hyperpolarizing cardioplegia is responsible for myocardial preservation and researchers have suggested that the adenosine triphosphate-sensitive potassium channels (KATP) were the end effectors of cardio-protection.But whether mitochondrial KATP plays an important role in hyperpolarizing cardioplegia is not apparent.The present study investigated the effect of hyperpolarizing cardioplegia containing pinacidil (a nonselective KATP opener) on ischemia/reperfusion injury in rat hearts,especially the role of mitochondrial KATP in pinacidil hyperpolarizing cardioplegia.Methods Sprague-Dawley rat hearts were Langendorff-perfused for 20 minutes with Krebs-Henseleit buffer at 37℃before equilibration.Cardiac arrest was then induced in different treatments:there was no arrest and ischemia in the normal group,the control group were arrested by clamping the aorta,depolarizing caidioplegia (St.Thomas solution containing 16 mmol/L KCI) and hyperpolarizing cardioplegia groups used St.Thomas solution containing 0.05 mmol/L pinacidil and 5 mmol/L KCI to induce cardiac arrest in group hyperkalemic and group pinacidil,in group hyperkalemic + 5-hydroxydecanote (5HD) and Pinacidil + 5HD,5HD (0.1 mmol/L) was added to the above two solutions to block mitochondria KATP channels.Global ischemia was then administrated for 40 minutes at 37℃,followed by 30 minutes of reperfusion.At the end of equilibration and reperfusion,hemodynamics,ultrastructure,and mitochondrial function were measured.Results In the control group,ischemia/reperfusion decreased the left ventricular developed pressure,heart rate,coronary flow,mitochondrial membrane potential,impaired mitochondrial respiratory function,increased reactive oxygen species and left ventricular end diastolic pressure.Damage to myocardial ultrastructure was also evident.Both depolarized arrest and especially hyperpolarized cardioplegia significantly reduced these lesions.5HD partially blocked the

  1. Intermittent peripheral tissue ischemia during coronary ischemia reduces myocardial infarction through a KATP-dependent mechanism: first demonstration of remote ischemic perconditioning

    DEFF Research Database (Denmark)

    Schmidt, Michael Rahbek; Smerup, M; Konstantinov, I E;

    2006-01-01

    Remote ischemic preconditioning reduces myocardial infarction (MI) in animal models. We tested the hypothesis that the systemic protection thus induced is effective when ischemic preconditioning is administered during ischemia (PerC) and before reperfusion and examined the role of the K......(+)-dependent ATP (K(ATP)) channel. Twenty 20-kg pigs were randomized (10 in each group) to 40 min of left anterior descending coronary artery occlusion with 120 min of reperfusion. PerC consisted of four 5-min cycles of lower limb ischemia by tourniquet during left anterior descending coronary artery occlusion...... of diastolic relaxation was significantly attenuated by PerC compared with control in ischemia and reperfusion (P = 0.01 and 0.04, respectively). At 120 min of reperfusion, preload-recruitable stroke work declined 38 +/- 6% and 3 +/- 5% in control and PerC, respectively (P = 0.001). The force...

  2. Acute Myocardial Infarction Caused by Filgrastim: A Case Report

    Directory of Open Access Journals (Sweden)

    Cemil Bilir

    2012-01-01

    Full Text Available Common uses of the granulocyte-colony stimulating factors in the clinical practice raise the concern about side effects of these agents. We presented a case report about an acute myocardial infarction with non-ST segment elevation during filgrastim administration. A 73-year-old man had squamous cell carcinoma of larynx with lung metastasis treated with the chemotherapy. Second day after the filgrastim, patient had a chest discomfort. An ECG was performed and showed an ST segment depression and negative T waves on inferior derivations. A coronary angiography had showed a critical lesion in right coronary arteria. This is the first study thats revealed that G-CSF can cause acute myocardial infarction in cancer patients without history of cardiac disease. Patients with chest discomfort and pain who are on treatment with G-CSF or GM-CSF must alert the physicians for acute coronary events.

  3. Effects of Nitrate Intake on Myocardial Ischemia-Reperfusion Injury in Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Sajad Jeddi

    Full Text Available Abstract Background: Coronary artery disease is 2-3 times more common in diabetic individuals. Dietary nitrate/nitrite has beneficial effects in both diabetes and cardiovascular disease. It also has protective effects against myocardial ischemia-reperfusion (IR injury in healthy animals. However, the effects of nitrate on myocardial IR injury in diabetic rats have not yet been investigated. Objective: We examined the effects of dietary nitrate on myocardial IR injury in streptozotocin-nicotinamide-induced diabetic rats. Method: Rats were divided into four groups (n=7 in each group: control, control+nitrate, diabetes, and diabetes+nitrate. Type 2 diabetes was induced by injection of streptozotocin and nicotinamide. Nitrate (sodium nitrate was added to drinking water (100 mg/L for 2 months. The hearts were perfused in a Langendorff apparatus at 2 months and assessed before (baseline and after myocardial IR for the following parameters: left ventricular developed pressure (LVDP, minimum and maximum rates of pressure change in the left ventricle (±dP/dt, endothelial nitric oxide (NO synthase (eNOS and inducible NO synthase (iNOS mRNA expression, and levels of malondialdehyde (MDA and NO metabolites (NOx. Results: Recovery of LVDP and ±dP/dt was lower in diabetic rats versus controls, but almost normalized after nitrate intake. Diabetic rats had lower eNOS and higher iNOS expression both at baseline and after IR, and dietary nitrate restored these parameters to normal values after IR. Compared with controls, heart NOx level was lower in diabetic rats at baseline but was higher after IR. Diabetic rats had higher MDA levels both at baseline and after IR, which along with heart NOx levels decreased following nitrate intake. Conclusion: Dietary nitrate in diabetic rats provides cardioprotection against IR injury by regulating eNOS and iNOS expression and inhibiting lipid peroxidation in the heart.

  4. Effects of Nitrate Intake on Myocardial Ischemia-Reperfusion Injury in Diabetic Rats

    Science.gov (United States)

    Jeddi, Sajad; Khalifi, Saeedeh; Ghanbari, Mahboubeh; Bageripour, Fatemeh; Ghasemi, Asghar

    2016-01-01

    Background Coronary artery disease is 2-3 times more common in diabetic individuals. Dietary nitrate/nitrite has beneficial effects in both diabetes and cardiovascular disease. It also has protective effects against myocardial ischemia-reperfusion (IR) injury in healthy animals. However, the effects of nitrate on myocardial IR injury in diabetic rats have not yet been investigated. Objective We examined the effects of dietary nitrate on myocardial IR injury in streptozotocin-nicotinamide-induced diabetic rats. Method Rats were divided into four groups (n=7 in each group): control, control+nitrate, diabetes, and diabetes+nitrate. Type 2 diabetes was induced by injection of streptozotocin and nicotinamide. Nitrate (sodium nitrate) was added to drinking water (100 mg/L) for 2 months. The hearts were perfused in a Langendorff apparatus at 2 months and assessed before (baseline) and after myocardial IR for the following parameters: left ventricular developed pressure (LVDP), minimum and maximum rates of pressure change in the left ventricle (±dP/dt), endothelial nitric oxide (NO) synthase (eNOS) and inducible NO synthase (iNOS) mRNA expression, and levels of malondialdehyde (MDA) and NO metabolites (NOx). Results Recovery of LVDP and ±dP/dt was lower in diabetic rats versus controls, but almost normalized after nitrate intake. Diabetic rats had lower eNOS and higher iNOS expression both at baseline and after IR, and dietary nitrate restored these parameters to normal values after IR. Compared with controls, heart NOx level was lower in diabetic rats at baseline but was higher after IR. Diabetic rats had higher MDA levels both at baseline and after IR, which along with heart NOx levels decreased following nitrate intake. Conclusion Dietary nitrate in diabetic rats provides cardioprotection against IR injury by regulating eNOS and iNOS expression and inhibiting lipid peroxidation in the heart. PMID:27849257

  5. Innate immune signaling in cardiac ischemia

    NARCIS (Netherlands)

    Arslan, F.; de Kleijn, D.P.V.; Pasterkamp, G.

    2011-01-01

    Despite advances in treatment of patients who suffer from ischemic heart disease, morbidity related to myocardial infarction is increasing in Western societies. Acute and chronic immune responses elicited by myocardial ischemia have an important role in the functional deterioration of the heart. Res

  6. Cardiac progenitor-derived exosomes protect ischemic myocardium from acute ischemia/reperfusion injury

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Lijuan [Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Wang, Yingjie [Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Internal Medicine of Traditional Chinese Medicine, Shuguang Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 201203 (China); Pan, Yaohua; Zhang, Lan [Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Shen, Chengxing [Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai (China); Qin, Gangjian [Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 (United States); Ashraf, Muhammad [Pathology and Lab Med, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Weintraub, Neal [Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States); Ma, Genshan, E-mail: magenshan@hotmail.com [Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Tang, Yaoliang, E-mail: tangyg@ucmail.uc.edu [Cardiovascular Disease, Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267 (United States)

    2013-02-15

    Highlights: ► Cardiac progenitor-derived (CPC) Exosomes protect H9C2 from apoptosis in vitro. ► CPC-exosomes protect cardiomyoyctes from MI/R induced apoptosis in vivo. ► CPC-exosomes were taken up by H9C2 with high efficiency using PKH26 labeling. ► miR-451, one of GATA4-responsive miRNA cluster, is enriched in CPC-exosomes. -- Abstract: Background: Cardiac progenitors (CPC) mediate cardioprotection via paracrine effects. To date, most of studies focused on secreted paracrine proteins. Here we investigated the CPC-derived-exosomes on protecting myocardium from acute ischemia/reperfusion (MI/R) injury. Methods and results: CPC were isolated from mouse heart using two-step protocol. Exosomes were purified from conditional medium, and confirmed by electron micrograph and Western blot using CD63 as a marker. qRT-PCR shows that CPC-exosomes have high level expression of GATA4-responsive-miR-451. Exosomes were ex vivo labeled with PKH26, We observed exosomes can be uptaken by H9C2 cardiomyoblasts with high efficiency after 12 h incubation. CPC-exosomes protect H9C2 from oxidative stress by inhibiting caspase 3/7 activation invitro. In vivo delivery of CPC-exosomes in an acute mouse myocardial ischemia/reperfusion model inhibited cardiomyocyte apoptosis by about 53% in comparison with PBS control (p < 0.05). Conclusion: Our results suggest, for the first time, the CPC-exosomes can be used as a therapeutic vehicle for cardioprotection, and highlights a new perspective for using non-cell exosomes for cardiac disease.

  7. Acute mesenteric ischemia after cardio-pulmonary bypass surgery

    Institute of Scientific and Technical Information of China (English)

    Bassam Abboud; Ronald Daher; Joe Boujaoude

    2008-01-01

    Acute mesenteric ischemia (AMI) is a highly-lethal surgical emergency.Several pathophysiologic events (arterial obstruction,venous thrombosis and diffuse vasospasm) lead to a sudden decrease in mesenteric blood flow.Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities,leading to multi-organ failure and death.Early diagnosis is difficult because the clinical presentation is subtle,and the biological and radiological diagnostic tools lack sensitivity and specificity.Therapeutic options vary from conservative resuscitation,medical treatment,endovascular techniques and surgical resection and revascularization.A high index of suspicion is required for diagnosis,and prompt treatment is the only hope of reducing the mortality rate.Studies are in progress to provide more accurate diagnostic tools for early diagnosis.AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB).Several factors contribute to the systemic hypo-perfusion state,which is the most frequent pathophysiologic event.In this particular setting,the clinical presentation of AMI can be misleading,while the laboratory and radiological diagnostic tests often produce inconclusive results.The management strategies are controversial,but early treatment is critical for saving lives.Based on the experience of our team,we consider prompt exploratory laparotomy,irrespective of the results of the diagnostic tests,is the only way to provide objective assessment and adequate treatment,leading to dramatic reduction in the mortality rate.

  8. Methylprednisolone improves microcirculation in streptozotocin-induced diabetic rats after myocardial ischemia/reperfusion

    Institute of Scientific and Technical Information of China (English)

    HU Zhi-cheng; CHEN Yun-dai; REN Yi-hong

    2011-01-01

    Background Methylprednisolone has been demonstrated to decrease inflammation, and it may protect organs from ischemia/reperfusion (I/R) injury. This study aimed to investigate the effects of methylprednisolone on diabetic myocardial I/R injury.Methods Forty adult male Sprague-Dawley (SD) rats were randomized into five groups (n=8 in each group) including a sham operation (sham) group, I/R group, diabetic sham operation (DMS) group, diabetic I/R (DM-I/R) group and methylprednisolone intervention (MP+DM-I/R) group. The diabetic model was produced by injection of streptozotocin (STZ). Body weight and blood glucose levels were determined after diabetes was established. Twelve weeks after induction of diabetes, a segmental I/R of the heart was induced by occluding the left anterior descending artery for one hour and then three hours of reperfusion in the I/R, DM-I/R and MP+DM-I/R groups. Blood pressure and electrocardiogram were continuously recorded during the procedure. IL-1β, IL-6 and TNF-α were measured at certain time points during the surgery. After reperfusion, a microcirculation scan was performed; myocardial biomarkers and tissue structure were utilized to evaluate the reperfusion damage. Intercellular adhesion molecule (ICAM)-1 and NF-κBp65 expression were quantified by immunohistological staining. Total Toil-like receptor 4 (TLR4) and nuclear NF-κBp65 protein were determined by Western blotting.Results Twelve weeks after diabetes was established, blood glucose levels were elevated and body weights were lower in diabetic rats. After reperfusion, infarction size was increased, myocardial biomarkers and inflammatory cytokines levels were elevated. Microcirculation perfusion was significantly reduced in the DM-I/R group compared with the I/R group, however it was improved in the MP+DM-I/R group. The expression of NF-κBp65 and ICAM-1 were increased in the DM-I/R group and decreased in the MP+DM-I/R group, Compared with the non-diabetic I/R group, TLR4 and NF

  9. Non-linear dynamic analysis of the cardiac rhythm during transient myocardial ischemia.

    Science.gov (United States)

    Gomis, Pedro; Caminal, Pere; Vallverdú, Montserrat; Warren, Stafford; Wagner, Galen

    2006-10-01

    Coronary artery occlusions related to myocardial ischemia drive cardiac control system reactions that may lead to heart failure. The purpose of this study was to assess the autonomic nervous system (ANS) response during prolonged percutaneous transluminal coronary angioplasty (PTCA). Continuous ECG data were acquired from 50 patients before and during PTCA, with occlusions in the left anterior descending, left circumflex or right coronary artery. Heart rate variability (HRV) was analyzed for 3-min segments of the R-R interval signal obtained from ECG data. The ANS behavior was evaluated by HRV analysis using fractal-like indices. The fractal scalar exponent alpha(1) and power-law slope beta decreased considerably during PTCA. This indicates that significant reactions of autonomic control of the heart rate occurred during coronary artery occlusions, with a reduction in complexity of the ANS.

  10. Area of ischemia assessed by physicians and software packages from myocardial perfusion scintigrams

    DEFF Research Database (Denmark)

    Edenbrandt, L.; Hoglund, P.; Frantz, S.;

    2014-01-01

    medicine delineated the extent of the ischemic defects. After at least two weeks, they delineated the defects again, and were this time provided a suggestion of the defect delineation by EXINI Heart(TM) (EXINI). Summed difference scores and ischemic extent values were obtained from four software programs......Background: The European Society of Cardiology recommends that patients with > 10% area of ischemia should receive revascularization. We investigated inter-observer variability for the extent of ischemic defects reported by different physicians and by different software tools, and if inter......-observer variability was reduced when the physicians were provided with a computerized suggestion of the defects. Methods: Twenty-five myocardial perfusion single photon emission computed tomography (SPECT) patients who were regarded as ischemic according to the final report were included. Eleven physicians in nuclear...

  11. Serum YKL-40 for monitoring myocardial ischemia after revascularization in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Harutyunyan, Marina Jurjevna; Johansen, Julia S; Mygind, Naja D

    2014-01-01

    AIM: The aim was to investigate the inflammatory biomarker YKL-40 as a monitor of myocardial ischemia in patients with coronary artery disease (CAD). METHODS: A total of 311 patients with stable CAD were included. Blood samples were taken at baseline, the day after coronary angiography and/or after...... percutaneous coronary intervention and after 6 months. RESULTS: A total of 148 (48%) patients were revascularized and 163 patients underwent only coronary angiography. In the entire population, serum YKL-40 increased significantly from baseline to 6 months (p = 0.05). This tendency was seen...... in nonrevascularized patients (p = 0.06), but not in revascularized patients (p = 0.46). Serum YKL-40 increased approximately 25% the day after the invasive procedure (p Serum YKL-40 is a potential promising biomarker...

  12. Melatonin reduces cardiac morbidity and markers of myocardial ischemia after elective abdominal aortic aneurism repair

    DEFF Research Database (Denmark)

    Gögenür, Ismail; Kücükakin, Bülent; Panduro Jensen, Leif

    2014-01-01

    The aim was to examine the effect of perioperative melatonin treatment on clinical cardiac morbidity and markers of myocardial ischemia in patients undergoing elective surgery for abdominal aortic aneurism. Reperfusion injury results in increased cardiac morbidity in patients undergoing surgery...... for abdominal aortic aneurisms (AAA). A randomized, placebo-controlled, clinical trial including patients undergoing surgery for AAA was performed. The patients received by infusion over a 2-hr period either, 50 mg melatonin or placebo intra-operatively, and 10 mg melatonin or placebo orally, the first three...... by Holter monitoring. A total of 26 patients received melatonin, while 24 received placebo. A significant reduction in cardiac morbidity was seen in the melatonin-treated patients compared with those given placebo [4% versus 29% (P = 0.02)]. Five patients (19%) who received melatonin had increased Tp...

  13. Acute digital ischemia: A rare presentation of antisynthetase syndrome.

    Science.gov (United States)

    Chan, Jin Ei; Palakodeti, Sandeep; Koster, Matthew J

    2017-03-01

    Antisynthetase syndrome (ASS) is recognized as a subgroup of idiopathic inflammatory myopathies (IIMs). It is associated with autoantibodies directed against aminoacyl-transfer ribonucleic acid (tRNA) synthetase enzymes. We report the first case of anti-PL-7/anti-SSA 52kD ASS presenting as acute digital ischemia, an association not described previously. Occlusive vasculopathy is a rare but serious manifestation that can be seen at presentation in patients with ASS and may herald the onset of severe interstitial lung disease (ILD). Comprehensive evaluation should be performed to confirm the presence of subclinical myositis. Extensive myositis-specific antibody testing is strongly recommended even if initial screening autoimmune serologies are unrevealing.

  14. Paracrine systems in the cardioprotective effect of angiotensin-converting enzyme inhibitors on myocardial ischemia/reperfusion injury in rats.

    Science.gov (United States)

    Liu, Y H; Yang, X P; Sharov, V G; Sigmon, D H; Sabbath, H N; Carretero, O A

    1996-01-01

    After transient episodes of ischemia, benefits of thrombolytic or angioplastic therapy may be limited by reperfusion injury. Angiotensin-converting enzyme inhibitors protect the heart against ischemia/reperfusion injury, an effect mediated by kinins. We examined whether the protective effect of the angiotensin-converting enzyme inhibitor ramiprilat on myocardial ischemia/reperfusion is due to kinin stimulation of prostaglandin and/or nitric oxide release. The left anterior descending coronary artery of Lewis inbred rats was occluded for 30 minutes, followed by 120 minutes of reperfusion. Immediately before reperfusion rats were treated with vehicle, ramiprilat, or the angiotensin II type 1 receptor antagonist losartan. We tested whether pretreatment with the kinin receptor antagonist Hoe 140, the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester, or the cyclooxygenase inhibitor indomethacin blocked the effect of ramiprilat on infarct size and reperfusion arrhythmias. In controls, infarct size as a percentage of the area at risk was 79 +/- 3%; ramiprilat reduced this to 49 +/- 4% (P < .001), but losartan had little effect (74 +/- 6%, P = NS). Pretreatment with Hoe 140, NG-nitro-L-arginine methyl ester, or indomethacin abolished the beneficial effect of ramiprilat. Compared with the 30-minute ischemia/120-minute reperfusion group, nonreperfused hearts with 30 minutes of ischemia had significantly smaller infarct size as a percentage of the area at risk, whereas in the 150-minute ischemia group it was significantly larger. This suggests that reperfusion caused a significant part of the myocardial injury, but it also suggests that compared with prolonged ischemia, reperfusion salvaged some of the myocardium. Ventricular arrhythmias mirrored the changes in infarct size. Thus, angiotensin-converting enzyme inhibitors protect the myocardium against ischemia/reperfusion injury and arrhythmias; these beneficial effects are mediated primarily by a kinin

  15. Protective effect of dietary n-3 polyunsaturated fatty acids on myocardial resistance to ischemia-reperfusion injury in rats.

    Science.gov (United States)

    Zeghichi-Hamri, Sabrina; de Lorgeril, Michel; Salen, Patricia; Chibane, Mohamed; de Leiris, Joël; Boucher, François; Laporte, François

    2010-12-01

    Dietary n-3 polyunsaturated fatty acids (PUFA) reduce coronary heart disease (CHD) complications, such as chronic arrhythmia and sudden cardiac death. Improved myocardial resistance to ischemia-reperfusion injury results in smaller myocardial infarction, which is a major factor in the occurrence of CHD complications. We hypothesized that a specific dietary fatty acid profile (low in saturated and n-6 PUFA but high in plant and marine n-3 PUFA) may improve myocardial resistance to ischemia-reperfusion injury and reduce infarct size. To test this assumption, we used a well-defined rat model of myocardial infarction. Based on our results, in comparison to a diet that is high in either saturated or n-6 PUFA but poor in plant and marine n-3 PUFA, a diet that is low in saturated fats and n-6 PUFA but rich in plant and marine n-3 PUFA results in smaller myocardial infarct size (P fatty acid composition of plasma, erythrocyte cell membranes, and the phospholipids of myocardial mitochondria. The results show a great accumulation of n-3 PUFA and a parallel decrease in arachidonic acid, the main n-6 PUFA, in plasma, cell membranes, and cardiac mitochondria (P < .0001). We conclude that improved myocardial resistance to ischemia-reperfusion may be one of the critical factors explaining the protective effects of dietary n-3 PUFA against CHD complications in humans. In addition to increasing n-3 PUFA intake, an optimal dietary pattern aimed at reducing cardiovascular mortality should include a reduction of the intake of both saturated and n-6 PUFA.

  16. Risk factors for silent myocardial ischemia in patients with well-controlled essential hypertension.

    Science.gov (United States)

    Rendina, Domenico; Ippolito, Renato; De Filippo, Gianpaolo; Muscariello, Riccardo; De Palma, Daniela; De Bonis, Silvana; Schiano di Cola, Michele; Benvenuto, Domenico; Galderisi, Maurizio; Strazzullo, Pasquale; Galletti, Ferruccio

    2017-03-01

    Silent myocardial ischemia (SMI) is frequently observed in patients with essential hypertension (EH). The major risk factor for SMI is uncontrolled blood pressure (BP), but SMI is also observed in patients with well-controlled BP. To evaluate the prevalence of SMI and the factors associated with SMI in EH patients with well-controlled BP. The medical records of 859 EH patients who underwent simultaneous 24-h ambulatory blood pressure monitoring (ABPM) and 24-h ambulatory electrocardiogram recording (AECG) were retrospectively evaluated. Each SMI episode was characterized by: (a) ST segment depression ≥0.5 mm; (b) duration of ST segment depression >60 s; and (c) reversibility of the ST segment depression. Overall 126 EH patients (14.7 %) had at least one episode of SMI. The SMI events were more frequent among patients with poorly controlled compared to those with well-controlled BP [86/479 (17.95 %) vs. 40/380 (10.52 %), p < 0.01]. Among EH patients with well-controlled BP, current and past smoking as well as the presence of an additional metabolic syndrome (MetS) constitutive element (obesity, impaired fasting glucose level or dyslipidemia) were significantly associated with the occurrence of SMI. In all EH patients with well-controlled BP and AECG evidence of SMI, there were one or more coronary artery stenotic lesions greater than 50 % found at coronary angiography. In EH patients who are current smokers, or have one or more additional components of a MetS there is markedly reduced benefit associated with good BP control with regard to the occurrence of myocardial ischemia: in this patient category, an AECG may help detect this condition.

  17. Noninvasive Imaging of Hypoxia-Inducible Factor-1α Gene Therapy for Myocardial Ischemia

    Science.gov (United States)

    Chen, Ian Y.; Gheysens, Olivier; Li, Zongjin; Rasooly, Julia A.; Wang, Qian; Paulmurugan, Ramasamy; Rosenberg, Jarrett; Rodriguez-Porcel, Martin; Willmann, Juergen K.; Wang, David S.; Contag, Christopher H.; Robbins, Robert C.; Wu, Joseph C.

    2013-01-01

    Abstract Hypoxia-inducible factor-1 alpha (HIF-1α) gene therapy holds great promise for the treatment of myocardial ischemia. Both preclinical and clinical evaluations of this therapy are underway and can benefit from a vector strategy that allows noninvasive assessment of HIF-1α expression as an objective measure of gene delivery. We have developed a novel bidirectional plasmid vector (pcTnT-HIF-1α-VP2-TSTA-fluc), which employs the cardiac troponin T (cTnT) promoter in conjunction with a two-step transcriptional amplification (TSTA) system to drive the linked expression of a recombinant HIF-1α gene (HIF-1α-VP2) and the firefly luciferase gene (fluc). The firefly luciferase (FLuc) activity serves as a surrogate for HIF-1α-VP2 expression, and can be noninvasively assessed in mice using bioluminescence imaging after vector delivery. Transfection of cultured HL-1 cardiomyocytes with pcTnT-HIF-1α-VP2-TSTA-fluc led to a strong correlation between FLuc and HIF-1α-dependent vascular endothelial growth factor expression (r2=0.88). Intramyocardial delivery of pcTnT-HIF-1α-VP2-TSTA-fluc into infarcted mouse myocardium led to persistent HIF-1α-VP2 expression for 4 weeks, even though it improved neither CD31+ microvessel density nor echocardiographically determined left ventricular systolic function. These results lend support to recent findings of suboptimal efficacy associated with plasmid-mediated HIF-1α therapy. The imaging techniques developed herein should be useful for further optimizing HIF-1α-VP2 therapy in preclinical models of myocardial ischemia. PMID:23937265

  18. Allogeneic amniotic membrane-derived mesenchymal stromal cell transplantation in a porcine model of chronic myocardial ischemia

    Directory of Open Access Journals (Sweden)

    Kimura M

    2012-01-01

    Full Text Available Introduction. Amniotic membrane contains a multipotential stem cell population and is expected to possess the machinery to regulate immunological reactions. We investigated the safety and efficacy of allogeneic amniotic membrane-derived mesenchymal stromal cell (AMSC transplantation in a porcine model of chronic myocardial ischemia as a preclinical trial. Methods. Porcine AMSCs were isolated from amniotic membranes obtained by cesarean section just before delivery and were cultured to increase their numbers before transplantation. Chronic myocardial ischemia was induced by implantation of an ameroid constrictor around the left circumflex coronary artery. Four weeks after ischemia induction, nine swine were assigned to undergo either allogeneic AMSC transplantation or normal saline injection. Functional analysis was performed by echocardiography, and histological examinations were carried out by immunohistochemistry 4 weeks after AMSC transplantation. Results. Echocardiography demonstrated that left ventricular ejection fraction was significantly improved and left ventricular dilatation was well attenuated 4 weeks after AMSC transplantation. Histological assessment showed a significant reduction in percentage of fibrosis in the AMSC transplantation group. Injected allogeneic green fluorescent protein (GFP-expressing AMSCs were identified in the immunocompetent host heart without the use of any immunosuppressants 4 weeks after transplantation. Immunohistochemistry revealed that GFP colocalized with cardiac troponin T and cardiac troponin I. Conclusions. We have demonstrated that allogeneic AMSC transplantation produced histological and functional improvement in the impaired myocardium in a porcine model of chronic myocardial ischemia. The transplanted allogeneic AMSCs survived without the use of any immunosuppressants and gained cardiac phenotype through either their transdifferentiation or cell fusion.

  19. Prognostic significance of transient myocardial ischaemia after first acute myocardial infarction: five year follow up study

    DEFF Research Database (Denmark)

    Mickley, H; Nielsen, J R; Berning, J

    1995-01-01

    an association between transient ST segment depression and an adverse long term outcome was found (Kaplan-Meier analysis; P = 0.004). The presence of exercise induced angina identified a similar proportion of patients with a poor prognosis (Kaplan-Meier analysis; P ...OBJECTIVE: To assess the five year prognostic significance of transient myocardial ischaemia on ambulatory monitoring after a first acute myocardial infarction, and to compare the diagnostic and long term prognostic value of ambulatory ST segment monitoring, maximal exercise testing...... discharge (left ventricular ejection fraction), maximal bicycle ergometric testing one day before discharge (ST segment depression, angina, blood pressure, heart rate), and ambulatory ST segment monitoring (transient myocardial ischaemia) started at hospital discharge a mean of 11 (SD 5) days after...

  20. Acute Anteroseptal Myocardial Infarction after a Negative Exercise Stress Test

    Directory of Open Access Journals (Sweden)

    Abdullah M. Al-Alawi

    2016-05-01

    Full Text Available A myocardial infarction is a rare complication which can occur after an exercise stress test. We report a 48-year-old male who was referred to the Mildura Cardiology Practice, Victoria, Australia, in August 2014 with left-sided chest pain. He underwent an exercise stress test which was negative for myocardial ischaemia. However, the patient presented to the Emergency Department of the Mildura Base Hospital 30 minutes after the test with severe retrosternal chest pain. An acute anteroseptal ST segment elevation myocardial infarction was observed on electrocardiography. After thrombolysis, he was transferred to a tertiary hospital where coronary angiography subsequently revealed significant left anterior descending coronary artery stenosis. Thrombus aspiration and a balloon angioplasty were performed. The patient was discharged three days after the surgical procedure in good health.

  1. Improvement of pacing induced regional myocardial ischemia by Solcoseryl in conscious dogs with coronary stenosis.

    Science.gov (United States)

    Shimada, T; Sasayama, S; Takahashi, M; Osakada, G; Kawai, C

    1984-02-01

    The effects of Solcoseryl on regional myocardial function were studied in 5 conscious dogs with partial coronary constriction, in which temporary ischemia was induced by rapid cardiac pacing. During the coronary artery constriction, the percent shortening of the ischemic segment decreased by 9%. When the heart rate was increased by pacing, the percent shortening of the ischemic segments was further reduced by 57%. On cessation of cardiac pacing, the early potentiation of dP/dt and of control segment shortening became evident and was followed by exponential decay in the subsequent several beats. In the ischemic segment, the percent shortening was significantly improved in the first post-pacing beat but was more severely depressed at five seconds. Thirty minutes after administration of Solcoseryl, the cardiac pacing was repeated in the same manner but the pacing-induced hypokinesia of the ischemic segment were less marked, the percent shortening being at an average of 9.1% during control pacing and 12.7% during the second pacing after Solcoseryl (p less than 0.05). Postpacing deterioration of the ischemic segment shortening was also significantly improved from 9.8 to 11.8% at 5 seconds (p less than 0.05). These findings indicate that Solcoseryl exerts protective effects on the ischemic myocardium by promoting a rapid recovery from ischemia, probably due to the improvement of oxygen utility through activated cellular respiration.

  2. Biphasic modulation of the mitochondrial electron transport chain in myocardial ischemia and reperfusion.

    Science.gov (United States)

    Lee, Hsin-Ling; Chen, Chwen-Lih; Yeh, Steve T; Zweier, Jay L; Chen, Yeong-Renn

    2012-04-01

    Mitochondrial electron transport chain (ETC) is the major source of reactive oxygen species during myocardial ischemia-reperfusion (I/R) injury. Ischemic defect and reperfusion-induced injury to ETC are critical in the disease pathogenesis of postischemic heart. The properties of ETC were investigated in an isolated heart model of global I/R. Rat hearts were subjected to ischemia for 30 min followed by reperfusion for 1 h. Studies of mitochondrial function indicated a biphasic modulation of electron transfer activity (ETA) and ETC protein expression during I/R. Analysis of ETAs in the isolated mitochondria indicated that complexes I, II, III, and IV activities were diminished after 30 min of ischemia but increased upon restoration of flow. Immunoblotting analysis and ultrastructural analysis with transmission electron microscopy further revealed marked downregulation of ETC in the ischemic heart and then upregulation of ETC upon reperfusion. No significant difference in the mRNA expression level of ETC was detected between ischemic and postischemic hearts. However, reperfusion-induced ETC biosynthesis in myocardium can be inhibited by cycloheximide, indicating the involvement of translational control. Immunoblotting analysis of tissue homogenates revealed a similar profile in peroxisome proliferator-activated receptor-γ coactivator-1α expression, suggesting its essential role as an upstream regulator in controlling ETC biosynthesis during I/R. Significant impairment caused by ischemic and postischemic injury was observed in the complexes I- III. Analysis of NADH ferricyanide reductase activity indicated that injury of flavoprotein subcomplex accounts for 50% decline of intact complex I activity from ischemic heart. Taken together, our findings provide a new insight into the molecular mechanism of I/R-induced mitochondrial dysfunction.

  3. Quantitative analysis of myocardial ischemia by technetium-99m sestamibi exercise scintigraphy. A new method for change rate mapping

    Energy Technology Data Exchange (ETDEWEB)

    Nakata, Shigeru; Kuwahara, Taishi; Tanada, Shuji [Ehime Univ., Shigenobu, Ehime (Japan). School of Medicine; Higashino, Hiroshi; Hamamoto, Ken

    1997-11-01

    In order to quantitatively assess the extent and severity of myocardial ischemia by Tc-99m sestamibi exercise myocardial scintigraphy, we developed a new method of change rate (CR) mapping and examined its efficiency. CR was calculated to divide the counts per pixel in the stress polar map by that in the rest polar map at each corresponding pixel. The CR map showed the CR values at each pixel. To correct the differences between the stress and rest images for the dose of Tc-99m sestamibi administered, the mean counts per pixel in the stress polar map and the rest map were adjusted to the same level. Regarding the regions in which the CR value was less than 1 as ischemia, we compared the abilities of the CR map and the polar map to detect coronary artery stenosis in 5 patients with angina pectoris. The sensitivity for coronary artery stenosis was 80% in the CR map, and 40% in the polar map. The specificity for both was 75%. We concluded that the CR map was effective in assessing the extent and severity of myocardial ischemia in Tc-99m sestamibi exercise myocardial scintigraphy. (author)

  4. Cardioprotective Effects of Salvianolic Acid A on Myocardial Ischemia-Reperfusion Injury In Vivo and In Vitro

    Directory of Open Access Journals (Sweden)

    Huaying Fan

    2012-01-01

    Full Text Available Salvianolic acid A (SAA, one of the major active components of Danshen that is a traditional Chinese medicine, has been reported to possess protective effect in cardiac diseases and antioxidative activity. This study aims to investigate the cardioprotection of SAA in vivo and in vitro using the model of myocardial ischemia-reperfusion in rat and hydrogen peroxide (H2O2-induced H9c2 rat cardiomyoblasts apoptosis. It was found that SAA significantly limited infarct size of ischemic myocardium when given immediately prior to reperfusion. SAA also significantly suppressed cellular injury and apoptotic cell death. Additionally, the results of western blot and phospho-specific antibody microarray analysis showed that SAA could up-regulate Bcl-2 expression and increase the phosphorylation of proteins such as Akt, p42/p44 extracellular signal-related kinases (Erk1/2, and their related effectors. The phosphorylation of those points was related to suppress apoptosis. In summary, SAA possesses marked protective effect on myocardial ischemia-reperfusion injury, which is related to its ability to reduce myocardial cell apoptosis and damage induced by oxidative stress. The protection is achieved via up-regulation of Bcl-2 expression and affecting protein phosphorylation. These findings indicate that SAA may be of value in cardioprotection during myocardial ischemia-reperfusion injury, which provide pharmacological evidence for clinical application.

  5. Cardioprotective Effects of Salvianolic Acid A on Myocardial Ischemia-Reperfusion Injury In Vivo and In Vitro

    Science.gov (United States)

    Fan, Huaying; Yang, Liu; Fu, Fenghua; Xu, Hui; Meng, Qinggang; Zhu, Haibo; Teng, Lirong; Yang, Mingyan; Zhang, Leiming; Zhang, Ziliang; Liu, Ke

    2012-01-01

    Salvianolic acid A (SAA), one of the major active components of Danshen that is a traditional Chinese medicine, has been reported to possess protective effect in cardiac diseases and antioxidative activity. This study aims to investigate the cardioprotection of SAA in vivo and in vitro using the model of myocardial ischemia-reperfusion in rat and hydrogen peroxide (H2O2)-induced H9c2 rat cardiomyoblasts apoptosis. It was found that SAA significantly limited infarct size of ischemic myocardium when given immediately prior to reperfusion. SAA also significantly suppressed cellular injury and apoptotic cell death. Additionally, the results of western blot and phospho-specific antibody microarray analysis showed that SAA could up-regulate Bcl-2 expression and increase the phosphorylation of proteins such as Akt, p42/p44 extracellular signal-related kinases (Erk1/2), and their related effectors. The phosphorylation of those points was related to suppress apoptosis. In summary, SAA possesses marked protective effect on myocardial ischemia-reperfusion injury, which is related to its ability to reduce myocardial cell apoptosis and damage induced by oxidative stress. The protection is achieved via up-regulation of Bcl-2 expression and affecting protein phosphorylation. These findings indicate that SAA may be of value in cardioprotection during myocardial ischemia-reperfusion injury, which provide pharmacological evidence for clinical application. PMID:21789047

  6. Left atrial ball thrombus with acute mesenteric ischemia: Anesthetic management and role of transesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Neeti Makhija

    2014-01-01

    Full Text Available A 62 year old female with severe mitral stenosis, large left atrial ball thrombus and acute mesenteric ischemia emergently underwent mitral valve replacement, left atrial clot removal and emergency laparotomy for mesenteric ischemia. Peri-operative management issues, particularly, the anesthetic challenges and the role of transesophageal echocardiography are discussed.

  7. Lipoxin A4 Preconditioning and Postconditioning Protect Myocardial Ischemia/Reperfusion Injury in Rats

    Directory of Open Access Journals (Sweden)

    Qifeng Zhao

    2013-01-01

    Full Text Available This study aims to investigate the pre- and postconditioning effects of lipoxin A4 (LXA4 on myocardial damage caused by ischemia/reperfusion (I/R injury. Seventy-two rats were divided into 6 groups: sham groups (C1 and C2, I/R groups (I/R1 and I/R2, and I/R plus LXA4 preconditioning and postconditioning groups (LX1 and LX2. The serum levels of IL-1β, IL-6, IL-8, IL-10, TNF-α, and cardiac troponin I (cTnI were measured. The content and the activity of Na+-K+-ATPase as well as the superoxide dismutase (SOD, and malondialdehyde (MDA levels were determined. Along with the examination of myocardium ultrastructure and ventricular arrhythmia scores (VAS, connexin 43 (Cx43 expression were also detected. Lower levels of IL-1β, IL-6, IL-8, TNF-α, cTnI, MDA content, and VAS and higher levels of IL-10, SOD activity, Na+-K+-ATPase content and activity, and Cx43 expression appeared in LX groups than I/R groups. Besides, H&E staining, TEM examination as well as analysis of gene, and protein confirmed that LXA4 preconditioning was more effective than postconditioning in preventing arrhythmogenesis via the upregulation of Cx43. That is, LXA4 postconditioning had better protective effect on Na+-K+-ATPase and myocardial ultrastructure.

  8. Asymptomatic cardiovascular manifestations in diabetes mellitus: Left ventricular diastolic dysfunction and silent myocardial ischemia

    Directory of Open Access Journals (Sweden)

    Seferović-Mitrović Jelena P.

    2011-01-01

    Full Text Available Introduction. Several cardiovascular manifestations in patients with diabetes may be asymptomatic. Left ventricular diastolic dysfunction (LVDD is considered to be the earliest metabolic myocardial lesion in these patients, and can be diagnosed with tissue Doppler echocardiography. Silent myocardial ischemia (SMI is a characteristic and frequently described form of ischemic heart disease in patients with diabetes. Objective. The aim of the study was to assess the prevalence of LVDD and SMI in patients with type 2 diabetes, as well as to compare demographic, clinical, and metabolic data among defined groups (patients with LVDD, patients with SMI and patients with type 2 diabetes, without LVDD and SMI. Methods. We investigated 104 type 2 diabetic patients (mean age 55.4±9.1 years, 64.4% males with normal blood pressure, prehypertension and arterial hypertension stage I. Study design included basic laboratory assessment and cardiological workup (transthoracic echocardiography and tissue Doppler, as well as the exercise stress echocardiography. Results. LVDD was diagnosed in twelve patients (11.5%, while SMI was revealed in six patients (5.8%. Less patients with LVDD were using metformin, in comparison to other two groups (χ2 =12.152; p=0.002. Values of HDL cholesterol (F=4.515; p=0.013 and apolipoprotein A1 (F=5.128; p= 0.008 were significantly higher in patients with LVDD. Conclusion. The study confirmed asymptomatic cardiovascular complications in 17.3% patients with type 2 diabetes.

  9. Cardioprotection by a novel recombinant serine protease inhibitor in myocardial ischemia and reperfusion injury.

    Science.gov (United States)

    Murohara, T; Guo, J P; Lefer, A M

    1995-09-01

    Polymorphonuclear neutrophils (PMN) play an important role in myocardial ischemia/reperfusion (MI/R) injury; however, the role of neutrophilic proteases is less understood. The effects of a novel serine protease inhibitor (serpin), LEX032, were investigated in a murine model of MI (20 min) and R (24 hr) injury in vivo. LEX032 is a recombinant human alpha 1-antichymotrypsin in which six amino acid residues were replaced around the active center with those of alpha-1 protease inhibitor. LEX032 has the ability to inhibit both neutrophil elastase and cathepsin G, two major neutral serine proteases in neutrophils, as well as superoxide generation. LEX032 (25 or 50 mg/kg) administered i.v. 1 min before reperfusion significantly attenuated myocardial necrotic injury evaluated by cardiac creatine kinase loss compared to MI/R rats receiving only vehicle (P LEX032 as compared with rats receiving vehicle (P LEX032 also moderately attenuated leukotriene B4-stimulated PMN adherence to rat superior mesenteric artery endothelium and markedly diminished superoxide radical release from LTB4-stimulated PMN in vitro. In a glycogen-induced rat peritonitis model, LEX032 (50 mg/kg) significantly attenuated PMN transmigration into the peritoneal cavity in vivo. In conclusion, the recombinant serine protease inhibitor, LEX032, appears to be an effective agent for attenuating MI/R injury by inhibiting neutrophil-accumulation into the ischemic-reperfused myocardium and by inactivating cytotoxic metabolites (proteases and superoxide radical) released from neutrophils.

  10. Reduction of myocardial ischemia reperfusion injury with regular consumption of grapes.

    Science.gov (United States)

    Cui, Jianhua; Cordis, Gerald A; Tosaki, Arpad; Maulik, Nilanjana; Das, Dipak K

    2002-05-01

    Recently several polyphenolic antioxidants derived from grape seeds and skins have been implicated in cardioprotection. This study was undertaken to determine if the grapes were equally cardioprotective. Sprague Dawley male rats were given (orally) standardized grape extract (SGE) for a period of three weeks. Time-matched control experiments were performed by feeding the animals 45 microg/100 of glucose plus 45 microg/100 g fructose per day for three weeks. After 30 days, rats were sacrificed, hearts excised and perfused via working-mode. Hearts were made ischemic for 30 min followed by two hours of reperfusion. At 100 mg/kg and at 200 mg/kg, SGE provided significant cardioprotection as evidenced by improved post-ischemic ventricular recovery and reduced amount of myocardial infarction. No cardioprotection was apparent when rats were given grape samples at a dose of 50 mg/100 g/day. In vitro studies demonstrated that the SGE could directly scavenge superoxide and hydroxyl radicals which are formed in the ischemic reperfused myocardium. The results demonstrate that the heats of the rats fed SGE reduced myocardial ischemia reperfusion injury by functioning as in vivo antioxidant.

  11. Myocardial salvage after intracoronary thrombolysis with streptokinase in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Markis, J.E.; Malagold, M.; Parker, J.A.; Silverman, K.J.; Barry, W.H.; Als, A.V.; Paulin, S.; Grossman, W.; Braunwald, E.

    1981-10-01

    Nine patients with acute myocardial infarction had cardiac catheterization and intracoronary infusions of streptokinase 2.3 to 4.3 hours (mean, 3.5) after the onset of symptoms. Occluded coronary arteries were opened within approximately 20 minutes in all patients, but reocclusion occurred in one patient. The immediate effect of thrombolysis on myocardial salvage was assessed with the intracoronary injection of thallium-201. Improved regional perfusion, indicating myocardial salvage after recanalization, was observed in seven of the nine patients. One patient, who had also sustained a nontransmural infarction one week before, had no change after thrombolysis. In the ninth patient, recanalization of a coronary artery was followed by reocclusion and worsening of the myocardial-perfusion defect. Intracoronary thallium-201 studies two weeks and three months after streptokinase infusion in two patients were unchanged in comparison with scintiscans performed 1.5 hours after thrombolysis. These short-term observations suggest that recanalization of obstructed coronary arteries after intracoronary thrombolysis can salvage jeopardized myocardium, However, evaluation of the long-term effects of this procedure on survival and myocardial function will require controlled clinical trials.

  12. Raman and UV-Vis Spectroscopy Applied to the Analysis of Liver Tissues from Rats with Myocardial Ischemia Induced by Isoproterenol

    Institute of Scientific and Technical Information of China (English)

    GAO Hai-cheng; ZOU Ying-gang; HUANG Yu-xin; GAO Hai-mei; CHEN Lei; PEI Jin

    2011-01-01

    The application of the laser Raman spectroscopic(LRS) technique for the analysis of liver tissues from rats with myocardial ischemia induced by isoproterenol(ISO) was described.Animal model of myocardial ischemia was established for rats induced by ISO.Rats were randomly divided into four groups as normal group and myocardial ischemia groups.We observed the successful myocardial ischemia model via serum enzymes levels and hematoxylin-eosin(HE) staining,and detected the liver tissue of the rats from normal group and liver tissue of the rats from myocardial ischemia groups via UV-Vis spectroscopy(UV-Vis) and LRS,and the changes of the absorbance spectra were compared in the above four different groups.The results show that ISO can induce rat myocardial ischemia successfully.The spectrum of normal liver tissue supernatant exhibits a strong absorption band at 968 nm,but no absorption band appears in the spectra of liver tissue supernatant solutions from the rats with myocardial ischemia induction after 2,12 and 72 h presented at 968 nm.LRS results show that Raman intensities of the precipitates suffered from ISO-treatment after 2,12 and 72 h were obviously increased compared with that of the precipitate of the liver tissue of the normal rats suffered from 0.9 g/L normal saline(NS) treatment.These results indicate that LRS and UV-Vis can be harmless,nondestructive,rapid and effective methods for analyzing different pathological specimens of liver tissue from myocardial ischemia rats.

  13. [Bradyarrhythmias in the acute phase of myocardial infarct].

    Science.gov (United States)

    Maroto Montero, J M; Lemus, J M; Marín-Huerta, E; Gorodezky, M; Cárdenas, M

    1975-01-01

    The functioning of the Intensive Care Units has permitted a better study and treatment of the arrhythmias which complicate the acute phase of myocardial infarction. 1,100 charts of patients admitted to the Coronary Unit of the National Institute of Cardiology of Mexico were reviewed. Acute myocardial infarction was demonstrated in 819 of them by the usual methods. The frequency and characteristics of the following bradiarrhythmias were studied: sinus bradicardia, sinus stoppage, seno-atrial block, migration of the atrial pacing, union rhythm and slow ventricular tachycardia. Sinus bradicardia was presented in 23.7% of the infarctions, sinus stoppage in 2.4%, migration of the atrial pacing in 9.4%, nodal rhythm in 7.2% and slow ventricular tachycardia in 7.8%. Bradiarrhythmias, generally considered as "lesser" arrhythmias, favor the appearance of lethal arrhythmias, regardless of the degree of mechanical failure, and thus should be treated actively.

  14. Cancer risk of patients discharged with acute myocardial infarct

    DEFF Research Database (Denmark)

    Dreyer, L; Olsen, J H

    1998-01-01

    We studied whether common shared environmental or behavioral risk factors, other than tobacco smoking, underlie both atherosclerotic diseases and cancer. We identified a group of 96,891 one-year survivors of acute myocardial infarct through the Danish Hospital Discharge Register between 1977...... and 1989. We calculated the incidence of cancer in this group by linking it to the Danish Cancer Registry for the period 1978-1993. There was no consistent excess over the expected figures for any of the categories of cancer not related to tobacco smoking. Specifically, the rates of colorectal cancer...... in acute myocardial infarct patients were similar to those of the general population, as were the rates for hormone-related cancers, including endometrial and postmenopausal breast cancers. We found a moderate increase in the risk for tobacco-related cancers, which was strongest for patients with early...

  15. The nuclear melatonin receptor RORα is a novel endogenous defender against myocardial ischemia/reperfusion injury.

    Science.gov (United States)

    He, Ben; Zhao, Yichao; Xu, Longwei; Gao, Lingchen; Su, Yuanyuan; Lin, Nan; Pu, Jun

    2016-04-01

    Circadian rhythm disruption or decrease in levels of circadian hormones such as melatonin increases ischemic heart disease risk. The nuclear melatonin receptors RORs are pivotally involved in circadian rhythm regulation and melatonin effects mediation. However, the functional roles of RORs in the heart have never been investigated and were therefore the subject of this study on myocardial ischemia/reperfusion (MI/R) injury pathogenesis. RORα and RORγ subtypes were detected in the adult mouse heart, and RORα but not RORγ was downregulated after MI/R. To determine the pathological consequence of MI/R-induced reduction of RORα, we subjected RORα-deficient staggerer mice and wild-type (WT) littermates to MI/R injury, resulting in significantly increased myocardial infarct size, myocardial apoptosis and exacerbated contractile dysfunction in the former. Mechanistically, RORα deficiency promoted MI/R-induced endoplasmic reticulum stress, mitochondrial impairments, and autophagy dysfunction. Moreover, RORα deficiency augmented MI/R-induced oxidative/nitrative stress. Given the emerging evidence of RORα as an essential melatonin effects mediator, we further investigated the RORα roles in melatonin-exerted cardioprotection, in particular against MI/R injury, which was significantly attenuated in RORα-deficient mice, but negligibly affected by cardiac-specific silencing of RORγ. Finally, to determine cell type-specific effects of RORα, we generated mice with cardiomyocyte-specific RORα overexpression and they were less vulnerable to MI/R injury. In summary, our study provides the first direct evidence that the nuclear melatonin receptor RORα is a novel endogenous protective receptor against MI/R injury and an important mediator of melatonin-exerted cardioprotection; melatonin-RORα axis signaling thus appears important in protection against ischemic heart injury.

  16. Coronary microvascular obstruction in acute myocardial infarction.

    Science.gov (United States)

    Niccoli, Giampaolo; Scalone, Giancarla; Lerman, Amir; Crea, Filippo

    2016-04-01

    The success of a primary percutaneous intervention (PCI) in the setting of ST elevation myocardial infarction depends on the functional and structural integrity of coronary microcirculation. Coronary microvascular dysfunction and obstruction (CMVO) occurs in up to half of patients submitted to apparently successful primary PCI and is associated to a much worse outcome. The current review summarizes the complex mechanisms responsible for CMVO, including pre-existing coronary microvascular dysfunction, and highlights the current limitations in the assessment of microvascular function. More importantly, at the light of the substantial failure of trials hitherto published on the treatment of CMVO, this review proposes a novel integrated therapeutic approach, which should overcome the limitations of previous studies.

  17. [Sexuality in acute myocardial infarction patients].

    Science.gov (United States)

    Casado Dones, Ma J; de Andrés Gimeno, B; Moreno González, C; Fernández Balcones, C; Cruz Martín, R Ma; Colmenar García, C

    2002-01-01

    We as nurses in the Coronary Unit we do not see the sexuality of the patients sufficiently addressed neither by us nor by the patients themselves. In this article we are trying to analize the reasons and to emphasize the need to include this subject in our Nursing Problem List. In it we explaine the fears and the wrong ideas that we have identified in our patients. The sexual function is not affected by a myocardial infarction but psychological factors, age, drugs and other associated diseases might be a reason. A quiet enviroment, a fit training plan and looking for personalise proper alternatives may help the patient to start a satisfactory sexual life again.

  18. Early Biventricular Molecular Responses to an Acute Myocardial Infarction

    OpenAIRE

    Erdal, Cenk; Karakülah, Gökhan; Fermancı, Emel; Kunter, İmge; Silistreli, Erdem; Tülay CANDA; Erdal, Esra; Hepaguslar, Hasan

    2011-01-01

    Background: Acute myocardial infarction (AMI) remains as one of the most common lethal diseases in the world and therefore it is necessary to understand its effect on molecular basis. Genome-wide microarray analysis provides us to predict potential biomarkers and signaling pathways for this purpose. Objectives: The aim of this study is to understand the molecular basis of the immediate right ventricular cellular response to left ventricular AMI. Material and Methods: A rat model of left anter...

  19. [Acute myocardial infarction during tocolytic treatment with ritodrine].

    Science.gov (United States)

    Fornet, I; Calvo, M; Gimeno, M; Canser, E; Alonso, E; Gilsanz, F

    2006-05-01

    Ritodrine, a beta2-adrenergic agonist with a selective effect on the uterine muscle, is prescribed to prevent premature labor and to treat a hypertonic uterus. At therapeutic doses ritodrine has chronotropic and peripheral vasodilator effects. At high doses it has been related to sporadic cases of subendocardial necrosis, pulmonary edema, and death in pregnancy. We report the case of a pregnant woman who had a non-Q wave acute myocardial infarction after administration of ritodrine.

  20. An unusual presentation of mad honey poisoning: acute myocardial infarction.

    Science.gov (United States)

    Akinci, Sinan; Arslan, Uğur; Karakurt, Kamber; Cengel, Atiye

    2008-09-26

    An unusual type of food poisoning is commonly seen in the Black Sea coast of Turkey due to grayanotoxin containing toxic honey so called "mad honey" ingestion. In cases of toxication bradycardia and rhythm disturbances are commonly observed. Herein, we present a case of a patient who was admitted to the hospital because of acute myocardial infarction with normal coronary arteries after "mad honey" ingestion.

  1. Acute Anterolateral Myocardial Infarction Due to Aluminum Phosphide Poisoning

    Directory of Open Access Journals (Sweden)

    Bita Dadpour

    2013-08-01

    Full Text Available Aluminum phosphide (AlP is a highly effective rodenticide which is used as a suicide poison. Herein, a 24 year-old man who’d intentionally ingested about 1liter of alcohol and one tablet of AlP is reported. Acute myocardial infarction due to AlP poisoning has been occurred secondary to AIP poisoning. Cardiovascular complications are poor prognostic factors in AlP poisoning

  2. Remote postconditioning induced by brief pulmonary ischemia and reperfusion attenuates myocardial reperfusion injury in rabbits

    Institute of Scientific and Technical Information of China (English)

    TANG Yan-hua; XU Jian-jun; LI Ju-xiang; CHENG Xiao-shu

    2011-01-01

    Background The lung is one of the most important organs that are sensitive to ischemia. We hypothesized that remote postconditioning (RPostC) induced by brief occlusion and reperfusion of the pulmonary artery could attenuate myocardial reperfusion injury.Methods Thirty rabbits were randomized into three groups. Group ischemia-reperfusion (IR) (n=10) were anesthetized rabbits subjected to 30-minute occlusion of the left anterior descending coronary artery followed by 180-minute reperfusion. Group RPostC (n=10) had the left pulmonary artery blocked for five minutes followed by a 5-minute reperfusion, and the left anterior descending coronary artery (LAD) occluded for 30 minutes with a 180-minute reperfusion. Group L-Nw-nitro-L-arginine methylester (L-NAME) + RPostC (n=10) had the left pulmonary artery blocked for five minutes followed by a 5-minute reperfusion and intravenous infusion of L-NAME (10 mg/kg), and the LAD occluded for 30 minutes with a 180-minute reperfusion. Blood samples were taken for levels of creatine kinase (CK),superoxide dismutase (SOD) and malondialdehyde (MDA) at three different time points. At the end of the experiment,tissue samples of the infarcted region were harvested to calculate the cardiomyocyte apoptosis index (Al) by TUNEL. A piece of left and right lung tissue was harvested to evaluate the damage to the lung.Results After reperfusion for 180 minutes, the concentration of CK was lower in group RPostC, (4.79±0.27) U/ml, than that in group IR, (6.23±0.55) U/ml (P <0.01), and group L-NAME + RPsotC, (5.86±0.42) U/ml (P <0.01). The concentration of MDA was lower in group RPostC, (6.06±0.36) nmol/ml, than that in group IR, (11.41±0.91) nmol/ml (P <0.01), and group L-NAME + RPostC, (11.06±0.62) nmol/ml (P<0.01). The activity of SOD was higher in group RPostC,(242.34±25.02) U/ml, than that in group IR, (148.05±18.24) U/ml (P<0.01), and group L-NAME + RPostC, (160.66±9.55) U/ml (P<0.01). The apoptosis index was lower in

  3. Effects of N-n-butyl Haloperidol Iodide on Myocardial Ischemia/Reperfusion Injury and Egr-1 Expression in Rat

    Institute of Scientific and Technical Information of China (English)

    Yan-Mei ZHANG; Gang-Gang SHI; Zhao TANG; Jin-Hong ZHENG; Wei-Qiu LI; Fu-Xiao GUO; Qiang-Yong JIA

    2006-01-01

    We have previously shown that N-n-butyl haloperidol iodide (F2) derived from haloperidol reduces ischemia/reperfusion-induced myocardial injury by blocking intracellular Ca2+ overload. This study tested the hypothesis that cardio-protection with F2 is associated with an attenuation in the expression of early growth response gene 1 (Egr-1). In an in vivo rat model of 60 min coronary occlusion followed by 180 min of reperfusion, treatment with F2 significantly reduced myocardial injury evidenced by the reduction in release of plasma creatine kinase, myocardial creatine kinase isoenzyme and lactate dehydrogenase. In cultured neonatal rat cardiomyocytes of hypoxia for 3 h and reoxygenation for 1 h, F2 treatment attenuated necrotic and apoptotic cell death, as demonstrated by electron microscopy. Concomitant with cardio-protection by F2, the increased expression levels of Egr-1 mRNA and proteinwere significantly reduced in myocardial tissue and cultured cardiomyocytes as detected by reverse transcription-polymerase chain reaction, immunohistochemistry and immunocytochemistry. In conclusion, these results suggest that the protective effect of F2 on ischemia/reperfusion- or hypoxia/reoxygenation-induced myocardial injury might be partly mediated by downregulating Egr-1 expression.

  4. Histochemical and immunohistochemical analyses of the myocardial scar fallowing acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Tatić Vujadin

    2012-01-01

    Full Text Available Background/Aim. The heart has traditionally been considered as a static organ without capacity of regeneration after trauma. Currently, the more and more often asked question is whether the heart has any intrinsic capacities to regenerate myocytes after myocardial infarction. The aim of this study was to present the existence of the preserved muscle fibers in the myocardial scar following myocardial infarction as well as the presence of numerous cells of various size and form that differently reacted to the used immunohistochemical antibodies. Methods. Histological, histochemical and immunohistochemical analyses of myocardial sections taken from 177 patients who had died of acute myocardial infarction and had the myocardial scar following myocardial infarction, were carried out. More sections taken both from the site of acute infarction and scar were examined by the following methods: hematoxylin-eosin (HE, periodic acid schiff (PAS, PAS-diastasis, Masson trichrom, Malory, van Gieson, vimentin, desmin, myosin, myoglobin, alpha actin, smoth muscle actin (SMA, p53, leukocyte common antigen (LCA, proliferating cell nuclear antigen (PCNA, Ki-67, actin HHF35, CD34, CD31, CD45, CD45Ro, CD8, CD20. Results. In all sections taken from the scar region, larger or smaller islets of the preserved muscle fibers with the signs of hypertrophy were found. In the scar, a large number of cells of various size and form: spindle, oval, elongated with abundant cytoplasm, small with one nucleus and cells with scanty cytoplasm, were found. The present cells differently reacted to histochemical and immunohistochemical methods. Large oval cells showed negative reaction to lymphocytic and leukocytic markers, and positive to alpha actin, actin HHF35, Ki-67, myosin, myoglobin and desmin. Elongated cells were also positive to those markers. Small mononuclear cells showed positive reaction to lymphocytic markers. Endothelial and smooth muscle cells in the blood vessel walls

  5. Amphetamine Containing Dietary Supplements and Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Julio Perez-Downes

    2016-01-01

    Full Text Available Weight loss is one of the most researched and marketed topics in American society. Dietary regimens, medications that claim to boost the metabolism, and the constant pressure to fit into society all play a role in our patient’s choices regarding new dietary products. One of the products that are well known to suppress appetite and cause weight loss is amphetamines. While these medications suppress appetite, most people are not aware of the detrimental side effects of amphetamines, including hypertension, tachycardia, arrhythmias, and in certain instances acute myocardial infarction. Here we present the uncommon entity of an acute myocardial infarction due to chronic use of an amphetamine containing dietary supplement in conjunction with an exercise regimen. Our case brings to light further awareness regarding use of amphetamines. Clinicians should have a high index of suspicion of use of these substances when young patients with no risk factors for coronary artery disease present with acute arrhythmias, heart failure, and myocardial infarctions.

  6. Pancreatitis with Electrocardiographic Changes Mimicking Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Paul Khairy

    2001-01-01

    Full Text Available A 64-year-old woman with mild acute pancreatitis presented with epigastric pain, nausea and vomiting while undergoing hemodialysis for chronic renal insufficiency. Serial electrocardiograms revealed new onset ST segment elevations in leads V2 to V4 mimicking an anterior myocardial infarction, followed by diffusely inverted deep T waves. No cardiac pathology was demonstrated by echocardiography or coronary angiography. A review of the literature and possible pathophysiological mechanisms of electrocardiographic changes in acute pancreatitis, such as metabolic abnormalities, hemodynamic instability, vasopressors, pericarditis, myocarditis, a cardiobiliary reflex, exacerbation of underlying cardiac pathology, coagulopathy and coronary vasospasm, are discussed.

  7. Effect of metoprolol on chest pain in acute myocardial infarction.

    OpenAIRE

    Herlitz, J; Hjalmarson, A.; Holmberg, S.; Pennert, K; Swedberg, K; Vedin, A; Waagstein, F; Waldenström, A; Wedel, H.; Wilhelmsen, L

    1984-01-01

    A total of 1395 patients aged 40 to 74 years were included in a double blind trial with the beta 1 selective blocker metoprolol in suspected acute myocardial infarction. Metoprolol was given intravenously (15 mg) as soon as possible after admission to hospital followed by 200 mg daily for three months. A placebo was given in the same manner. The severity of chest pain in the acute phase was calculated by recording the number of injections of analgesics given and the time from the start of bli...

  8. Glycyrrhiza glabra protects from myocardial ischemia-reperfusion injury by improving hemodynamic, biochemical, histopathological and ventricular function.

    Science.gov (United States)

    Ojha, Shreesh; Golechha, Mahaveer; Kumari, Santosh; Bhatia, Jagriti; Arya, Dharamvir S

    2013-01-01

    Present study evaluated the cardioprotective effect of Glycyrrhiza glabra against ischemia-reperfusion injury (I-R) induced by ligation of left anterior descending coronary artery (LADCA) in rats. Ligation of LADCA for 45 min followed by 60 min of reperfusion has induced significant (pglabra significantly (pglabra also prevented GSH depletion and inhibited lipid peroxidation in heart. In addition to improving biochemical indices of myocardial function, G. glabra also significantly (pglabra. Taken together, results of the present study clearly suggest the cardioprotective potential of G. glabra against myocardial infarction by amelioration of oxidative stress and favorable modulation of cardiac function.

  9. Aromatase inhibition attenuates desflurane-induced preconditioning against acute myocardial infarction in male mouse heart in vivo.

    Directory of Open Access Journals (Sweden)

    Virginija Jazbutyte

    Full Text Available The volatile anesthetic desflurane (DES effectively reduces cardiac infarct size following experimental ischemia/reperfusion injury in the mouse heart. We hypothesized that endogenous estrogens play a role as mediators of desflurane-induced preconditioning against myocardial infarction. In this study, we tested the hypothesis that desflurane effects local estrogen synthesis by modulating enzyme aromatase expression and activity in the mouse heart. Aromatase metabolizes testosterone to 17β- estradiol (E2 and thereby significantly contributes to local estrogen synthesis. We tested aromatase effects in acute myocardial infarction model in male mice. The animals were randomized and subjected to four groups which were pre-treated with the selective aromatase inhibitor anastrozole (A group and DES alone (DES group or in combination (A+DES group for 15 minutes prior to surgical intervention whereas the control group received 0.9% NaCl (CON group. All animals were subjected to 45 minutes ischemia following 180 minutes reperfusion. Anastrozole blocked DES induced preconditioning and increased infarct size compared to DES alone (37.94 ± 15.5% vs. 17.1 ± 3.62% without affecting area at risk and systemic hemodynamic parameters following ischemia/reperfusion. Protein localization studies revealed that aromatase was abundant in the murine cardiovascular system with the highest expression levels in endothelial and smooth muscle cells. Desflurane application at pharmacological concentrations efficiently upregulated aromatase expression in vivo and in vitro. We conclude that desflurane efficiently regulates aromatase expression and activity which might lead to increased local estrogen synthesis and thus preserve cellular integrity and reduce cardiac damage in an acute myocardial infarction model.

  10. THE EFFECT OF ANISODAMINE ON CEREBRAL RESUSCITATION OF RATS IN ACUTE CEREBRAL ISCHEMIA FROM CARDIAC ARREST

    Institute of Scientific and Technical Information of China (English)

    彭新琦; 曹苏谊; 可君

    1995-01-01

    In order to investigate the mechanisms of acute cerebral ischemia,and to look for effective drugs on cerebral resuscitation,we made a model of acute complete global brain ischemia,reperfusion and resuscita-tion on rats according to Garavilla's method.Our results showed that the event of cerebral ischemia and reperfusion injury could result in the in-crease of total brain calcium content,and anisodamine has the same reducing brain calcium contents as dil-tiazem's,while improving neurological outcome and alleviating injury to neurons.

  11. Metabolism of biogenic amines in acute cerebral ischemia: Influence of systemic hyperglycemia

    Directory of Open Access Journals (Sweden)

    Milovanović Aleksandar

    2012-01-01

    Full Text Available Dopamine, norepinephrine and serotonin are biogenic amines which are transmitters of the central nervous system. The effects of ischemia on the brain parenchyma depends on many factors, such is the mechanism of blood flow interruption, velocity of the occurring blood flow interruption, duration of an ischemic episode, organization of anatomical structures of the brain blood vessels etc., which all influence the final outcome. During interruption of the brain circulation in experimental or clinical conditions, neurotransmitter metabolism, primarily of biogenic amines, is disturbed. Many researches with various experimental models of complete ischemia reported a decrease in the content of norepinephrine, dopamine and serotonin in the CNS tissue. It was proven that hyperglycemia can drastically increase cerebral injury followed by short-term cerebral ischemia. Considering the fact that biogenic amines (dopamine, norepinephrine and serotonin influence the size of neurologic damage, as well as the fact that in hyperglycemic conditions infarct size (from the morphological aspect is larger relative to normoglycemic status, the intention was to evaluate the role of biogenic amines in occurrence of damage in conditions of hyperglycemia, i.e. in the case of brain apoplexia in diabetics. Analysis of biogenic amines metabolism in states of acute hyperglycemia, as well as analysis of the effects of reversible and irreversible brain ischemia on metabolism of serotonin, dopamine and norepinephrine, showed that acute hyperglycemia slows down serotonin, dopamine and norepinephrine metabolism in the cerebral cortex and n. caudatus. Brain ischemia in normoglycemic animals by itself has no influence on biogenic amines metabolism, but the effect of ischemia becomes apparent during reperfusion. In recirculation, which corresponds to the occurrences in penumbra, release of biogenic amines is uncontrolled and increased. Brain ischemia in acute hyperglycemic animals

  12. Effect of Shenfu injection on nuclear factor-kB during myocardial ischemia/reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ben-jing; WANA Yan-lin; WANG Cheng-yao; KE Jian-juan

    2005-01-01

    Objective: To investigate effects of Shenfu injection on the concentrations of plasma tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), activity of Nuclear Factor kappa B (NF-κB) and heart tissue ultrastructure during myocardial ischemia/reperfusion (I/R) injury in rats and its potential mechanism.Methods: Myocardial ischemia/reperfusion (I/R) was produced by ligation and release of the left anterior descending coronary artery. Ischemia lasted for 30 min and reperfusion for 60 min. Twenty-four healthy male SD rats weighing 230-280 g were randomly divided into three groups (n=8, each): Group I (Sham-operation group); Group II (I/R group); Group III (Shenfu group), in which Shenfu injection (10 ml/kg) was intraperitoneally injected 30 min before ischemia in animals with I/R. The plasma concentrations of IL-6 and TNF-α were measured by ELISA, and the heart was harvested for determination of NF-κB levels by Ecl-western blot analysis. Electron microscopy was used to study its ultrastructure.Results: After reperfusion, NF-κB binding activity in myocardial nuclei and the plasma concentrations of IL-6 and TNF-α were significantly increased in Group II, compared with Group I (P<0.01), and they were markedly reduced in Group III, compared with Group II (P<0.01). In addition, electron microscopic examination showed more serious injury of the myocardium ultrastructure in Group II, while in Group III the myocardial ultrastructure was similar to normal state.Conclusions: Shenfu injection inhibits NF-κB activity in I/R myocardium and leads to down-regulation of proinflammatory cytokine expression, which might be one of the molecular mechanisms of Shenfu injection in cardioprotection.

  13. Acute myocardial infarction and stress cardiomyopathy following the Christchurch earthquakes.

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    Christina Chan

    Full Text Available BACKGROUND: Christchurch, New Zealand, was struck by 2 major earthquakes at 4:36 am on 4 September 2010, magnitude 7.1 and at 12:51 pm on 22 February 2011, magnitude 6.3. Both events caused widespread destruction. Christchurch Hospital was the region's only acute care hospital. It remained functional following both earthquakes. We were able to examine the effects of the 2 earthquakes on acute cardiac presentations. METHODS: Patients admitted under Cardiology in Christchurch Hospital 3 week prior to and 5 weeks following both earthquakes were analysed, with corresponding control periods in September 2009 and February 2010. Patients were categorised based on diagnosis: ST elevation myocardial infarction, Non ST elevation myocardial infarction, stress cardiomyopathy, unstable angina, stable angina, non cardiac chest pain, arrhythmia and others. RESULTS: There was a significant increase in overall admissions (p<0.003, ST elevation myocardial infarction (p<0.016, and non cardiac chest pain (p<0.022 in the first 2 weeks following the early morning September earthquake. This pattern was not seen after the early afternoon February earthquake. Instead, there was a very large number of stress cardiomyopathy admissions with 21 cases (95% CI 2.6-6.4 in 4 days. There had been 6 stress cardiomyopathy cases after the first earthquake (95% CI 0.44-2.62. Statistical analysis showed this to be a significant difference between the earthquakes (p<0.05. CONCLUSION: The early morning September earthquake triggered a large increase in ST elevation myocardial infarction and a few stress cardiomyopathy cases. The early afternoon February earthquake caused significantly more stress cardiomyopathy. Two major earthquakes occurring at different times of day differed in their effect on acute cardiac events.

  14. CLINICAL PROFILE OF ACUTE MYOCARDIAL INFARCTION YOUNG ADULTS

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    Patel G. N

    2015-08-01

    Full Text Available BACKGROUND : Although acute myocardial infarction was believed to be an uncommon entity in the young, of late there has been a rising incidence in this group of population. The analysis of its clinical profile, including the etiologic and the risk factors gains much importance, for the preventive purpose. AIMS AND OBJECTIVES: To study the clinical profile of acute MI, including the evaluation of the cardiac enzyme markers, the risk factors, the management and the complications and outcome of this g roup of patients aged 40 years or younger. RESULTS: Majority of patients belonged to the age group of 36 - 40years. 31 patients were overweight and 16 patients were obese. 46 patients (67.64% had anterior wall myocardial infarction, 22 patients had inferior wall myocardial infarction (32.35% and ST - elevation myocardial infarction was found in 69.2% of patients. Smoking/tobacco use was the most common risk factor (64.70% followed by dyslipidemia (60.29%, metabolic syndrome (52.94% diabetes mellitus (52.94 %, hyperhomocysteinemia (52.94%, alcohol consumption (48.52%, hypertension (34%, family history (26.47%, obesity (23.52%. Other than these, two patients had chronic kidney disease stage 3, two female patients were irregular oral contraceptive pill us ers, one was diagnosed as systemic lupus erythematosus and another patient had antiphospholipid antibody syndrome. Conclusions: Apart from early diagnosis and adequate treatment of acute MI in young patients, it is also essential to identify and prevent or control the risk factors at primary and secondary level.

  15. Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia

    DEFF Research Database (Denmark)

    Fakhri, Yama; Schoos, Mikkel Malby; Sejersten-Ripa, Maria;

    2017-01-01

    BACKGROUND: Elevated levels of N-terminal pro brain natriuretic peptide (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score (based on the electrocardiographic score by Anderson-Wilkins acu...

  16. Activated Notch1 reduces myocardial ischemia reperfusion injury in vitro during ischemic postconditioning by crosstalk with the RISK signaling pathway

    Institute of Scientific and Technical Information of China (English)

    ZHOU Xue-liang; WAN Li; LIU Ji-chun

    2013-01-01

    Background Ischemic postconditioning (IPost),able to significantly attenuate myocardial ischemia reperfusion injury,is dependent on RISK signaling.Studies have shown that Notch signaling repairs damaged myocardium,and this study aimed to investigate the effect of Notch signaling in myocardial IPost.Methods We used H9c2 cells to establish the myocardial IPost and Hypoxia/Reoxygenation (H/R) model in vitro,which were randomly divided into control,H/R,IPost,Hepatocyte growth factor (HGF)+IPost and DAPT+IPost,N1ICD+IPost,miRNA+lPost,and Mock treatment groups.The myocardial cell viability was assessed by MTT,the cell apoptosis was detected using Annexin V/PI double staining and flow cytometry analyses.The expression of N1ICD,Hes1,PTEN Phospho-Akt/Akt,Phospho-GSK-3β/GSK-3β were detected by Western blotting.Finally,we assessed the changes in Ψm using the potential-sensitive dye JC-1 and measured using flow cytometry analyses.Results The Notch1 signaling is activated by HGF and ectopic expression of N1ICD during myocardial IPost,which increased myocardial cell viability,prevented cardiomyocyte apoptosis,and reduced loss of the mitochondrial membrane potential.However,myocardial ischemia reperfusion injury was increased in IPost when Notch1 signaling was inhibited using DAPT or with knockdown by Notch1-miRNA.Western blotting found that PTEN was down-regulated by Hes1 when Notch1 was activated,which consequently promoted Akt and GSK-3β phosphorylation.Conclusions Notch1 crosstalk with RISK signaling may be dependent on PTEN,which plays a cardioprotective role during IPost.This mechanism could provide a promising therapeutic target for the treatment of ischemic heart disease.

  17. Hemodynamic effects of acute digitalization several months after acute myocardial infarction.

    Science.gov (United States)

    Ressl, J; Jandová, R; Jebavý, P; Kasalický, J; Widimský, J

    1975-01-01

    Left ventricular function was investigated at rest and during exercise by heart catheterization in 15 patients 3-5 months after acute myocardial infarction. The effect of 1 mg digoxin i.v. in ten patients was correlated to placebo (saline solution) in five patients. A significant decrease of the left ventricular enddiastolic pressure, increase of left ventricular systolic ejection fraction and a shift of the left ventricular function curve to left upwards was found after digoxin with no changes in the placebo group. This beneficial effect of acute digitalization in patients convalescing from uncomplicated myocardial infarction without clinical signs of manifest heart failure could have therapeutic implication.

  18. Regulation of signal transducer and activator of transcription 3 and apoptotic pathways by betaine attenuates isoproterenol-induced acute myocardial injury in rats.

    Science.gov (United States)

    Zheng, P; Liu, J; Mai, S; Yuan, Y; Wang, Y; Dai, G

    2015-05-01

    The present study was designed to investigate the cardioprotective effects of betaine on acute myocardial ischemia induced experimentally in rats focusing on regulation of signal transducer and activator of transcription 3 (STAT3) and apoptotic pathways as the potential mechanism underlying the drug effect. Male Sprague Dawley rats were treated with betaine (100, 200, and 400 mg/kg) orally for 40 days. Acute myocardial ischemic injury was induced in rats by subcutaneous injection of isoproterenol (85 mg/kg), for two consecutive days. Serum cardiac marker enzyme, histopathological variables and expression of protein levels were analyzed. Oral administration of betaine (200 and 400 mg/kg) significantly reduced the level of cardiac marker enzyme in the serum and prevented left ventricular remodeling. Western blot analysis showed that isoproterenol-induced phosphorylation of STAT3 was maintained or further enhanced by betaine treatment in myocardium. Furthermore, betaine (200 and 400 mg/kg) treatment increased the ventricular expression of Bcl-2 and reduced the level of Bax, therefore causing a significant increase in the ratio of Bcl-2/Bax. The protective role of betaine on myocardial damage was further confirmed by histopathological examination. In summary, our results showed that betaine pretreatment attenuated isoproterenol-induced acute myocardial ischemia via the regulation of STAT3 and apoptotic pathways.

  19. Congestive heart failure with preserved left ventricular systolic function after acute myocardial infarction

    DEFF Research Database (Denmark)

    Møller, Jacob Eifer; Brendorp, Bente; Ottesen, Michael

    2003-01-01

    AIMS: To characterise the prevalence, in-hospital complications, management, and long-term outcome of patients with congestive heart failure but preserved left ventricular systolic function after acute myocardial infarction. METHODS: 3166 consecutive patients screened for entry in the Bucindolol...... Evaluation in Acute Myocardial Infarction Trial with definite acute myocardial infarction and echocardiographic assessment of left ventricular systolic function were included between 1998 and 1999 in this prospective observational study. Main outcome measures were occurrences of in-hospital complications...... ventricular systolic function, and is associated with increased risk of in-hospital complications and death following acute myocardial infarction....

  20. Novel curcumin analogue 14p protects against myocardial ischemia reperfusion injury through Nrf2-activating anti-oxidative activity

    Energy Technology Data Exchange (ETDEWEB)

    Li, Weixin [Department of Cardiology, The 5th Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang (China); Chemical Biology Research Center, School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, Zhejiang (China); Wu, Mingchai [Department of Pharmacy, The Third Affiliated Hospital of Wenzhou Medical University, Wenzou, Zhejiang (China); Tang, Longguang; Pan, Yong; Liu, Zhiguo [Chemical Biology Research Center, School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, Zhejiang (China); Zeng, Chunlai [Department of Cardiology, The 5th Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang (China); Wang, Jingying [Chemical Biology Research Center, School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, Zhejiang (China); Wei, Tiemin, E-mail: lswtm@sina.com [Department of Cardiology, The 5th Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang (China); Liang, Guang, E-mail: wzmcliangguang@163.com [Chemical Biology Research Center, School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, Zhejiang (China)

    2015-01-15

    Background: Alleviating the oxidant stress associated with myocardial ischemia reperfusion has been demonstrated as a potential therapeutic approach to limit ischemia reperfusion (I/R)-induced cardiac damage. Curcumin, a natural compound with anti-oxidative activity, exerts beneficial effect against cardiac I/R injury, but poor chemical and metabolic stability. Previously, we have designed and synthesized a series of mono-carbonyl analogues of curcumin (MACs) with high stability. This study aims to find new anti-oxidant MACs and to demonstrate their effects and mechanisms against I/R-induced heart injury. Methods: H9c2 cells challenged with H{sub 2}O{sub 2} or TBHP were used for in vitro bio-screening and mechanistic studies. The MDA, H{sub 2}O{sub 2} and SOD levels in H9C2 cells were determined, and the cell viability was assessed by MTT assay. Myocardial I/R mouse models administrated with or without the compound were used for in vivo studies. Results: The in vitro cell-based screening showed that curcumin analogues 8d and 14p exhibited strong anti-oxidative effects. Pre-treatment of H9c2 cells with 14p activated Nrf2 signaling pathway, attenuated H{sub 2}O{sub 2}-increased MDA and SOD level, followed by the inhibition of TBHP-induced cell death and Bax/Bcl-2–caspase-3 pathway activation. Silencing Nrf2 significantly reversed the protective effects of 14p. In in vivo animal model of myocardial I/R, administration of low dose 14p (10 mg/kg) reduced infarct size and myocardial apoptosis to the same extent as the high dose curcumin (100 mg/kg). Conclusion: These data support the novel curcumin analogue 14p as a promising antioxidant to decrease oxidative stress and limit myocardial ischemia reperfusion injury via activating Nrf2. - Highlights: • Mono-carbonyl analogue of curcumin, 14p, exhibited better chemical stability. • Compound 14p inhibited TBHP-induced apoptosis through activating Nrf2 in vitro. • Compound 14p limited myocardial ischemia

  1. [Modulation of the beta-adrenergic system during acute myocardial infarction: rationale for a new clinical trial].

    Science.gov (United States)

    Ibáñez, Borja; Fuster, Valentín; Macaya, Carlos; Jiménez-Borreguero, Jesús; Iñiguez, Andrés; Fernández-Ortiz, Antonio; Sanz, Ginés; Sánchez-Brunete, Vicente

    2011-07-01

    Acute myocardial infarction is caused by sudden coronary artery occlusion. Persistent ischemia results in necrosis of the myocardial tissue supplied by the occluded vessel. It has recently been shown that the final size of the infarct is a major predictor of future clinical events, and is, therefore, used as a surrogate outcome in clinical trials. Moreover, it has become clear that the duration of ischemia in the main determinant of the success of myocardial salvage (i.e. of non-necrotic at-risk myocardium). In addition to minimizing the time between symptom onset and reperfusion, there is considerable interest in finding therapies that can further limit the size of the infarction (i.e. cardioprotective therapies) and they are the focus of numerous clinical studies. Oral β-blockade within the first few hours of an AMI is a class-IA indication in clinical practice guidelines. However, early intravenous β-blockade, even before coronary artery reperfusion, is not routinely recommended. Preclinical research has demonstrated that the selectiveβ1-blocker metoprolol is able to reduce the infarct size only when administered before coronary artery reperfusion, which indicates that its cardioprotective properties are secondary to its ability to reduce reperfusion injury. In addition, retrospective studies of AMI suggest that starting intravenous β-blockade early has clinical benefits (i.e. lower mortality and better recovery of left ventricular contractility) in patients without contraindications. Our general hypothesis is that early administration of metoprolol (i.e. intravenously before reperfusion) results in smaller infarcts than administering the drug orally after reperfusion. The Effect of METOprolol in CARDioproteCtioN during an acute myocardial InfarCtion (METOCARD-CNIC) trial will test this hypothesis in patients with ST-segment elevation AMI.

  2. Redox activation of Ref-1 potentiates cell survival following myocardial ischemia reperfusion injury.

    Science.gov (United States)

    Gurusamy, Narasimman; Malik, Gautam; Gorbunov, Nikolai V; Das, Dipak K

    2007-08-01

    A recent study showed that cardiac adaptation could potentiate translocation of thioredoxin-1 (Trx-1) into the nucleus, which then interacted with Ref-1, resulting in a survival signal. Here, we present evidence that such adaptation also causes nuclear translocation of Ref-1, which is almost completely inhibited when the hearts were pretreated with antisense Ref-1 that also abolished the cardioprotective adaptive response. Significant amounts of NFkappaB and Nrf2 were found to be associated with Ref-1 when the nuclear extract obtained from the left ventricle was immunoprecipitated with Ref-1. Such Ref-1-NFkappaB and Ref-1-Nrf2 interactions were significantly inhibited with antisense Ref-1. However, immunoprecipitation of nuclear extract with NFkappaB showed that the association of Trx-1 with NFkappaB is increased in the adapted heart, which was again significantly blocked by antisense Ref-1. Nrf2 was also associated with NFkappaB; however, such association appeared to be independent of Ref-1. In contrast, myocardial adaptation to ischemia inhibited the ischemia reperfusion-induced loss of Nrf2 from the nucleus, which was inhibited by antisense Ref-1. The nuclear translocation and activation of Ref-1 appeared to generate a survival signal as evidenced by the increased phosphorylation of Akt that was inhibited with antisense Ref-1. Finally, confocal microscopy confirmed the results of immunoblotting, clearly showing the nuclear translocation of Ref-1 and nuclear 3D colocalization of Ref-1 with NFkappaB in the adapted heart and its inhibition with antisense Ref-1. Our results show that PC potentiates a survival signal through the phosphorylation of Akt by causing nuclear translocation and activation of Ref-1, where significant interaction among NFkappaB and Ref-1, Trx-1, and Nrf2 appears to regulate Ref-1-induced survival signal.

  3. Effects of phytoestrogen genistein on myocardial ischemia/reperfusion injury and apoptosis in rabbits

    Institute of Scientific and Technical Information of China (English)

    En-sheng JI; Hua YUE; Yu-ming WU; Rui-rong HE

    2004-01-01

    AIM: To study the effect of genistein (GST) on rabbit heart ischemia/reperfusion (I/R) injury. METHODS: Rabbit heart I/R injury was induced by occluding the left anterior descending coronary artery for 45 min and reperfusing for 180 min. GST (1.0 mg/kg) was intravenously injected 5 min before heart ischemia. Hemodynamic data, infarct size, and cardiomyocytic apoptosis were measured. The pathologic changes of I/R myocardium were observed.RESULTS: During the I/R, heart rate, mean arterial blood pressure, myocardial oxygen consumption, left ventricular (LV) -dp/dtmax and +dp/dtmax were decreased progressively. The infarct size was occupied 60.23 %±3.97 % (%of area at risk) in vehicle +I/R group while GST reduced the infarct size to 39.62 %±4.30 % (P<0.01). DNA ladder patter in myocardium was revealed by agarose gel electrophoresis in vehicle +I/R group while was not found in GST+I/R group. Apoptotic cardiomyocytes were sparse within ischemic myocardium at risk in GST+I/R group as compared with that in vehicle +I/R group (TUNEL stain). Apoptosis rate in ischemic myocardium from vehicle +I/R and GST+I/R groups detected by flow cytometry were 15.33 %±1.31% and 3.88 %±0.33 %,respectively. Fas and Bax protein expressions in ischemic myocardium of vehicle +I/R group were higher than that in GST+I/R group (P<0.01). Bcl-2/Bax ratio in vehicle +I/R group was lower than that in nonischemic myocardium (P<0.01), while in GST+I/R group, the Bcl-2/Bax ratio was higher than that in vehicle +I/R group (P<0.01).CONCLUSION: GST reduced infarct size and apoptosis of myocytes in I/R rabbit heart.

  4. Acute Occlusive Mesenteric Ischemia in Taif Province, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohamed Al Saeed ** Mohamed Abu Shady *Mohamed Hatem *Khalid Alzahrani

    2012-04-01

    Full Text Available Mesenteric ischemia is relatively a rare disorder seen in the emergency department (ED. Due to the effect of hypobaric hypoxia and higher liability for thrombosis encountered in high altitude areas, acute occlusive mesenteric ischemia (AOMI would represent an actual challenge in Taif and related districts. Another risk factor is that about twenty-five percent of Saudis are victims of diabetes due to the changes in lifestyle and diet leading to increasing levels of obesity. Vague nonspecific clinical findings and limitations of diagnostic studies in addition to cultural and social factors, may lead to late presentation making the diagnosis a significant challenge and in turn higher morbidity and mortality are expected. Objectives: In this study, we review type of AOMI, pattern of presentation, laboratory, radiological, Intraoperative findings and results of treatment in 36 patients who were admitted to King Abdul Aziz Specialist Hospital and King Faisal Hospital, Al Taif, Saudi Arabia from January 2009 to January 2012. Methods: 36 patients with final diagnosis of AOMI were included in this retrospective study by means of review of their files and medical records. Results: The disease was more common in men than women (23 male and 13 females. The mean age of patients was 54 years. The mean time of presentation was 2.4 days after occurrence of symptoms. Abdominal pain was the most common symptom of patients followed by nausea, vomiting, constipation and bloody diarrhea. On physical examination; tachycardia was prevalent, Oliguria was seen in approximately 69.4% of patients, 11.1% of patients were in shock status. All patients had abdominal tenderness and 61.1% of patients had marked peritoneal signs (rebound tenderness with guarding or/and rigidity. Twenty one/36 (58.3% patients were diabetics, 17/36 patients (47.2% were hypertensive and 8/36 patients (22.2% with associated cardiac disorders. In laboratory tests, Leukocytosis was present in all

  5. Depression, dietary habits, and cardiovascular events among women with suspected myocardial ischemia

    Science.gov (United States)

    Rutledge, Thomas; Kenkre, Tanya S.; Thompson, Diane V.; Bittner, Vera A; Whittaker, Kerry; Eastwood, Jo-Ann; Eteiba, Wafia; Cornell, Carol E.; Krantz, David S.; Pepine, Carl J.; Johnson, B. Delia; Handberg, Eileen M.; Merz, C. Noel Bairey

    2014-01-01

    Background Dietary habits and depression are each associated with cardiovascular disease risk. Patient with depression often report poor eating habits and dietary factors may help explain commonly observed associations between depression and cardiovascular disease. Method From 1996–2000, 936 women were enrolled in the Women's Ischemia Syndrome Evaluation (WISE) at four US academic medical centers at the time of clinically indicated coronary angiography and then assessed (median follow-up, 5.9 years) for adverse outcomes (cardiovascular disease death, heart failure, myocardial infarction, stroke). Participants completed a protocol including coronary angiography (coronary artery disease severity), depression assessments (Beck Depression Inventory [BDI] scores, antidepressant use, & depression treatment history). A subset of 201 women (mean age= 58.5(SD=11.4) further completed the Food Frequency Questionnaire for Adults (FFQ; 1998 Block). We extracted daily fiber intake and daily servings of fruit and vegetables as measures of dietary habits. Results In separate Cox regression models adjusted for age, smoking, and coronary artery disease severity, Beck Depression Inventory scores (HR=1.05, 95% CI=1.01–1.10), antidepressant use (HR=2.4, 95% CI=1.01–5.9) and a history of treatment for depression (HR=2.4, 95%CI=1.1–5.3) were each adversely associated with time to cardiovascular disease outcomes. Fiber intake (HR=.87, 95% CI=.78–.97) and fruit and vegetable consumption (HR=.36, 95% CI=.19–.70) was associated with a decreased time to cardiovascular disease event risk. In models including dietary habits and depression, fiber intake and fruit and vegetable consumption remained associated with time to cardiovascular disease outcomes, whereas depression relationships were reduced by 10–20% and non-significant. Conclusions Among women with suspected myocardial ischemia, we observed consistent relationships between depression, dietary habits, and time to

  6. Chronic Losartan Treatment Up-Regulates AT1R and Increases the Heart Vulnerability to Acute Onset of Ischemia and Reperfusion Injury in Male Rats.

    Science.gov (United States)

    Song, Minwoo A; Dasgupta, Chiranjib; Zhang, Lubo

    2015-01-01

    Inhibition of angiotensin II type 1 receptor (AT1R) is an important therapy in the management of hypertension, particularly in the immediate post-myocardial infarction period. Yet, the role of AT1R in the acute onset of myocardial ischemia and reperfusion injury still remains controversial. Thus, the present study determined the effects of chronic losartan treatment on heart ischemia and reperfusion injury in rats. Losartan (10 mg/kg/day) was administered to six-month-old male rats via an osmotic pump for 14 days and hearts were then isolated and were subjected to ischemia and reperfusion injury in a Langendorff preparation. Losartan significantly decreased mean arterial blood pressure. However, heart weight, left ventricle to body weight ratio and baseline cardiac function were not significantly altered by the losartan treatment. Of interest, chronic in vivo losartan treatment significantly increased ischemia-induced myocardial injury and decreased post-ischemic recovery of left ventricular function. This was associated with significant increases in AT1R and PKCδ expression in the left ventricle. In contrast, AT2R and PKCε were not altered. Furthermore, losartan treatment significantly increased microRNA (miR)-1, -15b, -92a, -133a, -133b, -210, and -499 expression but decreased miR-21 in the left ventricle. Of importance, addition of losartan to isolated heart preparations blocked the effect of increased ischemic-injury induced by in vivo chronic losartan treatment. The results demonstrate that chronic losartan treatment up-regulates AT1R/PKCδ and alters miR expression patterns in the heart, leading to increased cardiac vulnerability to ischemia and reperfusion injury.

  7. Craniofacial pain can be the sole prodromal symptom of an acute myocardial infarction: an interdisciplinary study.

    Science.gov (United States)

    Kreiner, Marcelo; Álvarez, Ramón; Michelis, Virginia; Waldenström, Anders; Isberg, Annika

    2016-04-01

    We recently found craniofacial pain to be the sole symptom of an acute myocardial infarction (AMI) in 4% of patients. We hypothesized that this scenario is also true for symptoms of prodromal (pre-infarction) angina. We studied 326 consecutive patients who experienced myocardial ischemia. Intra-individual variability analyses with respect to ECG findings and pain characteristics were performed for those 150 patients who experienced at least one recurrent ischemic episode. AMI patients (n=113) were categorized into two subgroups: "abrupt onset" (n=81) and "prodromal angina" (n=32). Age, gender and risk factor comparisons were performed between groups. Craniofacial pain constituted the sole prodromal symptom of an AMI in 5% of patients. In those who experienced two ischemic episodes, women were more likely than men to experience craniofacial pain in both episodes (ppain quality descriptors "pressure" and "burning". This study is to our knowledge the first to report that craniofacial pain can be the only symptom of a pre-infarction angina. Craniofacial pain constitutes the sole prodromal AMI symptom in one out of 20 AMI patients. Recognition of this atypical symptom presentation is low because research on prodromal AMI symptoms has to date studied only patients with chest pain. To avoid a potentially fatal misdiagnosis, awareness of this clinical presentation needs to be brought to the attention of clinicians, researchers and the general public.

  8. The role and modulation of autophagy in experimental models of myocardial ischemia-reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Carol Chen-Scarabelli; Richard Knight; Pratik R Agrawal; Louis Saravolatz; Cadigia Abuniat; Gabriele Scarabelli; Anastasis Stephanou; Leena Loomba; Jagat Narula; Tiziano M Scarabelli

    2014-01-01

    A physiological sequence called autophagy qualitatively determines cellular viability by removing protein aggregates and damaged cyto-plasmic constituents, and contributes significantly to the degree of myocardial ischemia-reperfusion (I/R) injury. This tightly orchestrated cata-bolic cellular‘housekeeping’ process provides cells with a new source of energy to adapt to stressful conditions. This process was first described as a pro-survival mechanism, but increasing evidence suggests that it can also lead to the demise of the cell. Autophagy has been implicated in the pathogenesis of multiple cardiac conditions including myocardial I/R injury. However, a debate persists as to whether autophagy acts as a protec-tive mechanism or contributes to the injurious effects of I/R injury in the heart. This controversy may stem from several factors including the va-riability in the experimental models and species, and the methodology used to assess autophagy. This review provides updated knowledge on the modulation and role of autophagy in isolated cardiac cells subjected to I/R, and the growing interest towards manipulating autophagy to increase the survival of cardiac myocytes under conditions of stress-most notably being I/R injury. Perturbation of this evolutionarily conserved intracellular cleansing autophagy mechanism, by targeted modulation through, among others, mammalian target of rapamycin (mTOR) inhibitors, adenosine monophosphate-activated protein kinase (AMPK) modulators, calcium lowering agents, resveratrol, longevinex, sirtuin activators, the proapoptotic gene Bnip3, IP3 and lysosome inhibitors, may confer resistance to heart cells against I/R induced cell death. Thus, therapeutic ma-nipulation of autophagy in the challenged myocardium may benefit post-infarction cardiac healing and remodeling.

  9. Fenofibrate Therapy Restores Antioxidant Protection and Improves Myocardial Insulin Resistance in a Rat Model of Metabolic Syndrome and Myocardial Ischemia: The Role of Angiotensin II

    Directory of Open Access Journals (Sweden)

    Luz Ibarra-Lara

    2016-12-01

    Full Text Available Renin-angiotensin system (RAS activation promotes oxidative stress which increases the risk of cardiac dysfunction in metabolic syndrome (MetS and favors local insulin resistance. Fibrates regulate RAS improving MetS, type-2 diabetes and cardiovascular diseases. We studied the effect of fenofibrate treatment on the myocardic signaling pathway of Angiotensin II (Ang II/Angiotensin II type 1 receptor (AT1 and its relationship with oxidative stress and myocardial insulin resistance in MetS rats under heart ischemia. Control and MetS rats were assigned to the following groups: (a sham; (b vehicle-treated myocardial infarction (MI (MI-V; and (c fenofibrate-treated myocardial infarction (MI-F. Treatment with fenofibrate significantly reduced triglycerides, non-high density lipoprotein cholesterol (non-HDL-C, insulin levels and insulin resistance index (HOMA-IR in MetS animals. MetS and MI increased Ang II concentration and AT1 expression, favored myocardial oxidative stress (high levels of malondialdehyde, overexpression of nicotinamide adenine dinucleotide phosphate (NADPH oxidase 4 (NOX4, decreased total antioxidant capacity and diminished expression of superoxide dismutase (SOD1, SOD2 and catalase and inhibited expression of the insulin signaling cascade: phosphatidylinositol 3-kinase (PI3K/protein kinase B (PkB, also known as Akt/Glut-4/endothelial nitric oxide synthase (eNOS. In conclusion, fenofibrate treatment favors an antioxidant environment as a consequence of a reduction of the Ang II/AT1/NOX4 signaling pathway, reestablishing the cardiac insulin signaling pathway. This might optimize cardiac metabolism and improve the vasodilator function during myocardial ischemia.

  10. Diagnosis of Coronary Heart Diseases Using Gene Expression Profiling; Stable Coronary Artery Disease, Cardiac Ischemia with and without Myocardial Necrosis.

    Science.gov (United States)

    Kazmi, Nabila; Gaunt, Tom R

    2016-01-01

    Cardiovascular disease (including coronary artery disease and myocardial infarction) is one of the leading causes of death in Europe, and is influenced by both environmental and genetic factors. With the recent advances in genomic tools and technologies there is potential to predict and diagnose heart disease using molecular data from analysis of blood cells. We analyzed gene expression data from blood samples taken from normal people (n = 21), non-significant coronary artery disease (n = 93), patients with unstable angina (n = 16), stable coronary artery disease (n = 14) and myocardial infarction (MI; n = 207). We used a feature selection approach to identify a set of gene expression variables which successfully differentiate different cardiovascular diseases. The initial features were discovered by fitting a linear model for each probe set across all arrays of normal individuals and patients with myocardial infarction. Three different feature optimisation algorithms were devised which identified two discriminating sets of genes, one using MI and normal controls (total genes = 6) and another one using MI and unstable angina patients (total genes = 7). In all our classification approaches we used a non-parametric k-nearest neighbour (KNN) classification method (k = 3). The results proved the diagnostic robustness of the final feature sets in discriminating patients with myocardial infarction from healthy controls. Interestingly it also showed efficacy in discriminating myocardial infarction patients from patients with clinical symptoms of cardiac ischemia but no myocardial necrosis or stable coronary artery disease, despite the influence of batch effects and different microarray gene chips and platforms.

  11. Cells involved in extracellular matrix remodeling after acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Larissa Ferraz [Faculdade de Medicina do ABC, Santo André, SP (Brazil); Mataveli, Fábio D’Aguiar [Universidade Federal de São Paulo, São Paulo, SP (Brazil); Mader, Ana Maria Amaral Antônio; Theodoro, Thérèse Rachell [Faculdade de Medicina do ABC, Santo André, SP (Brazil); Justo, Giselle Zenker; Pinhal, Maria Aparecida da Silva [Universidade Federal de São Paulo, São Paulo, SP (Brazil)

    2015-07-01

    Evaluate the effects of VEGF{sub 165} gene transfer in the process of remodeling of the extracellular matrix after an acute myocardial infarct. Wistar rats were submitted to myocardial infarction, after the ligation of the left descending artery, and the left ventricle ejection fraction was used to classify the infarcts into large and small. The animals were divided into groups of ten, according to the size of infarcted area (large or small), and received or not VEGF{sub 165} treatment. Evaluation of different markers was performed using immunohistochemistry and digital quantification. The primary antibodies used in the analysis were anti-fibronectin, anti-vimentin, anti-CD44, anti-E-cadherin, anti-CD24, anti-alpha-1-actin, and anti-PCNA. The results were expressed as mean and standard error, and analyzed by ANOVA, considering statistically significant if p≤0.05. There was a significant increase in the expression of undifferentiated cell markers, such as fibronectin (protein present in the extracellular matrix) and CD44 (glycoprotein present in the endothelial cells). However, there was decreased expression of vimentin and PCNA, indicating a possible decrease in the process of cell proliferation after treatment with VEGF{sub 165}. Markers of differentiated cells, E-cadherin (adhesion protein between myocardial cells), CD24 (protein present in the blood vessels), and alpha-1-actin (specific myocyte marker), showed higher expression in the groups submitted to gene therapy, compared to non-treated group. The value obtained by the relation between alpha-1-actin and vimentin was approximately three times higher in the groups treated with VEGF{sub 165}, suggesting greater tissue differentiation. The results demonstrated the important role of myocytes in the process of tissue remodeling, confirming that VEGF{sub 165} seems to provide a protective effect in the treatment of acute myocardial infarct.

  12. The impaired activity of sensory afferent nerves in diabetes mellitus of rats in acute myocardial ischemia and reperfusion%糖尿病诱发大鼠神经退化及其对心肌缺血-再灌注神经反应性病理改变的影响

    Institute of Scientific and Technical Information of China (English)

    刘超杰; 李兔平; 郭政

    2015-01-01

    Objective The aim of the study was to investigate the diabetic neuro-degeneration and its changes in neuroreaction to myocardial ischemia and reperfusion,by evaluation of the altera-tion of noxious thermal threshold and expression of substance P (SP),calcitonin gene related peptide (CGRP)in dorsal root ganglia in upper thoracic segments (T1-5 )in diabetic rats.Methods Thirty two male Sprague-Dawley rats,weighing 180-200g,were randomly divided into control group (group C)and diabetic group (group DM),1 6 rats in each group.rats in DM group were fed with high sug-ar-fat diet for 14 weeks and were given streptozotocin (STZ,35 mg/mg,i.p.)at the end of the 4 th week,to set up diabetes experimental model.The animals in control group were fed with standard la-boratory diet.Tail flick latency to thermal stimulation was measured weekly.At the end of 10 weeks after administration of STZ,diabetic rats (and rats in control group)were further divided into myo-cardial ischemia-reperfusion group (group IR)and sham operation group (group Sham).The left an-terior descending branch of coronary artery was occluded for 30 min followed by reperfusion for 120 min,establishing myocardial ischemia-reperfusion.The histological immunofluorescence assay and Enzyme-linked immunosorbent assay (ELISA)were carried out to evaluate the changes of the expres-sions of CGRP and SP in the dorsal root ganglia.Results The tail flick latency was significantly in-creased in group DM,compared to the group C (P < 0.01).The immunoreactive materials for CGRP and SP in the sensory neurons in dorsal root ganglia of upper thoracic segments (T1-5 )were markedly declined in group DM (P <0.01 or P < 0.05).Furthermore,levels of SP and CGRP were signifi-cantly lower in the DRG of the group IR after myocardial ischemia-reperfusion,compared to that in the group sham (P <0.01).Conclusion Diabetes causes sensory denervation and obvious reduction of expression of SP and CGRP in the sensory neuron innervating heart during

  13. Thrombophilic state in young patients with acute myocardial infarction.

    Science.gov (United States)

    Maor, Elad; Fefer, Paul; Varon, David; Rosenberg, Nurit; Levi, Nitza; Hod, Hanoch; Matetzky, Shlomi

    2015-05-01

    The prevalence of thrombophilia and dyslipidemia among young survivors of acute coronary syndrome has not been clearly defined. The purpose of the current study was to investigate the prevalence of multiple markers of thrombophilia and dyslipidemia in a cohort of consecutive young survivors of acute coronary syndrome. The study cohort included 156 consecutive young patients (men women acute coronary syndrome. Analysis included baseline, clinical and epidemiological characteristics, angiographic coronary anatomy, echocardiographic evaluation, extensive lipid and thrombophilia laboratory profiles, and in-hospital and 1-year clinical outcomes for all patients. Acute myocardial infarction was diagnosed in 142 (92 %) patients, of whom 108 (72 %) had ST-segment elevation. Eighteen (12 %) patients had no traditional risk factors. Low levels of high-density lipoprotein (30 mg/dL). Eighteen (12 %) patients were diagnosed with antiphospholipid antibody syndrome (APS), and 73 (47 %) had at least one laboratory finding consistent with thrombophilia. Patients with APS had significantly higher levels of Lp(a) (46 ± 32 vs. 29 ± 31 mg/dL, p = 0.005). APS is a common prothrombotic state found in young survivors of acute coronary syndrome. Lp(a) levels are elevated among APS patients who present with premature acute coronary syndrome.

  14. Holmium:YAG laser angioplasty: treatment of acute myocardial infarction

    Science.gov (United States)

    Topaz, On

    1993-06-01

    We report our clinical experience with a group of 14 patients who presented with acute myocardial infarction. A holmium:YAG laser was applied to the infarct-related artery. This laser emits 250 - 600 mJ per pulse, with a pulse length of 250 microseconds and repetition rate of 5 Hz. Potential benefits of acute thrombolysis by lasers include the absence of systemic lytic state; a shortened thrombus clearing time relative to using thrombolytics; safe removal of the intracoronary thrombus and facilitation of adjunct balloon angioplasty. Potential clinical difficulties include targeting the obstructive clot and plaque, creation of debris and distal emboli and laser-tissue damage. It is conceivable that holmium:YAG laser can be a successful thrombolytic device as its wave length (2.1 microns) coincides with strong water absorption peaks. Since it is common to find an atherosclerotic plaque located under or distal to the thrombotic occlusion, this laser can also be applied for plaque ablation, and the patient presenting with acute myocardial infarction can clearly benefit from the combined function of this laser system.

  15. Intermedin protects against myocardial ischemia-reperfusion injury in hyperlipidemia rats.

    Science.gov (United States)

    Yang, S M; Liu, J; Li, C X

    2014-10-20

    Hyperlipidemia is a well-established risk factor for the development of coronary atherosclerosis, while intermedin (IMD) has been identified as a novel calcitonin/calcitonin gene-related peptide family member involved in cardiovascular protection. However, whether IMD protects against hyperlipidemia-associated myocardial ischemia/reperfusion (MI/R) injury is unknown. We established a hyperlipidemia model using Sprague-Dawley rats, and created a MI/R condition by ligating the cardiac left circumflex artery. The possible pathophysiological role of IMD and its physiological function in MI/R was further studied. The level of IMD significantly decreased in hyperlipidemia rats (P hyperlipidemia rats compared to the sham-operated rats (P hyperlipidemia rats (P hyperlipidemia-associated MI/R injury. Additional IMD could protect cardiac myocytes against MI/R injury via reduction of apoptosis and inflammation in the hyperlipidemia rat model, and thus, it may play a potential role as a novel therapeutic target for cardiac ischemic injury in hyperlipidemic patients.

  16. Metabolomic profiles of myocardial ischemia under treatment with salvianolic acid B

    Directory of Open Access Journals (Sweden)

    Lu Yonghai

    2012-03-01

    Full Text Available Abstract Background Radix Salvia miltiorrhiza (Danshen has been used as a principal herb in treating cardiovascular diseases in Chinese medicine. Salvianolic acid B (SA-B, a water-soluble active component of Danshen, was found to have anti-myocardial ischemia (anti-MI effect. This study aims to investigate mechanisms of SA-B on MI. Methods Five conventional Western medicines (isosorbide dinitrate, verapamil, propranolol, captopril and trimethazine with different mechanisms for treating cardiovascular diseases were selected as positive references to compare with SA-B in changing of the metabolomic profiles in MI rats under treatment. Potential mechanisms of SA-B were further investigated in H9C2 cell line. Results The metabolomic profiles between SA-B- and propranolol-treated MI rats were similar, since there was a big overlap between the two groups in the PLS-DA score plot. Finally, it was demonstrated that SA-B exhibited a protective effect on MI mainly by decreasing the concentration of cyclic adenosine monophosphate (cAMP and Ca2+ and inhibiting protein kinase A (PKA. Conclusion SA-B and propanolol exhibited similar metabolomic profiles, indicating that the two drugs might have a similar mechanism.

  17. Hematopoietic stem cells: ex-vivo expansion and therapeutic potential for myocardial ischemia

    Directory of Open Access Journals (Sweden)

    Jingwei Lu

    2010-03-01

    Full Text Available Jingwei Lu, Vincent J Pompili, Hiranmoy DasCardiovascular Stem Cell Research Laboratory, The Dorothy M Davis Heart and Lung Research Institute, The Ohio State University Medical Center, Columbus, OH 43210, USAAbstract: Despite recent advances in cardiovascular medicine, ischemic heart disease remains the major cause of death in the United States and abroad. Cell-based therapy for degenerative diseases like myocardial ischemia using stem cells is currently under serious investigation. Various types of stem cells are being considered to be candidates for cell transplantation in cell-based therapy. Hematopoietic stem cells are one of the most promising cell types as several studies demonstrated their ability to improve ischemic cardiac functions by enhancing neovascularization and by reducing the total size of scar tissue. However, in order to procure sufficient numbers of functional stem cells, ex-vivo expansion technology became critically important. In this review, we focus on the state-of-the-art ex-vivo technology for the expansion of hematopoietic stem cells, and the underlying mechanisms regulating stem cell self-renewal as well as differentiation.Keywords: ischemic heart disease, ex-vivo expansion, hematopoietic stem cells, cytokines, nanofibers

  18. Silent myocardial ischemia and related risk factors in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mehmet Zorlu

    2010-06-01

    Full Text Available Objectives: The aim of this study was to investigate the frequency of silent myocardial ischemia (SMI in patients with Type 2 diabetes mellitus (DM who do not have ischemiccardiac disease.Materials and Methods: To examine the relationship between ischemic cardiac disease and related factors such as blood pressure, lipid profile, smoking, gender, family history, body mass index (BMI, microalbuminuria, hsCRP, 150 diabetic patients who have never had any known coroner artery disease, exertional or rest dyspnea and labored breathing, aged between 35 and 70 years were included. Effort testing (treadmill were performed to examine the existence of SMI.Results: Effort testing gave positive result for SMI in 20 patients and negative in 130 patients. Coronary angiographywas performed in 20 patients with positive effort testing results. The frequency of SMI was found as %13.3 by effort testing. The frequency of SMI (including non-criticalpatients was %10.6 (16 patients by using coronary angiography, which 13(8.6% had critical and 3(2% had non-critical coronary stenosis. No significant differences were found in age, gender, diabetic duration, trigliserid, HDL- cholesterol, blood pressure, BMI and hsCRP levels between positive and negative SMI patients with Type 2 DM.Conclusion: We determined that high LDL-Cholesterol and HbA1c and existence of microalbuminuria indicated significant SMI risk for patients with Type 2 DM.

  19. Metabolomic profiles of myocardial ischemia under treatment with salvianolic acid B

    Science.gov (United States)

    2012-01-01

    Background Radix Salvia miltiorrhiza (Danshen) has been used as a principal herb in treating cardiovascular diseases in Chinese medicine. Salvianolic acid B (SA-B), a water-soluble active component of Danshen, was found to have anti-myocardial ischemia (anti-MI) effect. This study aims to investigate mechanisms of SA-B on MI. Methods Five conventional Western medicines (isosorbide dinitrate, verapamil, propranolol, captopril and trimethazine) with different mechanisms for treating cardiovascular diseases were selected as positive references to compare with SA-B in changing of the metabolomic profiles in MI rats under treatment. Potential mechanisms of SA-B were further investigated in H9C2 cell line. Results The metabolomic profiles between SA-B- and propranolol-treated MI rats were similar, since there was a big overlap between the two groups in the PLS-DA score plot. Finally, it was demonstrated that SA-B exhibited a protective effect on MI mainly by decreasing the concentration of cyclic adenosine monophosphate (cAMP) and Ca2+ and inhibiting protein kinase A (PKA). Conclusion SA-B and propanolol exhibited similar metabolomic profiles, indicating that the two drugs might have a similar mechanism. PMID:22409910

  20. Weather fronts and acute myocardial infarction

    Science.gov (United States)

    Kveton, Vit

    1991-03-01

    Some methodological aspects are discussed of the investigation of acute infarct myocarditis (AIM) in relation to weather fronts. Results of a new method of analysis are given. Data were analysed from about the hour of the onset of symptoms, and led to the diagnosis of AIM either immediately or within a few hours or days (3019 cases observed over 4.5 years during 1982 1986 in Plzen, Czechoslovakia). Weather classification was based on three factors (the type of the foregoing front, the type of the subsequent front, the time section of the time interval demarcated by the passage of the surfaces of the fronts). AIM occurrence increased in particular types of weather fronts: (i) by 30% during 7 12 h after a warm front, if the time span between fronts exceeded 24 h; (ii) by 10% in time at least 36 h distant from the foregoing cold or occlusion front and from the succeeding warm or occlusion front; (iii) by 20% during 0 2 h before the passage of the front, provided the foregoing front was not warm and the interval between fronts exceeded 5 h. AIM occurrence decreased by 15% 20% for time span between fronts > 24 h at times 6 11, 6 23 and 6 35 h before a coming warm or occlusion front (for interfrontal intervals 25 48, 49 72 and possibly > 72 h), and also at 12 23 and possibly 12 35 h before a cold front (for intervals 49 72 and possibly > 72 h), if the foregoing front was cold or an occlusion front.

  1. Influence of acute glycaemic level on measures of myocardial infarction in non-diabetic pigs

    DEFF Research Database (Denmark)

    Diemar, Sarah S; Sejling, Anne-Sophie; Iversen, Kasper K;

    2015-01-01

    OBJECTIVE: Patients with diabetes are at increased risk of experiencing myocardial infarction. The influence of the prevailing plasma glucose level on infarction and mortality after acute ischaemia is however unknown. The aim was to study the effect of the acute plasma glucose level on the myocar...... glycaemic level and measures of myocardial infarction, rates of ventricular fibrillation and subsequent premature death in the setting of acute ischaemia and reperfusion.......OBJECTIVE: Patients with diabetes are at increased risk of experiencing myocardial infarction. The influence of the prevailing plasma glucose level on infarction and mortality after acute ischaemia is however unknown. The aim was to study the effect of the acute plasma glucose level...

  2. Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

    NARCIS (Netherlands)

    Smit, M.; Buddingh, K. T.; Bosma, B; Nieuwenhuijs, V B; Hofker, H.S.; Zijlstra, J.G.

    2016-01-01

    INTRODUCTION: Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS

  3. Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

    NARCIS (Netherlands)

    Smit, M.; Buddingh, K. T.; Bosma, B.; Nieuwenhuijs, V. B.; Hofker, H. S.; Zijlstra, J. G.

    2016-01-01

    Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in particula

  4. Aortic plaque rupture in the setting of acute lower limb ischemia.

    LENUS (Irish Health Repository)

    O'Donnell, David H

    2012-02-01

    Acute aortic plaque rupture is an uncommon cause of acute lower limb ischemia. The authors report sequence computed tomographic imaging of a distal aortic plaque rupture in a young man with bilateral lower limb complications. Clinical awareness, prompt recognition and imaging, and appropriate treatment of this uncommon condition are necessary to improve patient outcomes.

  5. Comparison of Electric- and Magnetic-Cardiograms Produced by Myocardial Ischemia in Models of the Human Ventricle and Torso

    Science.gov (United States)

    Alday, Erick A. Perez; Ni, Haibo; Zhang, Chen; Colman, Michael A.; Gan, Zizhao; Zhang, Henggui

    2016-01-01

    Myocardial ventricular ischemia arises from a lack of blood supply to the heart, which may cause abnormal repolarization and excitation wave conduction patterns in the tissue, leading to cardiac arrhythmias and even sudden death. Current diagnosis of cardiac ischemia by the 12-lead electrocardiogram (ECG) has limitations as they are insensitive in many cases and may show unnoticeable differences to normal patterns. As the magnetic field provides extra information on cardiac excitation and is more sensitive to tangential currents to the surface of the chest, whereas the electric field is more sensitive to flux currents, it has been hypothesized that the magnetocardiogram (MCG) may provide a complementary method to the ECG in ischemic diagnosis. However, it is unclear yet about the differences in sensitivity regions of body surface ECG and MCG signals to ischemic conditions. The aim of this study was to investigate such differences by using 12-, 36- ECG and 36-MCG computed from multi-scale biophysically detailed computational models of the human ventricles and torso in both control and ischemic conditions. It was shown that ischemia produced changes in the ECG and MCG signals in the QRS complex, T-wave and ST-segment, with greater relative differences seen in the 36-lead ECG and MCG as compared to the 12-leads ECG (34% and 37% vs 26%, respectively). The 36-lead ECG showed more averaged sensitivity than the MCG in the change of T-wave due to ischemia (37% vs 32%, respectively), whereas the MCG showed greater sensitivity than the ECG in the change of the ST-segment (50% vs 40%, respectively). In addition, both MCG and ECG showed regional-dependent changes to ischemia, but with MCG showing a stronger correlation between ischemic region in the heart. In conclusion, MCG shows more sensitivity than ECG in response to ischemia, which may provide an alternative method for the diagnosis of ischemia. PMID:27556808

  6. Risk of stroke after acute myocardial infarction among Chinese

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Following an acute myocardial infarction (AMI), patients have an increased risk of stroke. Estimates of risk are mainly derived from AMI treatment trials or secondary prevention studies. The reported incidence of stroke in Caucasians in the early phase after AMI ranged from 0.5% to 2.5%.1-3 Similar assessment of risk in the Chinese population is lacking. As thrombolytic therapy becomes standard treatment for AMI, there is concern that there may be an increase in haemorrhagic stroke complicating AMI treatment, especially since haemorrhagic stroke is more common in Asian populations.

  7. Acute myocardial infarction and infarct size: do circadian variations play a role?

    Directory of Open Access Journals (Sweden)

    Ibáñez B

    2012-08-01

    Full Text Available Aída Suárez-Barrientos,1 Borja Ibáñez1,21Cardiovascular Institute, Hospital Clínico San Carlos, 2Centro Nacional de Investigaciones Cardiovasculares, Madrid, SpainAbstract: The circadian rhythm influences cardiovascular system physiology, inducing diurnal variations in blood pressure, heart rate, cardiac output, endothelial functions, platelet aggregation, and coronary arterial flow, among other physiological parameters. Indeed, an internal circadian network modulates cardiovascular physiology by regulating heart rate, metabolism, and even myocyte growth and repair ability. Consequently, cardiovascular pathology is also controlled by circadian oscillations, with increased morning incidence of cardiovascular events. The potential circadian influence on the human tolerance to ischemia/reperfusion has not been systematically scrutinized until recently. It has since been proven, in both animals and humans, that infarct size varies during the day depending on the symptom onset time, while circadian fluctuations in spontaneous cardioprotection in humans with ST-segment elevation myocardial infarction (STEMI have also been demonstrated. Furthermore, several studies have proposed that the time of day at which revascularization occurs in patients with STEMI may also influence infarct size and reperfusion outcomes. The potential association of the circadian clock with infarct size advocates the acknowledgment of time of day as a new prognostic factor in patients suffering acute myocardial infarction, which would open up a new field for chronotherapeutic targets and lead to the inclusion of time of day as a variable in clinical trials that test novel cardioprotective strategies.Keywords: cardioprotection, circadian rhythm, reperfusion injury, ST-segment elevation myocardial infarction

  8. A case: Acute myocardial infarction in a child due to spider bite

    OpenAIRE

    Laho, Edmond; Puca, Edmond

    2015-01-01

    This report presents a case of a ten-years-old girl, who suffered myocardial ischemia following by "black widow" spider bite. A few minutes after the bite, her parents saw a small, black and shiny lesion in insect bite. The clinical signs began about 3-4 hours after the bite. The venom of the Latrodectus mactans "black widow" is toxic, resulting about 5-6 % fatality rate. The case of a black widow spider bite resulting in myocardial ischemia is very rare and has not been d...

  9. Detection and evaluation of renal biomarkers in a swine model of acute myocardial infarction and reperfusion.

    Science.gov (United States)

    Duan, Su-Yan; Xing, Chang-Ying; Zhang, Bo; Chen, Yan

    2015-01-01

    The prevalence of type 1 cardiorenal syndrome (CRS) is increasing and strongly associated with long-term mortality. However, lack of reliable animal models and well-defined measures of renoprotection, made early diagnosis and therapy difficult. We previously successfully established the swine acute myocardial infarction (AMI) model of ischemia-reperfusion by blocking left anterior descending branch (LAD). Reperfusion was performed after 90-minute occlusion of the LAD. AMI was confirmed by ECG and left ventricular angiography (LVG). Then those 52 survived AMI reperfusion swine, including ventricular fibrillation-cardiac arrest after restoration of blood flow, were randomly divided into four groups (four/group) according to different interventions: resuscitation in room temperature, resuscitation with 500 ml saline in room temperature, resuscitation with 4°C 500 ml saline and normal control (with no intervention of resuscitation). Each group was further observed in four groups according to different time of resuscitation after ventricular arrhythmias: 1, 3, 5, 10-minute reperfusion after ventricular arrhythmias. Plasma and random urine were collected to evaluate renal function and test renal biomarkers of acute kidney injury (AKI). Our swine AMI model of ischemia-reperfusion provoked subclinical AKI with the elevation of the tubular damage biomarker, NGAL, IL-18 and L-FABP. Renal damage rapidly observed after hemodynamic instability, rather than observation after several hours as previously reported. The increasing rate of biological markers declined after interventions, however, its impact on the long-term prognosis remains to be further studied. These data show that elevation of tubular damage biomarkers without glomerular function loss may indicate appropriate timing for effective renoprotections like hypothermia resuscitation in type 1 CRS.

  10. Myocardial Ablation of G Protein-Coupled Receptor Kinase 2 (GRK2 Decreases Ischemia/Reperfusion Injury through an Anti-Intrinsic Apoptotic Pathway.

    Directory of Open Access Journals (Sweden)

    Qian Fan

    Full Text Available Studies from our lab have shown that decreasing myocardial G protein-coupled receptor kinase 2 (GRK2 activity and expression can prevent heart failure progression after myocardial infarction. Since GRK2 appears to also act as a pro-death kinase in myocytes, we investigated the effect of cardiomyocyte-specific GRK2 ablation on the acute response to cardiac ischemia/reperfusion (I/R injury. To do this we utilized two independent lines of GRK2 knockout (KO mice where the GRK2 gene was deleted in only cardiomyocytes either constitutively at birth or in an inducible manner that occurred in adult mice prior to I/R. These GRK2 KO mice and appropriate control mice were subjected to a sham procedure or 30 min of myocardial ischemia via coronary artery ligation followed by 24 hrs reperfusion. Echocardiography and hemodynamic measurements showed significantly improved post-I/R cardiac function in both GRK2 KO lines, which correlated with smaller infarct sizes in GRK2 KO mice compared to controls. Moreover, there was significantly less TUNEL positive myocytes, less caspase-3, and -9 but not caspase-8 activities in GRK2 KO mice compared to control mice after I/R injury. Of note, we found that lowering cardiac GRK2 expression was associated with significantly lower cytosolic cytochrome C levels in both lines of GRK2 KO mice after I/R compared to corresponding control animals. Mechanistically, the anti-apoptotic effects of lowering GRK2 expression were accompanied by increased levels of Bcl-2, Bcl-xl, and increased activation of Akt after I/R injury. These findings were reproduced in vitro in cultured cardiomyocytes and GRK2 mRNA silencing. Therefore, lowering GRK2 expression in cardiomyocytes limits I/R-induced injury and improves post-ischemia recovery by decreasing myocyte apoptosis at least partially via Akt/Bcl-2 mediated mitochondrial protection and implicates mitochondrial-dependent actions, solidifying GRK2 as a pro-death kinase in the heart.

  11. Prognostic usefulness of repeated echocardiographic evaluation after acute myocardial infarction. TRACE Study Group. TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Korup, E; Køber, L; Torp-Pedersen, C;

    1999-01-01

    The prognostic value of repeated echocardiographic measurement of left ventricular function after acute myocardial infarction was evaluated. We found that repeated measurements of wall motion index in survivors of acute myocardial infarction, with no reinfarction, provide important prognostic inf...... information about death and worsening of heart failure....

  12. Real world thirty-day mortality in female patients with acute myocardial infarction from Beijing

    Institute of Scientific and Technical Information of China (English)

    宋雷

    2013-01-01

    Objective To evaluate the gender differences on the short-term outcomes of patients with acute myocardial in-farction in the real world.Methods A total of 471 consecutive patients[male 368 (78.1%) and female103 (21.9%) ]with acute myocardial infarction<72 hours in cardiac care unit were included.The clinical data,

  13. Effects of chronic kidney disease on platelet response to antiplatelet therapy in acute myocardial infarction patients

    Institute of Scientific and Technical Information of China (English)

    邓捷

    2012-01-01

    Objective To elucidate the effects of dual antiplatelet therapy on platelet response in acute myocardial infarction patients with chronic kidney disease. Methods From September 2011 to June 2012,a total of 195 acute myocardial infarction patients with drug eluting stent implanting were enrolled. Among them,133 cases had normal

  14. Significance of the invasive strategy after acute myocardial infarction on prognosis and secondary preventive medication

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Galatius, Søren; Madsen, Mette

    2012-01-01

    To describe gender-specific long-term outcome and initiation of secondary preventive medication among patients with acute myocardial infarction (AMI).......To describe gender-specific long-term outcome and initiation of secondary preventive medication among patients with acute myocardial infarction (AMI)....

  15. THE SPEKL-TREKING PREDICTIVE VALUE OF THE ECHOCARDIOGRAPHY AT THE ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    N. A. Kosheleva

    2016-01-01

    Full Text Available Speckle-tracking echocardiography is a non-invasive method  for assessment of myocardial deformation, which is closely associated with its regional and global function. Although it is not yet introduced into clinical practice, deformation parameters are actively studied in different clinical conditions, particularly in acute myocardial infarction. Numerous studies show deformation  impairment may have important prognostic value at patients with a acute myocardial infarction.

  16. Combined use of transmyocardial stents with gene therapy in the treatment of acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    王永武

    2006-01-01

    Objective To determine the efficacy of combined use of transmyocardial stent with gene therapy to treat acute myocardial infarction in porcine model. Methods 24 Chinese mini swines have been devided into 4 groups randomly: group myocardial infarction (group MI n1 = 6), group transmyocardial stent (group ST n2 = 6) , group vascular endothelial growth factor (group VEGF n3 = 6) , group transmyocardial stent and VEGF (group ST + VEGF n4 = 6). In group MI,acute myocardial infarc-

  17. Metoprolol in acute myocardial infarction. Development of myocardial infarction. The MIAMI Trial Research Group.

    Science.gov (United States)

    1985-11-22

    The effect of metoprolol on the development of an acute myocardial infarction (AMI) during days 0 to 3 and on late first and recurrent infarctions during days 4 to 15 has been investigated. Signs on electrocardiogram (ECG) were well balanced between the treatment groups at entry; 70% of patients had signs of suspected AMI and 19% of patients had normal ECGs. The remaining patients had abnormal ECGs but actual infarction could not be localized. The localization of suspected AMI was equivalently distributed in the 2 groups before randomization. Metoprolol altered the distribution of patients diagnosed during days 0 to 3 as having definite, possible or no AMI (p less than 0.02). In the placebo group, there were more patients with definite AMI (72.5% vs 70.5%) and less with possible AMI (5.6% vs 7.4) than in the metoprolol group. A larger proportion of patients developed a Q-wave infarction during days 0 to 3 in the placebo group (53.9%) compared with the metoprolol group (50.9%, p = 0.024). No difference in the effect of metoprolol regarding localization of the early AMI was observed. Late first myocardial infarction development (days 4 to 15) was observed in 20 patients (0.7%) in each group. Recurrent myocardial infarction tended to develop more frequently during days 4 to 15 in the placebo group compared with the metoprolol group (3.9% vs 3.0%, p = 0.08).(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Diabetes mellitus and cardiogenic shock in acute myocardial infarction

    DEFF Research Database (Denmark)

    Lindholm, M G; Boesgaard, S; Torp-Pedersen, C

    2005-01-01

    AIMS: Cardiogenic shock is the leading cause of in-hospital mortality after acute myocardial infarction (MI). This study investigates the importance of age and preexisting diabetes mellitus on the incidence and prognosis of cardiogenic shock in a large group of consecutive patients with MI. METHODS...... AND RESULTS: Baseline characteristics and in-hospital complications to the infarction were prospectively recorded in 6676 patients with MI. Ten-year mortality was collected. Diabetes was present in 10.8% of the total population. A total of 443 developed cardiogenic shock with an incidence of 6.2% among...... nondiabetic patients with acute MI. The prognosis of diabetics with cardiogenic shock is similar to the prognosis of nondiabetic patients with cardiogenic shock....

  19. Over-Expression of Catalase in Myeloid Cells Confers Acute Protection Following Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    E. Bernadette Cabigas

    2014-05-01

    Full Text Available Cardiovascular disease is the leading cause of death in the United States and new treatment options are greatly needed. Oxidative stress is increased following myocardial infarction and levels of antioxidants decrease, causing imbalance that leads to dysfunction. Therapy involving catalase, the endogenous scavenger of hydrogen peroxide (H2O2, has been met with mixed results. When over-expressed in cardiomyocytes from birth, catalase improves function following injury. When expressed in the same cells in an inducible manner, catalase showed a time-dependent response with no acute benefit, but a chronic benefit due to altered remodeling. In myeloid cells, catalase over-expression reduced angiogenesis during hindlimb ischemia and prevented monocyte migration. In the present study, due to the large inflammatory response following infarction, we examined myeloid-specific catalase over-expression on post-infarct healing. We found a significant increase in catalase levels following infarction that led to a decrease in H2O2 levels, leading to improved acute function. This increase in function could be attributed to reduced infarct size and improved angiogenesis. Despite these initial improvements, there was no improvement in chronic function, likely due to increased fibrosis. These data combined with what has been previously shown underscore the need for temporal, cell-specific catalase delivery as a potential therapeutic option.

  20. Increased regional epicardial fat volume associated with reversible myocardial ischemia in patients with suspected coronary artery disease.

    Science.gov (United States)

    Khawaja, Tuba; Greer, Christine; Thadani, Samir R; Kato, Tomoko S; Bhatia, Ketan; Shimbo, Daichi; Kontak, Andrew; Konkak, Andrew; Bokhari, Sabahat; Einstein, Andrew J; Schulze, P Christian

    2015-04-01

    Epicardial adipose tissue is a source of pro-inflammatory cytokines and has been linked to the development of coronary artery disease. No study has systematically assessed the relationship between local epicardial fat volume (EFV) and myocardial perfusion defects. We analyzed EFV in patients undergoing SPECT myocardial perfusion imaging combined with computed tomography (CT) for attenuation correction. Low-dose CT without contrast was performed in 396 consecutive patients undergoing SPECT imaging for evaluation of coronary artery disease. Regional thickness, cross-sectional areas, and total EFV were assessed. 295 patients had normal myocardial perfusion scans and 101 had abnormal perfusion scans. Mean EFVs in normal, ischemic, and infarcted hearts were 99.8 ± 82.3 cm(3), 156.4 ± 121.9 cm(3), and 96.3 ± 102.1 cm(3), respectively (P coronary artery (87.1 ± 76.4 vs 46.7 ± 40.6 cm(3); P = 0.005). Our results demonstrate increased regional epicardial fat in patients with active myocardial ischemia compared to patients with myocardial scar or normal perfusion on nuclear perfusion scans. Our results suggest a potential role for cardiac CT to improve risk stratification in patients with suspected coronary artery disease.

  1. SIGNIFICANCE OF LIPID PROFILE ESTIMATION IN PATIENT WITH ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    Santhosh Kumar .N

    2013-06-01

    Full Text Available Acute myocardial infarction is one of the important reasons of death and unhealthiness in the world. The present study was undertaken to investigate the changes in serum lipids and lipoproteins in patients with acute myocardial infarction. The levels of lipid profile were significantly changed in the acute myocardial infarction patients. Acute myocardial infarction patients had significantly higher levels of total cholesterol, LDL-cholesterol, TG, Lipoprotein and lower level of HDL-cholesterol, as compared to the control subjects. We found a significant association of lipid profiles with acute myocardial infarction. Reduced serum HDL-cholesterol and increased Serum LDL, Serum TG, Lipoprotein (a, in our study subjects may be the effective reasonable lipid disorders in AMI patients.

  2. Effect of ranolazine, an antianginal agent with novel electrophysiological properties, on the incidence of arrhythmias in patients with non ST-segment elevation acute coronary syndrome: results from the Metabolic Efficiency With Ranolazine for Less Ischemia in Non ST-Elevation Acute Coronary Syndrome Thrombolysis in Myocardial Infarction 36 (MERLIN-TIMI 36) randomized controlled trial.

    NARCIS (Netherlands)

    Scirica, B.M.; Morrow, D.A.; Hod, H.; Murphy, S.A.; Belardinelli, L.; Hedgepeth, C.M.; Molhoek, P.; Verheugt, F.W.A.; Gersh, B.J.; McCabe, C.H.; Braunwald, E.

    2007-01-01

    BACKGROUND: Ranolazine, a piperazine derivative, reduces ischemia via inhibition of the late phase of the inward sodium current (late I(Na)) during cardiac repolarization, with a consequent reduction in intracellular sodium and calcium overload. Increased intracellular calcium leads to both mechanic

  3. Effect of Buyang Huanwu decoction on acute cerebral ischemia with myocardial damage and on serum hs - CRP,D - D,H - FABP and cTnI in the patients%补阳还五汤治疗急性脑梗死伴心肌损害患者疗效及对血清hs-CRP、D-D、H-FABP、cTnI的影响

    Institute of Scientific and Technical Information of China (English)

    张丽; 段红霞; 崔丽红

    2016-01-01

    目的:观察补阳还五汤治疗急性脑梗死伴心肌损害患者的疗效及对血清超敏C 反应蛋白(hs - CRP)、D -二聚体(D - D)、心脏型脂肪酸结合蛋白( H - FABP)、肌钙蛋白 I (cTnI)的影响。方法将86例急性脑梗死伴心肌损害患者随机分为对照组和研究组,每组43例。对照组给予常规西医治疗,观察组在对照组治疗基础上给予中药补阳还五汤口服,2组治疗周期均为2周。观察2组治疗前及治疗1周、2周后血清 hs - CRP、D - D、H - FABP、cTnI 水平及 MESS 评分、Barthel 指数评分,统计2组临床疗效。结果2组治疗1周、2周后血清 hs - CRP、D - D、H - FABP、cTnI 水平均明显降低(P 均<0.05),MESS 评分、Barthel 指数均明显改善(P 均<0.05),且观察组上述指标改善情况均优于对照组( P 均<0.05);观察组临床总有效率明显高于对照组(P <0.05);2组治疗期间均未发现严重药物不良反应。结论补阳还五汤能够显著降低急性脑梗死伴心肌损害患者血清 H - FABP、cTnI 水平,改善患者神经功能缺损症状,提高日常生活活动能力,机制可能与其抑制患者炎性反应及改善高凝状态有关。%ObjectiVe It is to observe the curative effect of Buyang Huanwu decoction on acute cerebral ischemia with my-ocardial damage and on serum hs - CRP,D - D,H - FABP and cTnT in the patients. Methods 86 acute cerebral ischemia patients with myocardial damage were randomly divided into control group and study group,each group had 43 cases. The con-trol group was given normal western medicine,additionally,the observation group was added with Buyang Huanwu decoction orally. Both groups were treated for 2 weeks. The changes of serum hs - CRP,D - D,H - FABP,cTnI,MESS scores,Bar-thel index scores before treatment and in 1,2 weeks after treatment were observed in both groups,and the curative effects were compared. Results The levels of serum hs

  4. Direct Coronary Intervention Therapy in Patients with Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    朱铁兵; 杨志健; 王连生; 马根山; 曹克将; 黄峻; 马文珠

    2002-01-01

    Objective To introduce the initial experience of direct pereutaneous transluminalcoronary angioplasty (PTCA) and intracoronary stenting in patients with acute myocardial infarction(AMl) from October t998 to Novermber 200l in our hospital. Methods Primary PTCA was per-formed in 38 patients with acute myocardial infarction. 29 cases were 20 male and 9 female, rangingin age from 30 to 76 old years. 23 cases hvad anterior and 15 lind inferior wall infarction. The patients we chose for direct coronary intervention therapy had stable hemodynamics. Of the 38 infarct re-lated arteries (IRA), 23 were left anterior descend arteries (LAD), 4 left circumflex (LCX) andl 1 right coronary arteries (RCA). 33 IRA were TIMI 0 flow and 5 TIMI 1 flow. The indicationsOf the 38 patients with AMI, PTCA tns successful in 35. Two patients were given up because 014guide-wire entered into false lumen. One was selected for emergency coronary artery bypass graft because of LAD infarct related artery accompanied by 70% stenosis of left main. 35 intracoronarystenls were implanted. 16 patients were followed up, of whom 2 patients trod restenosis and were suc-cessful in the second attempt. Conclusion Direct PTCA and stent implantation are effective andsafe means of treatment for AMI and stent implantation can prevent and cure the arute reocclusion after PTCA.

  5. [Characteristics of therapy of acute myocardial infarction in diabetes].

    Science.gov (United States)

    Motz, W; Kerner, W

    2012-05-01

    Therapy of acute myocardial infarction (STEMI and NSTEMI) in diabetics does not principally differ from that of non-diabetic patients. Due to the higher mortality in diabetics reperfusion measures, such as direct percutaneous coronary intervention (PCI), should be rapidly performed. An intensive drug treatment with thrombocyte aggregation inhibitors, angiotensin-converting enzyme (ACE) inhibitors and beta-receptor blocking agents must be carried out according to the current guidelines. An important factor is the high risk of renal failure due to the contrast dye administered during PCI in the presence of pre-existing diabetic kidney damage which should be limited to 100 ml if possible. Direct PCI should be limited to the infarcted vessel. After stabilization a comprehensive strategy to cure coronary artery disease, whether with PCI or coronary artery bypass graft (CABG) should be finalized. If severe coronary 3-vessel disease is present, CABG should be favored in diabetic patients. After surviving an acute myocardial infarction differentiated metabolic monitoring is mandatory.

  6. Characteristics of regional sympathetic innervation in diabetic patients with silent myocardial ischemia assessed by {sup 123}I-metaiodobenzylguanidine imaging

    Energy Technology Data Exchange (ETDEWEB)

    Matsuo, Shinro; Takahashi, Masayuki; Yoshida, Shintaro; Inoue, Tohru; Nakamura, Yasuyuki; Mitsunami, Kenichi; Kinoshita, Masahiro [Shiga Univ. of Medical Science, Otsu (Japan)

    1996-05-01

    The purpose of this study was to clarify any association between clinically detectable silent myocardial ischemia (SMI) and myocardial {sup 123}I-metaiodobenzylguanidine (MIBG) uptake. Subjects of this study were patients with SMI with diabetes (n=15), patients with angina pectoris with diabetes (n=15), patients with SMI without diabetes (n=8) and normal subjects (n=23). Subjects underwent planar and single photon-emission-computed tomography (SPECT) imaging 15 min and 3 hours after injection of {sup 123}I-MIBG. H/M ratio was significantly lower in diabetic SMI (2.1{+-}0.3) and non-diabetic SMI (2.3{+-}0.3) than control subjects (2.6{+-}0.3). The inferior-to-anterior wall count ratio (I/A) in diabetic SMI group was the lowest among all groups (p<0.05). A significant difference was observed in relative regional uptake in the inferior segment of the distal left ventricle between SMI and angina group in patients with diabetes mellittus (p<0.05). The decreased MIBG uptake in the inferior wall may be an important sign of cardiac sympathetic dysfunction, suggesting the abnormalities in cardiac nervous system play an important role in the mechanism of diabetic silent myocardial ischemia. (author)

  7. Effect of cerebrolysin on oxidative stress-induced apoptosis in an experimental rat model of myocardial ischemia.

    Science.gov (United States)

    Boshra, V; Atwa, A

    2016-09-01

    Apoptosis plays a role in the process of tissue damage after myocardial infarction (MI). This study was designed to investigate the possible effect of cerebrolysin against apoptosis triggered by oxidative cell stress in myocardial ischemia induced by isoproterenol in rat. Rats were pretreated with cerebrolysin 5 mL/kg intraperitoneally for 7 days and intoxicated with isoproterenol (ISO, 85 mg/kg, sc) on the last 2 days. Hearts were excised and stained to detect the infarction size. Serum levels of cardiotoxicity indices as creatine kinase isoenzyme (CK-MB) and troponin I (cTnI) as well as the cardiac oxidative stress parameters as thiobarbituric acid reactive substances and superoxide dismutase were estimated. The expression of prodeath gene p53 and antideath gene Bcl-2 was also assessed from the excised heart tissues. Leakage of cardiac enzymes, elevated oxidative stress markers, and apoptotic indices confirmed the MI occurring as a consequence of isoproterenol-induced ischemia. Cerebrolysin pretreatment caused significant attenuation of the oxidative stress-induced apoptosis in the ischemic myocardial tissue. These findings provided an evidence that cerebrolysin could protect rat myocardium against ischemic insult that was attributed to its antioxidant as well as its anti-apoptotic properties.

  8. Time-Course of the Effects of QSYQ in Promoting Heart Function in Ameroid Constrictor-Induced Myocardial Ischemia Pigs.

    Science.gov (United States)

    Qiu, Qi; Lin, Yang; Xiao, Cheng; Li, Chun; Wang, Yong; Yang, Kexu; Suo, Wei; Li, Yu; Chuo, Wenjing; Wei, Yongxiang; Wang, Wei

    2014-01-01

    We aim to investigate the therapeutic effects of QSYQ on a pig myocardial ischemia (MI) model and to determine its mechanism of action. The MI model was induced by Ameroid constriction of the left anterior descending coronary (LAD) in Ba-Ma miniature pigs. Four groups were created: model group, digoxin group, QSYQ group, and sham-operated group. Heart function, Ang II, CGMP, TXB2, BNP, and cTnT were evaluated before (3 weeks after operation: 0 weeks) and at 2, 4, and 8 weeks after drug administration. After 8 weeks of administration, the pigs were sacrificed for cardiac injury measurements. Pigs with MI showed obvious histological changes, including BNP, cTnT, Ang II, CGRP, TXB2, and ET, deregulated heart function, and increased levels of apoptotic cells in myocardial tissue. Treatment with QSYQ improved cardiac remodeling by counteracting those events. The administration of QSYQ was accompanied by a restoration of heart function and of the levels of Ang II, CGRP, TXB2, ET BNP, and cTnT. In addition, QSYQ attenuated administration, reduced the apoptosis, and decreased the level of TNF- α and active caspase-3. In conclusion, administration of QSYQ could attenuate Ameroid constrictor induced myocardial ischemia, and TNF- α and active caspase-3 seemed to be the critical potential target of QSYQ.

  9. Time-Course of the Effects of QSYQ in Promoting Heart Function in Ameroid Constrictor-Induced Myocardial Ischemia Pigs

    Directory of Open Access Journals (Sweden)

    Qi Qiu

    2014-01-01

    Full Text Available We aim to investigate the therapeutic effects of QSYQ on a pig myocardial ischemia (MI model and to determine its mechanism of action. The MI model was induced by Ameroid constriction of the left anterior descending coronary (LAD in Ba-Ma miniature pigs. Four groups were created: model group, digoxin group, QSYQ group, and sham-operated group. Heart function, Ang II, CGMP, TXB2, BNP, and cTnT were evaluated before (3 weeks after operation: 0 weeks and at 2, 4, and 8 weeks after drug administration. After 8 weeks of administration, the pigs were sacrificed for cardiac injury measurements. Pigs with MI showed obvious histological changes, including BNP, cTnT, Ang II, CGRP, TXB2, and ET, deregulated heart function, and increased levels of apoptotic cells in myocardial tissue. Treatment with QSYQ improved cardiac remodeling by counteracting those events. The administration of QSYQ was accompanied by a restoration of heart function and of the levels of Ang II, CGRP, TXB2, ET BNP, and cTnT. In addition, QSYQ attenuated administration, reduced the apoptosis, and decreased the level of TNF-α and active caspase-3. In conclusion, administration of QSYQ could attenuate Ameroid constrictor induced myocardial ischemia, and TNF-α and active caspase-3 seemed to be the critical potential target of QSYQ.

  10. Relationship Between Periodontal Disease and Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    M Zamirian

    2008-07-01

    Full Text Available Background: Conventional risk factors for coronary artery disease and myocardial infarction do not explain all of the clinical and epidemiological features of the disease. Periodontal disease is a common bacterial and destructive disorder of oral tissues. Many studies demonstrate close association between chronic periodontitis and development of generalized inflammation, vascular endothelial injury, and atherosclesis. Periodontal disease has been convincingly emerging as an important independent risk factor for ischemic heart disease. A case - control study was carried out to assess the prevalence of periodontitis in patients with Acute myocardial Infarction (AMI and evaluate the possible relationship between AMI and chronic periodontitis. Patients and Methods: A number of 160 patients, aged 35 to 70 years old, enrolled in the study. Eighty patients (43 men, 37 women were examined four days after hospitalization due to AMI. Control group consisted of 80 persons (38 men, 42 women with normal coronary angiography. The following periodontal parameters were examined: Plaque index (PI, gingiral index (GI, bleeding on probing (BOP, probing depth (PD, clinical attachment loss (CAL and number of sites with CAL.Results: The case, compared to control showed significantly worse results for some periodontal variables studied: The mean of PD and PD > 3 mm, CAL, and number of sites with CAL, had worse results compared to control despite similar oral hygiene and frequency of brushing. The confounding factors for the present study were found to be hypertension and diabetes. Conclusion: The association between periodontitis and acute myocardial infarction was significant after adjusting for conventional risk factors for AMI.

  11. Gaseous hydrogen sulfide protects against myocardial ischemia-reperfusion injury in mice partially independent from hypometabolism.

    Directory of Open Access Journals (Sweden)

    Pauline M Snijder

    Full Text Available BACKGROUND: Ischemia-reperfusion injury (IRI is a major cause of cardiac damage following various pathological processes. Gaseous hydrogen sulfide (H2S is protective during IRI by inducing a hypometabolic state in mice which is associated with anti-apoptotic, anti-inflammatory and antioxidant properties. We investigated whether gaseous H2S administration is protective in cardiac IRI and whether non-hypometabolic concentrations of H2S have similar protective properties. METHODS: Male C57BL/6 mice received a 0, 10, or 100 ppm H2S-N2 mixture starting 30 minutes prior to ischemia until 5 minutes pre-reperfusion. IRI was inflicted by temporary ligation of the left coronary artery for 30 minutes. High-resolution respirometry equipment was used to assess CO2-production and blood pressure was measured using internal transmitters. The effects of H2S were assessed by histological and molecular analysis. RESULTS: Treatment with 100 ppm H2S decreased CO2-production by 72%, blood pressure by 14% and heart rate by 25%, while treatment with 10 ppm H2S had no effects. At day 1 of reperfusion 10 ppm H2S showed no effect on necrosis, while treatment with 100 ppm H2S reduced necrosis by 62% (p<0.05. Seven days post-reperfusion, both 10 ppm (p<0.01 and 100 ppm (p<0.05 H2S showed a reduction in fibrosis compared to IRI animals. Both 10 ppm and 100 ppm H2S reduced granulocyte-influx by 43% (p<0.05 and 60% (p<0.001, respectively. At 7 days post-reperfusion both 10 and 100 ppm H2S reduced expression of fibronectin by 63% (p<0.05 and 67% (p<0.01 and ANP by 84% and 63% (p<0.05, respectively. CONCLUSIONS: Gaseous administration of H2S is protective when administered during a cardiac ischemic insult. Although hypometabolism is restricted to small animals, we now showed that low non-hypometabolic concentrations of H2S also have protective properties in IRI. Since IRI is a frequent cause of myocardial damage during percutaneous coronary intervention and cardiac

  12. Quantitative myocardial perfusion imaging in a porcine ischemia model using a prototype spectral detector CT system

    Science.gov (United States)

    Fahmi, Rachid; Eck, Brendan L.; Levi, Jacob; Fares, Anas; Dhanantwari, Amar; Vembar, Mani; Bezerra, Hiram G.; Wilson, David L.

    2016-03-01

    We optimized and evaluated dynamic myocardial CT perfusion (CTP) imaging on a prototype spectral detector CT (SDCT) scanner. Simultaneous acquisition of energy sensitive projections on the SDCT system enabled projection-based material decomposition, which typically performs better than image-based decomposition required by some other system designs. In addition to virtual monoenergetic, or keV images, the SDCT provided conventional (kVp) images, allowing us to compare and contrast results. Physical phantom measurements demonstrated linearity of keV images, a requirement for quantitative perfusion. Comparisons of kVp to keV images demonstrated very significant reductions in tell-tale beam hardening (BH) artifacts in both phantom and pig images. In phantom images, consideration of iodine contrast to noise ratio and small residual BH artifacts suggested optimum processing at 70 keV. The processing pipeline for dynamic CTP measurements included 4D image registration, spatio-temporal noise filtering, and model-independent singular value decomposition deconvolution, automatically regularized using the L-curve criterion. In normal pig CTP, 70 keV perfusion estimates were homogeneous throughout the myocardium. At 120 kVp, flow was reduced by more than 20% on the BH-hypo-enhanced myocardium, a range that might falsely indicate actionable ischemia, considering the 0.8 threshold for actionable FFR. With partial occlusion of the left anterior descending (LAD) artery (FFR  <  0.8), perfusion defects at 70 keV were correctly identified in the LAD territory. At 120 kVp, BH affected the size and flow in the ischemic area; e.g. with FFR ≈ 0.65, the anterior-to-lateral flow ratio was 0.29  ±  0.01, over-estimating stenosis severity as compared to 0.42  ±  0.01 (p  <  0.05) at 70 keV. On the non-ischemic inferior wall (not a LAD territory), the flow ratio was 0.50  ±  0.04 falsely indicating an actionable ischemic condition in a healthy

  13. Detecting Acute Myocardial Infarction by Diffusion-Weighted versus T2-Weighted Imaging and Myocardial Necrosis Markers

    Science.gov (United States)

    Chen, Min; Li, Yongjun; Wang, YaLing; Zhang, Shijun; Wang, Zhen; Wang, Lin; Ju, Shenghong

    2016-01-01

    We used a porcine model of acute myocardial infarction to study the signal evolution of ischemic myocardium on diffusion-weighted magnetic resonance images (DWI). Eight Chinese miniature pigs underwent percutaneous left anterior descending or left circumflex coronary artery occlusion for 90 minutes followed by reperfusion, which induced acute myocardial infarction. We used DWI preprocedurally and hourly for 4 hours postprocedurally. We acquired turbo inversion recovery magnitude T2-weighted images (TIRM T2WI) and late gadolinium enhancement images from the DWI slices. We measured the serum myocardial necrosis markers myoglobin, creatine kinase-MB isoenzyme, and cardiac troponin I at the same time points as the magnetic resonance scanning. We used histochemical staining to confirm injury. All images were analyzed qualitatively. Contrast-to-noise ratio (the contrast between infarcted and healthy myocardium) and relative signal index were used in quantitative image analysis. We found that DWI identified myocardial signal abnormity early (clinical serologic biomarkers.

  14. Human Placenta-Derived Multipotent Cells (hPDMCs) Modulate Cardiac Injury: From Bench to Small and Large Animal Myocardial Ischemia Studies.

    Science.gov (United States)

    Liu, Yuan-Hung; Peng, Kai-Yen; Chiu, Yu-Wei; Ho, Yi-Lwun; Wang, Yao-Horng; Shun, Chia-Tung; Huang, Shih-Yun; Lin, Yi-Shuan; de Vries, Antoine A F; Pijnappels, Daniël A; Lee, Nan-Ting; Yen, B Linju; Yen, Men-Luh

    2015-01-01

    Cardiovascular disease is the leading cause of death globally, and stem cell therapy remains one of the most promising strategies for regeneration or repair of the damaged heart. We report that human placenta-derived multipotent cells (hPDMCs) can modulate cardiac injury in small and large animal models of myocardial ischemia (MI) and elucidate the mechanisms involved. We found that hPDMCs can undergo in vitro cardiomyogenic differentiation when cocultured with mouse neonatal cardiomyocytes. Moreover, hPDMCs exert strong proangiogenic responses in vitro toward human endothelial cells mediated by secretion of hepatocyte growth factor, growth-regulated oncogene-α, and interleukin-8. To test the in vivo relevance of these results, small and large animal models of acute MI were induced in mice and minipigs, respectively, by permanent left anterior descending (LAD) artery ligation, followed by hPDMC or culture medium-only implantation with follow-up for up to 8 weeks. Transplantation of hPDMCs into mouse heart post-acute MI induction improved left ventricular function, with significantly enhanced vascularity in the cell-treated group. Furthermore, in minipigs post-acute MI induction, hPDMC transplantation significantly improved myocardial contractility compared to the control group (p = 0.016) at 8 weeks postinjury. In addition, tissue analysis confirmed that hPDMC transplantation induced increased vascularity, cardiomyogenic differentiation, and antiapoptotic effects. Our findings offer evidence that hPDMCs can modulate cardiac injury in both small and large animal models, possibly through proangiogenesis, cardiomyogenesis, and suppression of cardiomyocyte apoptosis. Our study offers mechanistic insights and preclinical evidence on using hPDMCs as a therapeutic strategy to treat severe cardiovascular diseases.

  15. Effect of Tumor Necrosis Factor-α on Neutralization of Ventricular Fibrillation in Rats with Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Yu Chen

    2011-01-01

    Full Text Available The purpose of this study was to explore the effects of tumor necrosis factor-α (TNF-α on ventricular fibrillation (VF in rats with acute myocardial infarction (AMI. Rats were randomly classified into AMI group, sham operation group and recombinant human tumor necrosis factor receptor:Fc fusion protein (rhTNFR:Fc group. Spontaneous and induced VFs were recorded. Monophasic action potentials (MAPs among different zones of myocardium were recorded at eight time points before and after ligation and MAP duration dispersions (MAPDds were calculated. Then expression of TNF-α among different myocardial zones was detected. After ligation of the left anterior descending coronary artery, total TNF-α expression in AMI group began to markedly increase at 10 min, reached a climax at 20–30min, and then gradually decreased. The time-windows of VFs and MAPDds in the border zone performed in a similar way. At the same time-point, the expression of TNF-α in the ischemia zone was greater than that in the border zone, and little in the non-ischemia zone. Although the time windows of TNF-α expression, the MAPDds in the border zone and the occurrence of VFs in the rhTNFR:Fc group were similar to those in the AMI group, they all decreased in the rhTNFR:Fc group. Our findings demonstrate that TNF-α could enlarge the MAPDds in the border zone, and promote the onset of VFs.

  16. Myocardial ischemia and reperfusion-induced cell death depends on JNK activation and leads to phosphorylation of mitochondrial p46

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@ Multiple signaling pathways, including the c-Jun N-terminal kinase (JNK) pathway, are activated in myocardial ischemia and reperfusion (MI/R) and correlate with cell death. However, the role of the JNK pathway with respect to protection or destruction in MI/R-induced cell death is poorly understood. In a rabbit model, we found that ischemia followed by reperfusion resulted in JNK activation which could be detected in cytosol as well as in mitochondria. To address the functional role of the JNK activation, we examined the consequences of blockade of JNK activation in isolated cardiomyocytes under conditions of simulated ischemia. The JNK activity was stimulated ~6-fold by simulated ischemia and reperfusion (simulated MI). When a dominant negative mutant of JNK kinase-2(dnJNKK2), an upstream regulator of JNK, and JNK-interacting protein-1 (JIP-1) were expressed in myocytes by recombinant adenovirus, the activation of JNK by simulated MI was reduced 53%. Furthermore, the TNFα-activated JNK activity in H9c2 cells was completely abolished by dnJNKK2 and JIP-1. In correlation, when dnJNKK2 and JIP-1 were expressed in cardiomyocytes, both constructs significantly reduced cell death after simulated MI compared to vector controls.

  17. Detecting Acute Myocardial Infarction by Diffusion-Weighted versus T2-Weighted Imaging and Myocardial Necrosis Markers.

    Science.gov (United States)

    Jin, Jiyang; Chen, Min; Li, Yongjun; Wang, YaLing; Zhang, Shijun; Wang, Zhen; Wang, Lin; Ju, Shenghong

    2016-10-01

    We used a porcine model of acute myocardial infarction to study the signal evolution of ischemic myocardium on diffusion-weighted magnetic resonance images (DWI). Eight Chinese miniature pigs underwent percutaneous left anterior descending or left circumflex coronary artery occlusion for 90 minutes followed by reperfusion, which induced acute myocardial infarction. We used DWI preprocedurally and hourly for 4 hours postprocedurally. We acquired turbo inversion recovery magnitude T2-weighted images (TIRM T2WI) and late gadolinium enhancement images from the DWI slices. We measured the serum myocardial necrosis markers myoglobin, creatine kinase-MB isoenzyme, and cardiac troponin I at the same time points as the magnetic resonance scanning. We used histochemical staining to confirm injury. All images were analyzed qualitatively. Contrast-to-noise ratio (the contrast between infarcted and healthy myocardium) and relative signal index were used in quantitative image analysis. We found that DWI identified myocardial signal abnormity early (acute myocardial infarction and identified the infarct-related high signal more often than did TIRM T2WI: 7 of 8 pigs (87.5%) versus 3 of 8 (37.5%) (P=0.046). Quantitative image analysis yielded a significant difference in contrast-to-noise ratio and relative signal index between infarcted and normal myocardium on DWI. However, within 4 hours after infarction, the serologic myocardial injury markers were not significantly positive. We conclude that DWI can be used to detect myocardial signal abnormalities early after acute myocardial infarction-identifying the infarction earlier than TIRM T2WI and widely used clinical serologic biomarkers.

  18. Effects of primary PCI and facilitated PCI on myocardial viability and ventricular systolic synchrony in acute myocardial infarction patients

    Institute of Scientific and Technical Information of China (English)

    谷新顺; 傅向华; 马宁

    2003-01-01

    Effects of primary PCI and facilitated PCI on myocardial viability and ventricular systolic synchrony in acute myocardial infarction patients!石家庄050000$河北医科大学第二医院@谷新顺 !石家庄050000$河北医科大学第二医院@傅向华 !石家庄050000$河北医科大学第二医院@马宁

  19. SILENT MYOCARDIAL ISCHEMIA AND CARDIAC RHYTHM DISTURBANCES IN WOMEN WITH RHEUMATOID ARTHRITIS

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    D. S. Novikova

    2014-07-01

    Full Text Available Objective: to assess the rate of silent myocardial ischemia (SMI and the pattern of cardiac rhythm disturbances in women with rheumatoidarthritis (RA, their association with traditional risk factors (TRF for cardiovascular diseases (CVD, with subclinical structural and functionalchanges in the heart and vessels, with the activity and severity of rheumatoid inflammation.Subjects and methods. Two hundred and ninety-one female patients aged less than 60 years with a valid diagnosis of RA and no clinicalsigns were examined. A control group consisted of 125 women without rheumatic diseases. In addition to the clinical manifestations, activity,and severity of RA, the authors assessed major TRFs for CVD, performed Holter ECG monitoring, common carotid artery duplex scanning, transthoracic echocardiographic study, and determined the levels of serum inflammatory markers.Results. The women with RA differ from the control group in the higher incidence of SMI, supraventricular arrhythmias (SVA and highgradepremature ventricular contractions (PVC. The patients with RA and SMI are characterized in terms of age-adjustment by higher disease activity (DAS28, systemic manifestations, cumulative larger-dose glucocorticoids (GC and a higher percentage of patients receiving disease-modifying anti-rheumatic drugs as compared with those with RA and no SMI with adjustment for age. High disease activity(DAS28, level of inflammatory markers, IgM rheumatoid arthritis seropositivity, and GC therapy are SVA-associated factors in women with RA; larger left ventricular end-diastolic dimension and serositis are factors associated with high-grade PVC.Conclusion. The RA women without clinical manifestations of CVD are recorded to have high rates of SMI, SVA, and high-grade PVC, which is primarily due to the activity and severity of rheumatoid inflammation.

  20. Plasma Catestatin: A Useful Biomarker for Coronary Collateral Development with Chronic Myocardial Ischemia

    Science.gov (United States)

    Xu, Weixian; Yu, Haiyi; Li, Weihong; Gao, Wei; Guo, Lijun; Wang, Guisong

    2016-01-01

    Backgrounds Catestatin is an endogenous multifunctional neuroendocrinepeptide. Recently, catestatin was discovered as a novel angiogenic cytokine. The study was to investigate the associations between endogenous catestatin and coronary collateral development among the patients with chronic myocardial ischemia. Methods Thirty-eight patients with coronary artery chronic total occlusions (CTO) (CTO group) and 38 patients with normal coronary arteries (normal group) were enrolled in the series. Among the patients with CTO, coronary collateral development was graded according to the Rentrop score method. Rentrop score 0–1 collateral development was regarded as poor collateral group and 2–3 collateral development was regarded as good collateral group. Plasma catestatin level and vascular endothelial growth factor (VEGF) were measured by ELISA kits. Results The plasma catestatin levels in CTO group were significantly higher than that in normal group (1.97±1.01 vs 1.36±0.97ng/ml, p = 0.009). In the CTO group, the patients with good collateral development had significantly higher catestatin and VEGF levels than those with poor collateral development (2.36±0.73 vs 1.61±1.12 ng/ml, p = 0.018; 425.23±140.10 vs 238.48±101.00pg/mL, pCTO. However, there is no correlations between plasma catestatin levels and VEGF (r = -0.06, p = 0.744). In the multiple linear regression models, plasma catestatin level was one of the independent factors of coronary collateral development after adjustment for confounders. Conclusions Plasma catestatin was associated with coronary collateral developments. It may be a useful biomarker for coronary collateral development and potential target for therapeutic angiogenesis in patients with CTO. PMID:27304618

  1. Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia

    Directory of Open Access Journals (Sweden)

    Anastasiou Nikolaos

    2011-10-01

    Full Text Available Abstract Background Atrial fibrillation (AF occurs in 28-33% of the patients undergoing coronary artery revascularization (CABG. This study focuses on both pre- and peri-operative factors that may affect the occurrence of AF. The aim is to identify those patients at higher risk to develop AF after CABG. Patients and methods Two patient cohorts undergoing CABG were retrospectively studied. The first group (group A consisted of 157 patients presenting AF after elective CABG. The second group (group B consisted of 191 patients without AF postoperatively. Results Preoperative factors presenting significant correlation with the incidence of post-operative AF included: 1 age > 65 years (p = 0.029, 2 history of AF (p = 0.022, 3 chronic obstructive pulmonary disease (p = 0.008, 4 left ventricular dysfunction with ejection fraction 120 minutes (p = 0.011, 2 myocardial ischemia index 2/Kg.min (p = 0.011, 3 total positive fluid-balance during ICU-stay (p 2/PO2 > 0, 4 after extubation and during the ICU-stay (p = 0.021, 5 inotropic support with doses 15-30 μg/Kg/min (p = 0.016, 6 long ICU-stay recovery for any reason (p Conclusions Our results suggest that the incidence of post-CABG atrial fibrillation can be predicted by specific preoperative and intraoperative measures. The intraoperative myocardial ischemia can be sufficiently quantified by the myocardial ischemia index. For those patients at risk we would suggest an early postoperative precautionary anti-arrhythmic treatment.

  2. Left Ventricular function during episodes of silent and symptomatic myocardial ischemia; Linksventrikulaere Funktion waehrend symptomatischer und asymptomatischer Myokardischaemie

    Energy Technology Data Exchange (ETDEWEB)

    Hartmann, A. [Abt. fuer Kardiologie, Zentrum der Inneren Medizin, Frankfurt Univ. (Germany); Maul, F.D. [Abt. fuer Nuklearmedizin, Zentrum der Radiologie, Frankfurt Univ. (Germany); Zimny, M. [Abt. fuer Kardiologie, Zentrum der Inneren Medizin, Frankfurt Univ. (Germany); Klepzig, H. [Abt. fuer Kardiologie, Zentrum der Inneren Medizin, Frankfurt Univ. (Germany); Hoer, G. [Abt. fuer Nuklearmedizin, Zentrum der Radiologie, Frankfurt Univ. (Germany)

    1993-12-01

    Transluminal coronary angioplasty (PTCA) causes transient occlusion of the coronary artery and temporary ischemia of the left ventricle. Left ventricular dysfunction during silent and symptomatic episodes of myocardial ischemia during PTCA was evaluated continuously with a newly developed miniature, non-imaging scintillation probe. Parameters of left ventricular function were compared before and during balloon inflations of 60 s duration: Ejection fraction (EF), indices of end-systolic and end-diastolic volumes (ESV, EDV), peak ejection and peak filling rates (PER, PFR). 13 patients (age 54{+-}7.4 years) were symptomatic, 10 patients (age 61{+-}8 years) were asymptomatic. Impairment of left ventricular function during ischemia did not show any significant differences between the symptomatic and asymptomatic patients. It is therefore concluded that symptomatic and asymptomatic episodes of myocardial ischemia during PTCA cause similar impairment of systolic and diastolic left ventricular function. The degree of left ventricular dysfunction during PTCA cannot be estimated on the basis of clinical symptoms. (orig.) [Deutsch] Um zu untersuchen, ob sich Episoden stummer und symptomatischer Myokardischaemie waehrend transluminaler koronarer Angioplastie (PTCA) im Ausmass der linksventrikulaeren (LV) Funktionsbeeintraechtigung unterscheiden, wurden Auswurffraktion (EF), Indices des endsystolischen und enddiastolischen Volumens (ESV, EDV) sowie maximale Auswurf- (PER) und maximale Fuellungsgeschwindigkeiten (PFR) vor aund waehrend PTCA kontinuierlich on-line mit einer nicht-bildgebenden CsI-Szintillationssonde bestimmt. 13 Patienten (Alter 54{+-}7,4 Jahre) waren symptomatisch, 10 Patienten (Alter 61{+-}8 Jahre) waren asymptomatisch. Die linksventrikulaeren Funktionsparameter zeigten keine signifkanten Unterschiede zwischen den beiden Patientengruppen. Es wird daher gefolgert, dass symptomatische und stumme Ischaemieepisoden waehrend PTCA zu einer gleichartigen

  3. Acute Lower Limb Ischemia | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available 77-40 A.3Full title of the trial Evaluation of MST-188 in Acute Lower Limb Ischemia: A Phase 2 Randomized Do... and Efficacy Of MST-188 in Subjects with Acute Lower Limb Ischemia Receiving Catheter-Directed Recombinant ...3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language Evaluation of MST-188 in Acute...an A.3.2Name or abbreviated title of the trial where available Evaluation of MST-188 in Acute Lower Limb Isc...neral Information on the Trial E.1 Medical condition or disease under investigation E.1.1Medical condition(s) being investigated Acut

  4. Time-Course of the Effects of QSYQ in Promoting Heart Function in Ameroid Constrictor-Induced Myocardial Ischemia Pigs

    OpenAIRE

    2014-01-01

    We aim to investigate the therapeutic effects of QSYQ on a pig myocardial ischemia (MI) model and to determine its mechanism of action. The MI model was induced by Ameroid constriction of the left anterior descending coronary (LAD) in Ba-Ma miniature pigs. Four groups were created: model group, digoxin group, QSYQ group, and sham-operated group. Heart function, Ang II, CGMP, TXB2, BNP, and cTnT were evaluated before (3 weeks after operation: 0 weeks) and at 2, 4, and 8 weeks after drug admini...

  5. Expression of Bcl-2 and NF-κB in brain tissue after acute renal ischemia-reperfusion in rats

    Institute of Scientific and Technical Information of China (English)

    Na Zhang; Gen-Yang Cheng; Xian-Zhi Liu; Feng-Jiang Zhang

    2014-01-01

    Objective:To investigate the effect of acute renal ischemia reperfusion on brain tissue. Methods:Fourty eight rats were randomly divided into four groups(n=12): sham operation group,30 min ischemia60 min reperfusion group,60 min ischemia60 min reperfusion group, and 120 min ischemia60 min reperfusion group.The brain tissues were taken after the experiment. TUNEL assay was used to detect the brain cell apoptosis, and western blot was used to detect the expression of apoptosis-related proteins and inflammatory factors.Results:Renal ischemia-reperfusion induced apoptosis of brain tissues, and the apoptosis increased with prolongation of ischemia time.The detection at the molecular level showed decreasedBcl-2 expression, increasedBax expression, upregulated expression ofNF-κB and its downstream factor COX-2/PGE2.Conclusions:Acute renal ischemia-reperfusion can cause brain tissue damage, manifested as induced brain tissues apoptosis and inflammation activation.

  6. Pretreatment with low doses of acenocoumarol inhibits the development of acute ischemia/reperfusion-induced pancreatitis.

    Science.gov (United States)

    Warzecha, Z; Sendur, P; Ceranowicz, P; Dembinski, M; Cieszkowski, J; Kusnierz-Cabala, B; Tomaszewska, R; Dembinski, A

    2015-10-01

    Coagulative disorders are known to occur in acute pancreatitis and are related to the severity of this disease. Various experimental and clinical studies have shown protective and therapeutic effect of heparin in acute pancreatitis. Aim of the present study was to determine the influence of acenocoumarol, a vitamin K antagonist, on the development of acute pancreatitis. Studies were performed on male Wistar rats weighing 250 - 270 g. Acenocoumarol at the dose of 50, 100 or 150 μg/kg/dose or vehicle were administered once a day for 7 days before induction of acute pancreatitis. Acute pancreatitis was induced in rats by pancreatic ischemia followed by reperfusion. The severity of acute pancreatitis was assessed after 5-h reperfusion. Pretreatment with acenocoumarol given at the dose of 50 or 100 μg/kg/dose reduced morphological signs of acute pancreatitis. These effects were accompanied with a decrease in the pancreatitis-evoked increase in serum activity of lipase and serum concentration of pro-inflammatory interleukin-1β. Moreover, the pancreatitis-evoked reductions in pancreatic DNA synthesis and pancreatic blood flow were partially reversed by pretreatment with acenocoumarol given at the dose of 50 and 100 μg/kg/dose. Administration of acenocoumarol at the dose of 150 μg/kg/dose did not exhibit any protective effect against ischemia/reperfusion-induced pancreatitis. We concluded that pretreatment with low doses of acenocoumarol reduces the severity of ischemia/reperfusion-induced acute pancreatitis.

  7. ST-Elevation Myocardial Infarction and Myelodysplastic Syndrome with Acute Myeloid Leukemia Transformation

    OpenAIRE

    2014-01-01

    Acute myocardial infarction and acute myeloid leukemia are rarely reported as concomitant conditions. The management of ST-elevation myocardial infarction (STEMI) in patients who have acute myeloid leukemia is challenging: the leukemia-related thrombocytopenia, platelet dysfunction, and systemic coagulopathy increase the risk of bleeding, and the administration of thrombolytic agents can be fatal. We report the case of a 76-year-old man who presented emergently with STEMI, myelodysplastic syn...

  8. Greater resistance of the rabbit antropyloric region to experimental acute gastric ischemia

    Directory of Open Access Journals (Sweden)

    Maria Angélica B. Magalhães

    2013-08-01

    Full Text Available INTRODUCTION: Gastric ischemia represents an important medical challenge in pathology and surgical practice. OBJECTIVE: The purpose of this study was to assess the effects of acute gastric ischemia on different regions of the stomach. METHOD: Rabbit stomachs were subjected to devascularization of the greater and lesser curvatures for 3, 6 and 12 hours. After these periods, the stomachs were removed for macro and microscopic analysis. RESULTS: Hemorrhagic necrosis was more marked in the gastric fundus and body. In contrast, the antropylorus remained preserved in 100% of the rabbits after 3 hours of ischemia (group I, and in 80% of the rabbits after 6 and 12 hours of ischemia (groups II and III. Necrosis of the gastric body and fundus mucosa were observed in all animals after 6 and 12 hours of ischemia. CONCLUSION: We concluded that this experimental model of acute gastric ischemia was effective in producing hemorrhagic necrosis of the gastric fundus and body in rabbits even within a short period of time. Furthermore, the antropyloric region was preserved in most animals.

  9. Activation of ALDH2 with Low Concentration of Ethanol Attenuates Myocardial Ischemia/Reperfusion Injury in Diabetes Rat Model

    Directory of Open Access Journals (Sweden)

    Pin-Fang Kang

    2016-01-01

    Full Text Available The aim of this paper is to observe the change of mitochondrial aldehyde dehydrogenase 2 (ALDH2 when diabetes mellitus (DM rat heart was subjected to ischemia/reperfusion (I/R intervention and analyze its underlying mechanisms. DM rat hearts were subjected to 30 min regional ischemia and 120 min reperfusion in vitro and pretreated with ALDH2 activator ethanol (EtOH; cardiomyocyte in high glucose (HG condition was pretreated with ALDH2 activator Alda-1. In control I/R group, myocardial tissue structure collapse appeared. Compared with control I/R group, left ventricular parameters, SOD activity, the level of Bcl-2/Bax mRNA, ALDH2 mRNA, and protein expressions were decreased and LDH and MDA contents were increased, meanwhile the aggravation of myocardial structure injury in DM I/R group. When DM I/R rats were pretreated with EtOH, left ventricular parameters, SOD, Bcl-2/Bax, and ALDH2 expression were increased; LDH, MDA, and myocardial structure injury were attenuated. Compared with DM + EtOH I/R group, cyanamide (ALDH2 nonspecific blocker, atractyloside (mitoPTP opener, and wortmannin (PI3K inhibitor groups all decreased left ventricular parameters, SOD, Bcl-2/Bax, and ALDH2 and increased LDH, MDA, and myocardial injury. When cardiomyocyte was under HG condition, CCK-8 activity and ALDH2 protein expression were decreased. Alda-1 increased CCK-8 and ALDH2. Our findings suggested enhanced ALDH2 expression in diabetic I/R rats played the cardioprotective role, maybe through activating PI3K and inhibiting mitoPTP opening.

  10. Diverse Effects of L-arginine on Cardiac Function of Rats Subjected to Myocardial Ischemia and Reperfusion in vivo

    Institute of Scientific and Technical Information of China (English)

    Xiaoliang WANG; Feng LIANG; Xiangying JIAO; Lei LIU; Xiaojie BAI; Meixia LI; Jianmin ZHI; Huirong LIU

    2007-01-01

    In vivo administration of L-arginine at different time points during the course of myocardial ischemia and reperfusion (MI/R) has been shown to differentially regulate postischemic apoptosis.Cardiac function is one of the most important indexes used to judge the degree of myocardial injury.The present study attempted to determine whether in vivo administration of L-arginine at different stages of MI/R has a diverse influence on cardiac function of ischemic reperfused hearts and,if So,to investigate the mechanisms involved.Male adult rats were subjected to 30 min myocardial ischemia followed by 5 h reperfusion.An intravenous L-arginine bolus was given either 10 min before and 50 min after reperfusion (early treatment) or 3 h and 4 h after reperfusion (late treatment).Early treatment with L-arginine markedly increased the left ventricular systolic pressure (LVSP) and dP/dtmax,and decreased myocardial nitrotyrosine content.In strict contrast,late treatment with L-arginine resulted in a significant decrease in LVSP and dP/dtmx from 4 h to 5h after reperfusion,and increase in toxic peroxynitrite formation as measured by nitrotyrosine.These results suggest that the administration of L-arginine at different time points during the course of MI/R leads to diverse effects on cardiac dysfunction.Early supplementation decreased the nitrative stress and improved left ventricular function.However,late treatment with L-arginine increased the formation of peroxynitrite and aggravated cardiac functional injury.

  11. Effects of KR-32570, a new sodium hydrogen exchanger inhibitor, on myocardial infarction and arrhythmias induced by ischemia and reperfusion.

    Science.gov (United States)

    Lee, Byung Ho; Yi, Kyu Yang; Lee, Sunkyung; Lee, Sunghou; Yoo, Sung-eun

    2005-10-31

    The present study was performed to evaluate the cardioprotective effects of [5-(2-methoxy-5-chloro-5-phenyl)furan-2-ylcarbonyl]guanidine (KR-32570) in rat and dog models of coronary artery occlusion and reperfusion. In addition, we sought to clarify the efficacy of KR-32570 on reperfusion-induced fatal ventricular arrhythmia. In anesthetized rats subjected to 45-min coronary occlusion and 90-min reperfusion, KR-32570 (i.v. bolus) dose-dependently reduced myocardial infarct size from 58.0% to 50.7%, 35.3%, 33.5% and 27.0% for 0.03, 0.1, 0.3 and 1.0 mg/kg, respectively (PKR-32570 (3 mg/kg, i.v. bolus) markedly decreased infarct size from 28.9% in vehicle-treated group to 8.0% (PKR-32570 dose-dependently decreased the incidence of premature ventricular contraction, ventricular tachycardia or ventricular fibrillation induced by ischemia and reperfusion in rats. Similar results were obtained in dogs with reperfusion-induced arrhythmia. In separate experiments to assess the effects of timing of treatment, KR-32570 given 10 min before or at reperfusion in rat models also significantly reduced the myocardial infarct size (40.9% and 46.1%, respectively) compared with vehicle-treated group. In all studies, KR-32570 caused no significant changes in any hemodynamic profiles. Taken together, these results indicate that KR-32570 significantly reduced the myocardial infarction and incidence of arrhythmias induced by ischemia and reperfusion in rats and dogs, without affecting hemodynamic profiles. Thus, it could be potentially useful in the prevention and treatment of myocardial injuries and lethal ventricular arrhythmias.

  12. Postoperative myocardial infarction documented by technetium pyrophosphate scan using single-photon emission computed tomography: Significance of intraoperative myocardial ischemia and hemodynamic control

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, D.C.; Chung, F.; Burns, R.J.; Houston, P.L.; Feindel, C.M. (Toronto Hospital, Ontario (Canada))

    1989-12-01

    The aim of this prospective study was to document postoperative myocardial infarction (PMI) by technetium pyrophosphate scan using single-photon emission computed tomography (TcPPi-SPECT) in 28 patients undergoing elective coronary bypass grafting (CABG). The relationships of intraoperative electrocardiographic myocardial ischemia, hemodynamic responses, and pharmacological requirements to this incidence of PMI were correlated. Radionuclide cardioangiography and TcPPi-SPECT were performed 24 h preoperatively and 48 h postoperatively. A standard high-dose fentanyl anesthetic protocol was used. Twenty-five percent of elective CABG patients were complicated with PMI, as documented by TcPPi-SPECT with an infarcted mass of 38.0 +/- 5.5 g. No significant difference in demographic, preoperative right and left ventricular function, number of coronary vessels grafted, or aortic cross-clamp time was observed between the PMI and non-PMI groups. The distribution of patients using preoperative beta-adrenergic blocking drugs or calcium channel blocking drugs was found to have no correlation with the outcome of PMI. As well, no significant differences in hemodynamic changes or pharmacological requirements were observed in the PMI and non-PMI groups during prebypass or postbypass periods, indicating careful intraoperative control of hemodynamic indices did not prevent the outcome of PMI in these patients. However, the incidence of prebypass ischemia was 39.3% and significantly correlated with the outcome of positive TcPPi-SPECT, denoting a 3.9-fold increased risk of developing PMI. Prebypass ischemic changes in leads II and V5 were shown to correlate with increased CPK-MB release (P less than 0.05) and tends to occur more frequently with lateral myocardial infarction.

  13. Effect of monoamine nervous transmitter and neuropeptide Y in the aged rats with myocardial injury after brain ischemia-reperfusion

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    AIM: To study the mechanism of myocardial injury after brain ischemia-reperfusion in aged rats from the changes in Dopamine (DA), Noradrenalin (NE), Epinephrine(E) and Neuropeptide Y(NPY).METHODS: Young (5 months) and aged (20 months or more) rats were divided into model groups and normal control groups, respectively. We observed the following items in rats with 60 minute reperfusion after 30 minute brain ischemia: the pathological changed of myocardium, the activities of lactic dehydrrogenase(LDH), creatine phosphokinase(CPK), the contents of NE, DA, E, NPY. RESULTS:The CPK and LDH activities in the young model rats were higher than those in the young control rats was higher than that in the young control rats (P<0.05). The serum CPK activity in the aged control rats was higher than that in the young control rats (P<0.05). The myocardial CPK activity was higher in the aged model rats compared with the young molel rats (P<0.05) and was higher in aged control rats compared with the young control rats (P<0.01). The myocardial LDH activity was lower in the aged control rats than that in the young control rats (P<0.05) and aged model rats (P<0.01). The serum NE level, the level of NE and DA in the hypothalamus were higher obviously than those in the young control rats. The serum NE contents in the two model groups (young and aged) were higher respectively than the two control rats (young and aged). The following items’ contents were higher in the aged model rats than in the young model rats: serum NE, serum E, hypothalamus NE. The hypothalamus NE and E content was lower in the aged model rats than in te aged control rats. NPY level in the brain tissue was lower in the aged control rats than that in the young control rats and aged model rats (P<0.05).CONCLUSION: The myocardial injury after brain ischemia-reperfusion was concerned with the enhanced excitability of sympathetic-adrenal system, espectially in the aged rats. However, the change in myocardial

  14. Comparative analysis of different cyclosporine A doses on protection after myocardial ischemia/reperfusion injury in rat

    Institute of Scientific and Technical Information of China (English)

    Kang Huang; Shi-Juan Lu; Jiang-Hua Zhong; Qun Xiang; Liu Wang; Miao Wu

    2014-01-01

    Objective:To investigate the protective effect of different cyclosporinA(CsA) doses on myocardial ischemia/reperfusion injury in rat models.Methods:A rat model of myocardial ischemia/reperfusion injury was established in vivoand the rats were randomly divided into four groups: placebo(PBS;T1), low-dose(CsA dose:1.0 mg/kg;T2), medium-dose(CsA dose:2.5 mg/kg;T3), and high-dose(CsA dose:5.0 mg/kg;T4) groups.Heart function indexes were monitored at different time points, the extent of myocardial infarction was assessed byEvans Blue-TTC staining, and creatine kinase MB mass and cardiac troponinI values were measured by biochemical assays.Results:Compared with theT1 andT2 groups, both the creatine kinase MB mass and cardiac troponinI were significantly lower in theT3 andT4 groups(P<0.05).The mean arterial pressure(MAP) and left ventricular systolic pressure(LVSP) decreased sequentially in each group, with the extending reperfusion time.Significant decreases inLVSP andMAP were observed in theT3 andT4 groups as compared to theT1 andT2 group(P<0.05), and theT2 group showed a significantly lowerLVSP andMAP decline than theT1 group(P<0.05).Compared with theT1 group, the rats from theT2,T3, andT4 groups suffered from a significantly lower extent of myocardial infarction(P<0.05).Also, the animals in theT3 andT4 groups had a significantly smaller extent of myocardial infarction than those in theT2 group(P<0.05).Conclusions:Various CsA doses exert different degrees of protection against ischemia/reperfusion injury, and this protective effect peaks at approximately2.5 mg/kg in rat models.

  15. Pathophysiology of brain ischemia as it relates to the therapy of acute ischemic stroke

    DEFF Research Database (Denmark)

    Lassen, N A

    1990-01-01

    Current knowledge of the pathophysiology of cerebral ischemia, summarized in the present study, predicts that neurological deficits caused by moderate ischemia (flows in the penumbral range between 23 and 10 ml/100 g/min) are reversible provided flow is restored within 3-4 h of onset. It also...... predicts that areas of dense ischemia cannot be salvaged and that reperfusion of such areas is risky, because massive edema or even hemorrhage may develop following reperfusion. On this basis, it is argued that selection of stroke cases for thrombolysis or surgical revascularization must be based not only...... on computed tomographic (CT) scanning to exclude hemorrhagic stroke, but also on cerebral blood flow (CBF) tomography to exclude lacunar infarcts, early reperfusion, and dense ischemia. The methods available for routing CBF tomography in acute stroke cases are discussed, and it is concluded that single photon...

  16. The association of depressed angiogenic factors with reduced capillary density in the Rhesus monkey model of myocardial ischemia.

    Science.gov (United States)

    Zhang, Wenjing; Zhao, Xinmei; Xiao, Ying; Chen, Jianmin; Han, Pengfei; Zhang, Jingyao; Fu, Haiying; James Kang, Y

    2016-07-13

    Depressed capillary density is associated with myocardial ischemic infarction, in which hypoxia-inducible factor 1α (HIF-1α) is increased. The present study was undertaken to examine changes in the angiogenic factors whose expression is regulated by HIF-1 and their relation to the depressed capillary density in the Rhesus monkey model of myocardial ischemic infarction. Male Rhesus monkeys 2-3 years old were subjected to myocardial ischemia by permanent ligation of left anterior descending (LAD) artery leading to the development of myocardial infarction. Eight weeks after LAD ligation, copper concentrations, myocardial histological changes and capillary density were examined, along with Western blot and immunohistochemical analysis of angiogenic factors and detection of HIF-1 activity. Capillary density was significantly decreased but the concentrations of HIF-1α and HIF-1β were significantly increased in the infarct area. However, the levels of mRNA and protein for VEGF and VEGFR1 were significantly decreased. Other HIF-1 regulated angiogenic factors, including Tie-2, Ang-1 and FGF-1, were also significantly depressed, but vascular destabilizing factor Ang-2 was significantly increased. Copper concentrations were depressed in the infarct area. Copper-independent HIF-1 activity was increased shown by the elevated mRNA level of IGF-2, a HIF-1 target gene. Removal of copper by a copper chelator, tetraethylenepentamine, from primary cultures of neonatal rat cardiomyocytes also suppressed the expression of HIF-1 regulated VEGF and BNIP3, but not IGF-2. The data suggest that under ischemic conditions, copper loss suppressed the expression of critical angiogenic genes regulated by HIF-1, but did not affect copper-independent HIF-1 activation of gene expression. This copper-dependent dysregulation of angiogenic gene expression would contribute to the pathogenesis of myocardial ischemic infarction.

  17. Enalapril protects against myocardial ischemia/reperfusion injury in a swine model of cardiac arrest and resuscitation

    Science.gov (United States)

    Wang, Guoxing; Zhang, Qian; Yuan, Wei; Wu, Junyuan; Li, Chunsheng

    2016-01-01

    There is strong evidence to suggest that angiotensin-converting enzyme inhibitors (ACEIs) protect against local myocardial ischemia/reperfusion (I/R) injury. This study was designed to explore whether ACEIs exert cardioprotective effects in a swine model of cardiac arrest (CA) and resuscitation. Male pigs were randomly assigned to three groups: sham-operated group, saline treatment group and enalapril treatment group. Thirty minutes after drug infusion, the animals in the saline and enalapril groups were subjected to ventricular fibrillation (8 min) followed by cardiopulmonary resuscitation (up to 30 min). Cardiac function was monitored, and myocardial tissue and blood were collected for analysis. Enalapril pre-treatment did not improve cardiac function or the 6-h survival rate after CA and resuscitation; however, this intervention ameliorated myocardial ultrastructural damage, reduced the level of plasma cardiac troponin I and decreased myocardial apoptosis. Plasma angiotensin (Ang) II and Ang-(1–7) levels were enhanced in the model of CA and resuscitation. Enalapril reduced the plasma Ang II level at 4 and 6 h after the return of spontaneous circulation whereas enalapril did not affect the plasma Ang-(1–7) level. Enalapril pre-treatment decreased the myocardial mRNA and protein expression of angiotensin-converting enzyme (ACE). Enalapril treatment also reduced the myocardial ACE/ACE2 ratio, both at the mRNA and the protein level. Enalapril pre-treatment did not affect the upregulation of ACE2, Ang II type 1 receptor (AT1R) and MAS after CA and resuscitation. Taken together, these findings suggest that enalapril protects against ischemic injury through the attenuation of the ACE/Ang II/AT1R axis after CA and resuscitation in pigs. These results suggest the potential therapeutic value of ACEIs in patients with CA. PMID:27633002

  18. Cardioprotective Effect of Licochalcone D against Myocardial Ischemia/Reperfusion Injury in Langendorff-Perfused Rat Hearts.

    Directory of Open Access Journals (Sweden)

    Xuan Yuan

    Full Text Available Flavonoids are important components of 'functional foods', with beneficial effects on cardiovascular function. The present study was designed to investigate whether licochalcone D (LD could be a cardioprotective agent in ischemia/reperfusion (I/R injury and to shed light on its possible mechanism. Compared with the I/R group, LD treatment enhanced myocardial function (increased LVDP, dp/dtmax, dp/dtmin, HR and CR and suppressed cardiac injury (decreased LDH, CK and myocardial infarct size. Moreover, LD treatment reversed the I/R-induced cleavage of caspase-3 and PARP, resulting in a significant decrease in proinflammatory factors and an increase in antioxidant capacity in I/R myocardial tissue. The mechanisms underlying the antiapoptosis, antiinflammation and antioxidant effects were related to the activation of the AKT pathway and to the blockage of the NF-κB/p65 and p38 MAPK pathways in the I/R-injured heart. Additionally, LD treatment markedly activated endothelial nitric oxide synthase (eNOS and reduced nitric oxide (NO production. The findings indicated that LD had real cardioprotective potential and provided support for the use of LD in myocardial I/R injury.

  19. Acute Myocardial Infarction: The First Manifestation of Ischemic Heart Disease and Relation to Risk Factors

    Directory of Open Access Journals (Sweden)

    Manfroi Waldomiro Carlos

    2002-01-01

    Full Text Available OBJECTIVE: To assess the association between cardiovascular risk factors and acute myocardial infarction as the first manifestation of ischemic heart disease, correlating them with coronary angiographic findings. METHODS: We carried out a cross-sectional study of 104 patients with previous acute myocardial infarction, who were divided into 2 groups according to the presence or absence of angina prior to acute myocardial infarction. We assessed the presence of angina preceding acute myocardial infarction and risk factors, such as age >55 years, male sex, smoking, systemic arterial hypertension, lipid profile, diabetes mellitus, obesity, sedentary lifestyle, and familial history of ischemic heart disease. On coronary angiography, the severity of coronary heart disease and presence of left ventricular hypertrophy were assessed. RESULTS: Of the 104 patients studied, 72.1% were males, 90.4% were white, 73.1% were older than 55 years, and 53.8% were hypertensive. Acute myocardial infarction was the first manifestation of ischemic heart disease in 49% of the patients. The associated risk factors were systemic arterial hypertension (RR=0.19; 95% CI=0.06-0.59; P=0.04 and left ventricular hypertrophy (RR=0.27; 95% CI=0,.8-0.88; P=0.03. The remaining risk factors were not statistically significant. CONCLUSION: Prevalence of acute myocardial infarction as the first manifestation of ischemic heart disease is high, approximately 50%. Hypertensive individuals more frequently have symptoms preceding acute myocardial infarction, probably due to ventricular hypertrophy associated with high blood pressure levels.

  20. Comparison of Different Adult Stem Cell Types for Treatment of Myocardial Ischemia

    Science.gov (United States)

    van der Bogt, Koen E.A.; Sheikh, Ahmad Y.; Schrepfer, Sonja; Hoyt, Grant; Cao, Feng; Ransohoff, Katie; Swijnenburg, Rutger-Jan; Pearl, Jeremy; Fischbein, Michael; Contag, Christopher H.; Robbins, Robert C.; Wu, Joseph C.

    2013-01-01

    Introduction A comparative analysis of the efficacy of different cell candidates for the treatment of heart disease remains to be described. This study is designed to evaluate the therapeutic efficacy of 4 cell types in a murine model of myocardial infarction. Methods Bone marrow mononuclear cells (MN), mesenchymal stem cells (MSC), skeletal myoblasts (SkMb) and fibroblasts (Fibro) were isolated from male L2G transgenic mice (FVB background) that constitutively express firefly luciferase (Fluc) and green fluorescence protein (GFP). Cells were characterized by flow cytometry, bioluminescence imaging (BLI), and luminometry. Female FVB mice (n=60) underwent LAD ligation and were randomized into 5 groups to intramyocardially receive one cell type (5 × 105) or PBS as control. Cell survival was measured in vivo by BLI and ex vivo by TaqMan PCR at week 6. Cardiac function was assessed by echocardiography and invasive hemodynamic measurements were made at week 6. Results Fluc expression correlated with the cell number in all groups (r2 >0.93). In vivo BLI revealed acute donor cell death of MSC, SkMb, and Fibro within 3 weeks after transplantation. By contrast, cardiac signals were still present after 6 weeks in the MN group, as confirmed by TaqMan PCR (P<0.01). Echocardiography showed significant preservation of fractional shortening in the MN group compared to controls (P<0.05). Measurements of left ventricular end-systolic/diastolic volumes revealed that the least amount of ventricular dilatation occurred in the MN group (P<0.05). Histology confirmed the presence of MN, although there was no evidence of transdifferentiation by donor MN into cardiomyocytes. Conclusion This is the first study to directly compare a variety of cell candidates for myocardial therapy. Compared to MSC, SkMB, and Fibro, our results suggest that MN cells exhibit a more favorable survival pattern, which translates into a more robust preservation of cardiac function. PMID:18824743

  1. Translation of Methdology used in Human Myocardial Imaging to a Sheep Model of Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Elizabeth A Bailey

    2013-10-01

    Full Text Available Introduction: Pre-clinical investigation of stem cells for repairing damaged myocardium predominantly used rodents, however large animals have cardiac circulation closely resembling the human heart. The aim of this study was to evaluate whether SPECT/CT myocardial perfusion imaging (MPI could be used for assessing sheep myocardium following an acute myocardial infarction (MI and response to intervention. Method: 18 sheep enrolled in a pilot study to evaluate [99mTc]-sestamibi MPI at baseline, post-MI and after therapy. Modifications to the standard MPI protocols were developed. All data was reconstructed with OSEM using CT-derived attenuation and scatter correction. Standard analyses were performed and inter-observer agreement were measured using Kappa (. Power determined the sample sizes needed to show statistically significant changes due to intervention. Results: Ten sheep completed the full protocol. Data processed were performed using pre-existing hardware and software used in human MPI scanning. No improvement in perfusion was seen in the control group, however improvements of 15% - 35% were seen after intra-myocardial stem cell administration. Inter-observer agreement was excellent (К=0.89. Using a target power of 0.9, 28 sheep were required to detect a 10-12% change in perfusion. Conclusions: Study demonstrates the suitability of large animal models for imaging with standard MPI protocols and it’s feasibility with a manageable number of animals. These protocols could be translated into humans to study the efficacy of stem cell therapy in heart regeneration and repair.

  2. Translation of Methdology used in Human Myocardial Imaging to a Sheep Model of Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Elizabeth Bailey

    2013-10-01

    Full Text Available Background: Pre-clinical investigation of stem cells for repairing damaged myocardium predominantly used rodents, however large animals have cardiac circulation closely resembling the human heart. The aim of this study was to evaluate whether SPECT/CT myocardial perfusion imaging (MPI could be used for assessing sheep myocardium following an acute myocardial infarction (MI and response to intervention. Method: 18 sheep enrolled in a pilot study to evaluate [99mTc]-sestamibi MPI at baseline, post-MI and after therapy. Modifications to the standard MPI protocols were developed. All data was reconstructed with OSEM using CT-derived attenuation and scatter correction. Standard analyses were performed and inter-observer agreement were measured using Kappa (. Power determined the sample sizes needed to show statistically significant changes due to intervention. Results: Ten sheep completed the full protocol. Data processed were performed using pre-existing hardware and software used in human MPI scanning. No improvement in perfusion was seen in the control group, however improvements of 15% - 35% were seen after intra-myocardial stem cell administration. Inter-observer agreement was excellent (К=0.89. Using a target power of 0.9, 28 sheep were required to detect a 10-12% change in perfusion. Conclusions: Study demonstrates the suitability of large animal models for imaging with standard MPI protocols and it’s feasibility with a manageable number of animals. These protocols could be translated into humans to study the efficacy of stem cell therapy in heart regeneration and repair.

  3. Comparison of the usefulness of heart rate variability versus exercise stress testing for the detection of myocardial ischemia in patients without known coronary artery disease.

    Science.gov (United States)

    Goldkorn, Ronen; Naimushin, Alexey; Shlomo, Nir; Dan, Ariella; Oieru, Dan; Moalem, Israel; Rozen, Eli; Gur, Ilan; Levitan, Jacob; Rosenmann, David; Mogilewsky, Yakov; Klempfner, Robert; Goldenberg, Ilan

    2015-06-01

    Heart rate variability (HRV) has been shown to be attenuated in patients with coronary artery disease (CAD) and may, therefore, be possibly used for the early detection of myocardial ischemia. We aimed to evaluate the diagnostic yield of a novel short-term HRV algorithm for the detection of myocardial ischemia in subjects without known CAD. We prospectively enrolled 450 subjects without known CAD who were referred to tertiary medical centers for exercise stress testing (EST) with single-photon emission computed tomography myocardial perfusion imaging (MPI). All subjects underwent 1-hour Holter testing with subsequent HRV analysis before EST with MPI. The diagnostic yield of HRV analysis was compared with EST, using MPI as the gold standard for the noninvasive detection of myocardial ischemia. All subjects had intermediate pretest probability for CAD. Mean age was 62 years, 38% were women, 51% had hypertension, and 25% diabetes mellitus. HRV analysis showed superior sensitivity (77%) compared with standard EST (27%). After multivariate adjustment, HRV was independently associated with an 8.4-fold (p coronary angiography, the respective sensitivities of HRV and EST for the detection of significant CAD were 73% versus 26%. Our data suggest that HRV can be used as an important noninvasive technique for the detection of myocardial ischemia in subjects without known CAD, providing superior sensitivity to conventional EST in this population.

  4. Regional protein synthesis in rat brain following acute hemispheric ischemia.

    Science.gov (United States)

    Dienel, G A; Pulsinelli, W A; Duffy, T E

    1980-11-01

    Regional protein synthesis was measured in rat brain at intervals up to 48 h following occlusion of the four major arteries to the brain for either 10 or 30 min. Four-vessel occlusions produces ischemia in the cerebral hemispheres and oligemia in the midbrain-diencephalon and brainstem. During the hour following 10 min of ischemia, protein synthesis, measured by incorporation of [14C]valine into protein, was inhibited in the cerebral cortex by 67%. Normal rates of protein synthesis were attained within 4 h of recirculation. In rats subjected to 30 min of ischemia, protein synthesis was inhibited by 83% during the first hour of recirculation in the cortex, caudate-putamen, and hippocampus. Recovery of protein synthesis in these regions was slow (25-48 h). The midbrain-diencephalon showed less inhibition, 67%, and faster recovery (by 12 h). Protein synthesis was unaffected in the brainstem. [14C]Autoradiography revealed that the pyramidal neurons of the hippocampus and areas of the caudate and cortex failed to recover normal rates of protein synthesis even after 48 h. The accumulation of TCA-soluble [14C]valine was enhanced (55-65%) in the cortex, caudate, and hippocampus after 30 min of ischemia; the increase persisted for 12 h. A smaller rise in [14C]valine content (30%) and more rapid normalization of valine accumulation (by 7 h) were observed in the midbrain-diencephalon; no changes were found in the brainstem. In the cortex, recovery was more rapid when the duration of ischemia was reduced. Thus, the degree of inhibition of protein synthesis, the accumulation of valine in the tissue, and the length of time required to reestablish normal values for these processes were dependent on both the severity and the duration of the ischemic insult. Restoration of normal rates of protein synthesis after ischemia was slow compared with the normalization of cerebral energy metabolites.

  5. MOEMS-based cardiac enzymes detector for acute myocardial infarction

    Science.gov (United States)

    Amritsar, Jeetender; Stiharu, Ion G.; Packirisamy, Muthukumaran; Balagopal, Ganesharam; Li, Xing

    2004-10-01

    Biomedical applications of MOEMS are limited only by the mankind imagination. Precision measurements on minute amounts of biological material could be performed by optical means with a remarkable accuracy. Although available in medical laboratories for general purposes, such analyzers are making their way directly to the users in the form of dedicated equipment. Such an example is a test kit to detect the existence of cardiac enzymes in the blood stream. Apart from the direct users, the medical personnel will make use of such tools given the practicality of the kit. In a large proportion of patients admitted to the hospital suspected of Acute Myocardial Infarction (AMI), the symptoms and electrocardiographic changes are inconclusive. This necessitates the use of biochemical markers of myocardial damage for correct exclusion or conformation of AMI. In this study the concept of MOEMS is applied for the detection of enzyme reaction, in which glass spectrums are scanned optically when enzyme molecules adsorb on their surface. This paper presents the optical behavior of glass spectrums under Horseradish Peroxide (HRP) enzyme reaction. The reported experimental results provide valuable information that will be useful in the development of biosensors for enzymatic detection. This paper also reports the dynamic behavior of different glass spectrums.

  6. Left ventricular muscle and fluid mechanics in acute myocardial infarction.

    Science.gov (United States)

    Nucifora, Gaetano; Delgado, Victoria; Bertini, Matteo; Marsan, Nina Ajmone; Van de Veire, Nico R; Ng, Arnold C T; Siebelink, Hans-Marc J; Schalij, Martin J; Holman, Eduard R; Sengupta, Partho P; Bax, Jeroen J

    2010-11-15

    Left ventricular (LV) diastolic filling is characterized by the formation of intraventricular rotational bodies of fluid (termed "vortex rings") that optimize the efficiency of LV ejection. The aim of the present study was to evaluate the morphology and dynamics of LV diastolic vortex ring formation early after acute myocardial infarction (AMI), in relation to LV diastolic function and infarct size. A total of 94 patients with a first ST-segment elevation AMI (59 ± 11 years; 78% men) were included. All patients underwent primary percutaneous coronary intervention. After 48 hours, the following examinations were performed: 2-dimensional echocardiography with speckle-tracking analysis to assess the LV systolic and diastolic function, the vortex formation time (VFT, a dimensionless index for characterizing vortex formation), and the LV untwisting rate; contrast echocardiography to assess LV vortex morphology; and myocardial contrast echocardiography to identify the infarct size. Patients with a large infarct size (≥ 3 LV segments) had a significantly lower VFT (p mechanical sequence of diastolic restoration play key roles in modulating the morphology and dynamics of early diastolic vortex ring formation.

  7. Acute myocardial infarction as a finding of acute promyelocytic leukemia-related coagulation disorder.

    Science.gov (United States)

    Özkurt, Zübeyde N; Aypar, Eda; Sarifakiogullari, Serpil; Taçoy, Gülten; Özdag, Murat; Kahraman, Seda; Çengel, Atiye

    2015-12-01

    Acute promyelocytic leukemia (APL) has one of the most favorable prognoses among other leukemia subtypes. However, the major cause of mortality in APL is disseminated intravascular coagulation at the presentation. We present a case of acute myocardial infarction (MI) at the time of APL diagnosis before treatment. The patient suffered from chest pain, sweating and giddiness. He was hypoxic, hypotensive and bradycardic. ECG showed inferior MI. Unfractioned heparin infusion (850 U/h) was started and 5 min after the previous ECG showed total ST resolution. We suggest that in this case, MI was not related to atherosclerotic plaque rupture but related to DIC manifestation.

  8. Acute myocardial/cerebral infarction as first/relapse manifestation in one acute promyelocytic leukemia patient.

    Science.gov (United States)

    Li, Ying; Suo, Shanshan; Mao, Liping; Wang, Lei; Yang, Chunmei; Xu, Weilai; Lou, Yinjun; Mai, Wenyuan

    2015-01-01

    In the clinical setting, bleeding is a common manifestation of acute promyelocytic leukemia (APL), whereas thrombosis is relatively rare, especially as an initial symptom. Here, we report an unusual case of APL with acute myocardial infarction as the first manifestation and cerebral infarction as the relapse manifestation in a healthy young woman. This unique case emphasizes that a thrombotic event could be the first manifestation of an underlying hematological disorder such as APL and could also be a sign of relapse. Rapid detection of the underlying disorder and the timely use of anticoagulation therapy and ATRA are crucial for preventing further deterioration of the disease and saving the patient's life.

  9. Chest pain characteristics and gender in the early diagnosis of acute myocardial infarction.

    Science.gov (United States)

    Arora, Garima; Bittner, Vera

    2015-02-01

    Acute myocardial infarction is one of the leading causes of cardiovascular disease mortality in both men and women. Chest pain, which is often described as chest pressure, tightness, or a squeezing sensation, is the most frequent symptom in patients presenting with acute myocardial infarction. Although the diagnosis of acute myocardial infarction is often based on typical changes on a surface electrocardiogram and on changes in cardiac biomarkers, there is a need to better recognize and understand the impact of sex on symptoms among patients presenting with acute coronary syndrome or acute myocardial infarction. We briefly review the pathophysiology of ischemic symptoms, discuss potential mechanisms for variation in ischemic symptoms by sex, and summarize recent publications that have addressed sex differences in ischemic symptoms.

  10. Evaluation of transplantation of mesenchymal cells in acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Aliya Dzholdasbekova

    2012-12-01

    Full Text Available It has been studied in the pilot clinical research the effect of systemic (intravenous transplantation of mesenchymal stem cells (MSC of a bone marrow to 20 patients with an acute myocardial infarction with lifting segment of ST (STEMI carried out in the first 2 hours by percutaneous coronary intervention (PCI with stenting infarct related artery and the common course of drug therapy. It has been shown that the transplantation of MSCs had not caused any complications (allergic reactions, hazardous to health arrhythmias, embolism and heavy frustration of hemodynamic and had not lead to condition deterioration afterwards. In the first 3-6 months after systemic transplantation of MSCs to the patients’ heart contractive activity has been advanced which was clinically proved in the reduction of the heart failure level degree of expressiveness of warm insufficiency.

  11. Diagnosing and treating acute myocardial infarction in pregnancy.

    LENUS (Irish Health Repository)

    Merrigan, Orla

    2012-02-01

    Acute myocardial infarction (AMI) in pregnancy is a very rare occurrence. However, statistics indicate high mortality rates, with a maternal death rate at 20-37%. Nursing and medical care of AMI in pregnancy is a very complex issue. Risk factors such as stress, smoking, obesity, high cholesterol and family history of heart disease may increase the risk of AMI in pregnancy. There are a variety of challenges for the nurse caring for this patient, as the presenting signs and symptoms of AMI in pregnancy can mimic regular pregnancy symptoms and therefore may be misdiagnosed. There is limited nursing literature on this topic to guide and educate nurses. Recommendations need to be implemented across multiple nursing settings. There is a need for both national and international guidelines on care of this type of patient. There is also a need for policies to be in place and links within the hospital setting and the community.

  12. Acute Myocardial Infarction after Switching from Warfarin to Dabigatran

    Directory of Open Access Journals (Sweden)

    Wael Abuzeid

    2015-01-01

    Full Text Available Dabigatran etexilate is a recently approved direct thrombin inhibitor (DTI, which is superior to warfarin in the prevention of stroke and systemic embolism in patients with atrial fibrillation (AF. However, dabigatran use is associated with an increased risk of myocardial infarction (MI compared to warfarin. The mechanisms for this association effect remain speculative. We present a case of an acute MI and cardiac arrest in a patient with chronic AF who had been recently switched from warfarin to dabigatran. Urgent coronary angiography, at St. Michael’s hospital (Toronto, Canada, revealed evidence of thromboembolism to the distal posterior descending artery. The patient was treated medically and switched back from dabigatran to warfarin. He did well and was discharged after an uneventful stay in the coronary care unit.

  13. Factors influencing prehospital delay for patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Shujuan CHENG; Lufen GUO; Juyuan LIU; Xiaoling ZHU; Hongbing YAN

    2007-01-01

    Objective To investigate the influencing factors for prehospital delay in patients with acute myocardial infarction (AMI).Methods A total of 807 consecutive patients with AMI who presented to the emergency department of Beijing Anzhen Hospital were analyzed. The influence of several potential risk factors on the prehospital delay time (PDT) was evaluated by comparing patients admitted more than 2 hours after onset of chese pain with those admitted within 2 hours after onset. Results Among 807 patients, 402 came to the hospital within 2 hours while the others arrived at the hospital after 2 hours. The median PDT was 130 min. Among the potential variables, advanced age, history of diabetes mellitus, occurrence of symptom at night and use of emergency medical service significantly affected PDT by multivariate analysis. Conclusion Interventions aimed at reducing the prehospital delay in AMI should primarily focus on the awareness of the risk and help-seeking behavior of patients.

  14. Recurrent Acute Myocardial Infarction in Patients with Immune Thrombocytopenic Purpura

    Directory of Open Access Journals (Sweden)

    Fengyi Shen

    2014-01-01

    Full Text Available Immune thrombocytopenic purpura (ITP, also known as idiopathic thrombocytopenic purpura, is an acquired immune-mediated disease of adults and children characterized by a transient or persistent decrease of platelets and, depending upon the degree of thrombocytopenia, an increased risk of bleeding. The use of standard treatments for acute myocardial infarction (AMI, such as antiplatelet agents and anticoagulants, pose serious problems in patients with ITP due to the potential higher risk of bleeding complications. There are no current guidelines available for management of ITP patients with AMI. In this brief review of the limited available literature, we discuss the proposed pathophysiological link between ITP and arterial thrombosis and the challenging medical and interventional treatment of these patients.

  15. Raman spectroscopy of human saliva for acute myocardial infarction detection

    Science.gov (United States)

    Chen, Maowen; Chen, Yuanxiang; Wu, Shanshan; Huang, Wei; Lin, Jinyong; Weng, Guo-Xing; Chen, Rong

    2014-09-01

    Raman spectroscopy is a rapidly non-invasive technique with great potential for biomedical research. The aim of this study was to evaluate the feasibility of using Raman spectroscopy of human saliva for acute myocardial infarction (AMI) detection. Raman spectroscopy measurements were performed on two groups of saliva samples: one group from patients (n=30) with confirmed AMI and the other group from healthy controls (n=31). The diagnostic performance for differentiating AMI saliva from normal saliva was evaluated by multivariate statistical analysis. The combination of principal component analysis (PCA) and linear discriminate analysis (LDA) of the measured Raman spectra separated the spectral features of the two groups into two distinct clusters with little overlaps, rendering the sensitivity of 80.0% and specificity of 80.6%. The results from this exploratory study demonstrated that Raman spectroscopy of human saliva can serve as a potentially clinical tool for rapid AMI detection and screening.

  16. Safety and efficacy of tenecteplase in acute myocardial infarction.

    Science.gov (United States)

    Guerra, Daniel R; Karha, Juhana; Gibson, C Michael

    2003-05-01

    The use of intravenous thrombolytic agents has revolutionised the treatment of acute myocardial infarction. However, the improved mortality achieved with these drugs is tempered by the risk of serious bleeding complications, especially intracranial haemorrhage (ICH). Tenecteplase (TNKase, Genetech Inc.) is an engineered variant of alteplase (Activase, Genentech Inc.) designed to have increased fibrin specificity, greater efficacy and a longer half-life. The longer half-life of tenecteplase compared to alteplase allows for convenient single bolus administration of the drug. In addition, tenecteplase dosing is based on actual or estimated patient weight, which enhances both the safety and efficacy outcomes. Large clinical trials have demonstrated equivalence in mortality and ICH between tenecteplase and alteplase. Compared to alteplase, tenecteplase use leads to lower rates of bleeding complications and a decreased risk of ICH among low weight, elderly women.

  17. N-Acetylaspartate distribution in rat brain striatum during acute brain ischemia

    DEFF Research Database (Denmark)

    Sager, T.N.; Laursen, H; Fink-Jensen, A

    1999-01-01

    Brain N-acetylaspartate (NAA) can be quantified by in vivo proton magnetic resonance spectroscopy (1H-MRS) and is used in clinical settings as a marker of neuronal density. It is, however, uncertain whether the change in brain NAA content in acute stroke is reliably measured by 1H-MRS and how NAA......]e increased linearly to 4 mmol/L after 3 hours and this level was maintained for the next 4 h. From the change in in vivo recovery of the interstitial space volume marker [14C]mannitol, the relative amount of NAA distributed in the interstitial space was calculated to be 0.2% of the total brain NAA during...... normal conditions and only 2 to 6% during ischemia. It was concluded that the majority of brain NAA is intracellularly located during ischemia despite large increases of interstitial [NAA]. Thus, MR quantification of NAA during acute ischemia reflects primarily changes in intracellular levels of NAA...

  18. Impact of obesity on long-term prognosis following acute myocardial infarction

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Hassager, Christian; Hildebrandt, Per

    2005-01-01

    OBJECTIVE: To evaluate the impact of obesity on mortality in patients with acute myocardial infarction. METHODS: This study comprises 6676 consecutive patients with acute myocardial infarction screened for entry into the Danish Trandolapril Cardiac Evaluation (TRACE) study. At baseline, body mass.......01)]. Increasing WHR in women showed a trend of increased mortality, although this was not significant [adjusted RR=1.13 (0.95-1.34, p=0.2)]. CONCLUSION: In patients with acute myocardial infarction overall obesity as assessed by body mass index is inversely related to mortality. However, abdominal obesity appears...

  19. Experimental reversal of acute coronary thrombotic occlusion and myocardial injury in animals utilizing streptokinase.

    Science.gov (United States)

    Lee, G; Giddens, J; Krieg, P; Dajee, A; Suzuki, M; Kozina, J A; Ikeda, R M; DeMaria, A N; Mason, D T

    1981-12-01

    Fresh autologous thrombus, 1.0 to 1.5 ml, was injected into the left anterior descending and/or left diagonal coronary arteries of 19 open-chest dogs to produce evolving acute myocardial infarction (AMI). Thrombotic obstruction was documented by coronary angiography. Multilead epicardial ECGs showed ST segment elevations of affected left ventricular (LV) areas within 2 minutes after thrombus injection, and LV segmental wall cyanosis with hypocontraction was observed within 10 minutes in the myocardial areas supplied by the thrombosed artery. Ten animals then received an initial dose of streptokinase (STK), 250,000 U (intravenous), followed by STK, 1000 to 3000 U/min (intracoronary), while nine control dogs untreated with STK received normal saline infusion. All but one STK-treated animal (all nine animals receiving intracoronary STK) had reestablishment of blood flow in the previously occluded vessels within 1 1/2 hours, disappearance of ventricular cyanosis, return of normal LV contractile function, and normalization of elevated ST segments within 1 hour after intracoronary STK therapy. In contrast, in the non-STK-treated control group, all animals had continued coronary obstruction, progressive ST elevations, and worsening LV cyanosis and hypocontraction until death or for more than 3 hours post thrombus; three control animals died of ventricular fibrillation (VF) within 1 hour of thrombus occlusion, three more died of VF within 2 hours post thrombus, and only three survived beyond 2 hours post thrombus. Postmortem examination of non-STK-treated animals revealed extensive residual coronary thrombus. All intracoronary STK-treated animals evidenced absence of residual coronary thrombus at postmortem examination. These data provide clinically relevant evidence that early intracoronary STK effects thrombolysis in AMI by reopening coronary vessels occluded by fresh thrombus, thereby protecting myocardium from further ischemia and necrosis, preserving LV function, and

  20. SPECT imaging of myocardial infarction using {sup 99m}Tc-labeled C2A domain of synaptotagmin I in a porcine ischemia-reperfusion model

    Energy Technology Data Exchange (ETDEWEB)

    Fang Wei [Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing 100037 (China); Wang Feng [Nuclear Medicine Department, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 210006 (China); Ji Shundong [Jiangsu Institute of Hematology, 1st Hospital of Suzhou University, Suzhou 215006 (China); Zhu Xiaoguang [Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, WI 53226 (United States); Meier, Heidi T. [Clinical Veterinarian and Radiology Research, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, WI 53295 (United States); Hellman, Robert S. [Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, WI 53226 (United States); Brindle, Kevin M. [MRC Laboratory of Molecular Biology, Cambridge CB2 2QH (United Kingdom); Davletov, Bazbek [Department of Biochemistry, University of Cambridge, Cambridge CB2 1GA (United Kingdom); Zhao Ming [Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, WI 53226 (United States)], E-mail: mzhao@mcw.edu

    2007-11-15

    Introduction: The C2A domain of synaptotagmin I recognizes necrotic and apoptotic cells by binding to exposed anionic phospholipids. The goal is to explore the potential imaging utility of {sup 99m}Tc-labeled C2A in the detection of acute cardiac cell death in a porcine model that resembles human cardiovascular physiology. Methods: Ischemia (20-25 min) was induced in pigs (M/F, 20-25 kg) using balloon angioplasty. {sup 99m}Tc-C2A-GST (n=7) or {sup 99m}Tc-BSA (n=2) was injected intravenously 1-2 h after reperfusion. Noninfarct animals were injected with {sup 99m}Tc-C2A-GST (n=4). SPECT images were acquired at 3 and 6 h postinjection. Cardiac tissues were analyzed to confirm the presence of cell death. Results: Focal uptake was detected in five out of seven subjects at 3 h and in all infarct subjects at 6 h postinjection but not in infarct animals injected with {sup 99m}Tc-BSA or in noninfarct animals with {sup 99m}Tc-C2A-GST. Gamma counting of infarct versus normal myocardium yielded a 10.2{+-}5.7-fold elevation in absolute radioactivity, with histologically confirmed infarction. Conclusions: We present data on imaging myocardial cell death in the acute phase of infarction in pigs. C2A holds promise and warrants further development as an infarct-avid molecular probe.

  1. Infarto agudo do miocárdio e morte súbita documentada Acute myocardial infarction and documented sudden death

    Directory of Open Access Journals (Sweden)

    Gustavo Carvalho

    2005-01-01

    Full Text Available Homem, sexagenário, deu entrada na emergência com dor torácica duvidosa e lipotímia. Investigado e estratificado, teve eletrocardiogramas e marcadores séricos de injúria miocárdica seriados negativos para isquemia miocárdica, e teste ergométrico sem critérios para isquemia miocárdica. Contudo, apresentou morte súbita presenciada dentro do hospital enquanto fazia uso da monitorização eletrocardiográfica contínua com o holter, que evidenciou, em seus traçados, infarto agudo do miocárdico complicado com arritmia ventricular complexa (taquicardia e fibrilação ventricular, que culminou em morte refratária às manobras de reanimação cardio-respiratória.A sexagenarian man sought the emergency unit complaining of dubious chest pain and lipothymia. He was investigated and stratified. His serial electrocardiograms and serum markers for myocardial injury were negative for myocardial ischemia, as was his exercise test. However, the patient died suddenly inside the hospital while under continuous electrocardiographic Holter monitoring, which evidenced acute myocardial infarction complicated by complex ventricular arrhythmia (ventricular tachycardia and fibrillation, which culminated in death refractory to the cardiopulmonary resuscitation maneuvers.

  2. The PI3K/Akt pathway mediates the protection of SO2 preconditioning against myocardial ischemia/reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Man-man ZHAO; Jin-yan YANG; Xin-bao WANG; Chao-shu TANG; Jun-bao DU; Hong-fang JIN

    2013-01-01

    Aim:To explore the mechanisms underlying the protection by SO2 preconditioning against rat myocardial ischemia/reperfusion (I/R)injury.Methods:Male Wistar rats underwent 30-min left coronary artery ligation followed by 120-min reperfusion.An S02 donor (1 μmol/kg)was intravenously injected 10 min before the ischemia,while LY294002 (0.3 mg/kg) was intravenously injected 30 min before the ischemia.Plasma activities of LDH and CK were measured with an automatic enzyme analyzer.Myocardial infarct size was detected using Evans-TTC method.The activities of caspase-3 and-9 in myocardium were assayed using a commercial kit,and the levels of p-Akt,Akt,P13K and p-P13K were examined with Western blotting.Results:Pretreatment with SO2 significantly reduced the myocardial infarct size and plasma LDH and CK activities,as well as myocardial caspase-3 and-9 activities in the rats.Furthermore,the pretreatment significantly increased the expression levels of myocardial p-Akt and p-PI3K p85.Administration of the PI3K inhibitor LY294002 blocked all the effects induced by SO2 pretreatment.Conclusion:The results suggest that the PI3K/Akt pathway mediates the protective effects of SO2 preconditioning against myocardial I/R injury in rats.

  3. Effect of small dose of EPO after PCI on cardiac function and myocardial injury in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Guo-Min Li

    2016-01-01

    Objective:To study the effect of small dose of erythropoietin (EPO) after PCI on cardiac function and myocardial injury in patients with acute myocardial infarction.Methods:A total of 86 patients with acute ST-elevation myocardial infarction who received percutaneous coronary intervention in our hospital from April 2012 to June 2015 were selected and randomly divided into EPO group and control group, serum was collected 1 week after operation to determine myocardial injury indexes, inflammation indexes, oxidative stress indexes and ventricular remodeling indexes, and color Doppler echocardiography was conducted 6 months after surgery to determine ventricular systolic and diastolic function indexes.Results:One week after operation, serum LDH, CK, CK-MB, cTnI, cTnT, sCD40L, E-selectin, P-selectin, sICAM-1, MDA, O2-, ox-LDL, PICP, CITP and PIIINP levels of EPO group were significantly lower than those of control group while GSH-Px and SOD levels were significantly higher than those of control group; 6 months after operation, LVEF of EPO group was significantly higher than that of control group while LVEDVI and LVESVI were significantly lower than those of control group.Conclusions:Small dose of EPO after PCI can alleviate myocardial damage, relieve inflammation and oxidative stress, and improve myocardial remodeling and cardiac diastolic and systolic function in patients with AMI.

  4. [Influence of treatment with metoprolol or enalapril on recovery of contractile function of the left ventricle in patients after acute myocardial infarction treated by thrombolytics].

    Science.gov (United States)

    Kosmala, W; Spring, A

    1999-08-01

    Regional left ventricular contractility caused by myocardial stunning as a result of transient ischemia and postreperfusion injury is a reversible state it can however persist even for several month. It seems reasonable to shorten this period as much as possible. The aim of the study was to estimate the influence of treatment with metoprolol or enalapril on the recovery of contractile function of left ventricle in patients after acute myocardial infarction treated thrombolytically. Investigations were carried out in 127 patients (mean age 62.3 +/- 11.9 years). Metoprolol was used in 37 patients in dose 0.02-0.05 g b.i.d., enalapril in 48 patients 0.0025-0.01 g b.i.d. 42 patients were not treated with any beta-blocker or ACE inhibitor. In all patients echocardiographic study was performed 3 times: on 2-3rd day following acute myocardial infarction immediately before introducing the treatment with metoprolol or enalapril, after 1 month and after 3 months. Echocardiographic study wall motion index (WMI) was calculated basing on. Significant decrease in WMI was observed after 1 month compared to its value on 2-3rd day acute myocardial infarction and after 3 months compared to 1 month after myocardial infarction in each of 3 subgroups of patients. No statistically significant differences in WMI were found out between studied subgroups. Neither metoprolol nor enalapril started on 2-3rd after thrombolytic treatment of acute myocardial infarction do not affect the recovery of contractile function of stunned myocardium.

  5. Calcium antagonistic effects of Bambusa Rigida investigated by 45Ca and its protection on myocardial ischemia of rats

    Institute of Scientific and Technical Information of China (English)

    LIN Rushan; YE Ling; YANG Yuanyou; LIAO Jiali; MO Shangwu; LIU Ning

    2008-01-01

    An investigation was conducted using 45Ca as a radioactive tracer to evaluate calcium antagonistic effects of several extracts from Bambusa Rigida in living rats. The relationship between the flavonoid and saccharide contents of Bambusa Rigida and calcium antagonistic effects were also analyzed. The protective effects of the alkali extracts ofBambusa Rigida on myocardial ischemia were investigated in living rats. The results indicated that the alkali extracts of Bambusa Rigida had a prominent influence on Ca2+ influx and efflux in the isolated rat aorta and heart, as they could obviously block 45Ca entering into cells and stimulate efflux of intracellular Ca2+. Moreover, the alkali extracts of Bambusa Rigida had favorable protective effects on myocardial ischemia induced either by isoproterenol injection (ISO) or by the ligation of coronary artery. These results implied that the Bambusa Rigida had attractive potential for the treatment of heart, cerebrovascular and other diseases. However, the conclusion that whether the flavonoid or saccharide in Bambusa Rigida affected the calcium antagonistic effects and Ca2+ channels or not was hard to make within the results of the investigation.

  6. Asymptomatic myocardial ischemia as a predictor of cardiac events after coronary artery bypass grafting for stable angina pectoris

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    Thirty-six patients with chronic stable angina were studied before and after coronary artery bypass grafting (CABG) to assess the prevalence and prognostic implications of asymptomatic myocardial ischemia obtained by ambulatory monitoring. Ambulatory monitoring performed during medical therapy be...... for angina pectoris in some patients, whereas angina did not occur during the follow-up period in others. This study does not reveal whether or not these patients are at higher risk for cardiac events during long-term follow-up.......Thirty-six patients with chronic stable angina were studied before and after coronary artery bypass grafting (CABG) to assess the prevalence and prognostic implications of asymptomatic myocardial ischemia obtained by ambulatory monitoring. Ambulatory monitoring performed during medical therapy...... to 39 episodes after CABG (41%, p less than 0.05). During a follow-up of 9 months, 8 cardiac events occurred: 6 in group 1 comprising sudden death (1), revascularization (2), and angina (3) and 2 in group 2, including revascularization (1) and angina (1) (p = 0.005). Kaplan-Meier analysis demonstrated...

  7. Protective effects of Ping-Lv-Mixture (PLM), a medicinal formula on arrhythmias induced by myocardial ischemia-reperfusion.

    Science.gov (United States)

    An, Wei; Yang, Jing

    2006-11-03

    Ping-Lv-Mixture (PLM) is a Chinese medicinal formula. The present study aimed to determine the effects of PLM on myocardial ischemia-reperfusion (MI/R) induced arrhythmias in rats. Arrhythmia model was established by occlusion of the left arterial descending coronary artery and thereafter reperfusion. A lead II electrocardiogram was monitored throughout the experiment. The results showed that pretreatment of PLM to MI/R rats significantly reduced the incidence and duration of ventricular tachycardia and ventricular fibrillation. On induction of MI/R, the activities of creatine kinase and lactate dehydrogenase were increased in vehicle group. PLM (0.04-1.00 g/kg) administration prevented the increase of these enzymes. Moreover, a significant increase of myocardium superoxide dismutase and decrease of malondialdehyde contents were observed in rats of PLM groups. On the other hand, the expressions of platelet activating factor (PAF) receptor mRNA was down-regulated in a dose-dependent manner in the PLM-treated groups by RT-PCR. Thus, it can be concluded that pretreatment with PLM inhibited lipid peroxidation in rats through suppressing the expression of PAF receptor, which may contribute to its preventive effect on myocardial ischemia-reperfusion induced arrhythmias.

  8. Real-Time 12-Lead High-Frequency QRS Electrocardiography for Enhanced Detection of Myocardial Ischemia and Coronary Artery Disease

    Science.gov (United States)

    Schlegel, Todd T.; Kulecz, Walter B.; DePalma, Jude L.; Feiveson, Alan H.; Wilson, John S.; Rahman, M. Atiar; Bungo, Michael W.

    2004-01-01

    Several studies have shown that diminution of the high-frequency (HF; 150-250 Hz) components present within the central portion of the QRS complex of an electrocardiogram (ECG) is a more sensitive indicator for the presence of myocardial ischemia than are changes in the ST segments of the conventional low-frequency ECG. However, until now, no device has been capable of displaying, in real time on a beat-to-beat basis, changes in these HF QRS ECG components in a continuously monitored patient. Although several software programs have been designed to acquire the HF components over the entire QRS interval, such programs have involved laborious off-line calculations and postprocessing, limiting their clinical utility. We describe a personal computer-based ECG software program developed recently at the National Aeronautics and Space Administration (NASA) that acquires, analyzes, and displays HF QRS components in each of the 12 conventional ECG leads in real time. The system also updates these signals and their related derived parameters in real time on a beat-to-beat basis for any chosen monitoring period and simultaneously displays the diagnostic information from the conventional (low-frequency) 12-lead ECG. The real-time NASA HF QRS ECG software is being evaluated currently in multiple clinical settings in North America. We describe its potential usefulness in the diagnosis of myocardial ischemia and coronary artery disease.

  9. Acute inferior myocardial infarction with right ventricular infarction is more prone to develop cardiogenic shock.

    Science.gov (United States)

    Bari, M A; Roy, A K; Islam, M Z; Aditya, G; Bhuiyan, A S

    2015-01-01

    Cardiogenic shock is rare in isolated acute inferior myocardial infarction but there is relationship of cardiogenic shock with inferior myocardial infarction if associated with right ventricular infarction. A prospective study was carried out to see the association of cardiogenic shock with inferior myocardial infarction if associated with right ventricular infarction. This study was conducted from January 2011 to November 2011. A total of 100 cases were selected as study population which was taken from the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Among them 50 were in Group A and 50 were in Group B. Group A was the patients of acute myocardial infarction with right ventricular infarction. Group B was the patients of acute myocardial infarction without right ventricular infarction. It revealed that 9(18%) in Group A and 3(6%) in Group B developed cardiogenic shock which is statistically significant (pcardiogenic shock.

  10. Global longitudinal strain predicts incident atrial fibrillation and stroke occurrence after acute myocardial infarction

    DEFF Research Database (Denmark)

    Olsen, Flemming Javier; Pedersen, Sune; Jensen, Jan Skov

    2016-01-01

    Patients with acute myocardial infarction are at increased risk of developing atrial fibrillation. We aimed to evaluate whether speckle tracking echocardiography improves risk stratification for atrial fibrillation in these patients.The study comprised of 373 patients with ST-segment elevation...... myocardial infarction (STEMI) treated with primary percutaneous coronary intervention. Patients had an echocardiogram performed at a median of 2 days after their STEMI. The echocardiograms consisted of conventional measurements and myocardial strain analysis by speckle tracking from 3 apical projections...

  11. Infarct healing is a dynamic process following acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Pokorney Sean D

    2012-09-01

    Full Text Available Abstract Background The role of infarct size on left ventricular (LV remodeling in heart failure after an acute ST-segment elevation myocardial infarction (STEMI is well recognized. Infarct size, as determined by cardiovascular magnetic resonance (CMR, decreases over time. The amount, rate, and duration of infarct healing are unknown. Methods A total of 66 patients were prospectively enrolled after reperfusion for an acute STEMI. Patients underwent a CMR evaluation within 1 week, 4 months, and 14 months after STEMI. Results Mean infarct sizes for the 66 patients at baseline (acute necrosis, early follow-up (early scar, and late follow-up (late scar were 25 ± 17 g, 17 ± 12 g, and 15 ± 11 g, respectively. Patients were stratified in tertiles, based on infarct size, with the largest infarcts having the greatest absolute