Recanalization Of Coronary Artery Research Articles

Long-pulsed ultrasound-mediated microbubble thrombolysis in a rat model of microvascular obstruction.

In up to 30% patients who experience acute myocardial infarction, successful recanalization of the epicardial coronary artery cannot provide adequate microvascular reperfusion. In this study, we sought to determine whether long-pulsed ultrasound (US)-mediated microbubble (MB) cavitation was useful for the treatment of microvascular obstruction, and the therapeutic effects were compared within different long-pulse-length and short-pulsed US. Microvascular obstruction model was established by injecting micro-thrombi into common iliac artery of a rat's hind limb. About 1 MHz US with different long pulse lengths (ranging from 100 to 50,000 cycles) was delivered, compared to short pulse (5 cycles). The control group was given MB only without therapeutic US. Contrast perfusion images were performed at baseline, emboli, and 1, 5, 10 min post-embolization, and peak plateau video intensity (A) was obtained to evaluate the therapeutic effects. Long-tone-burst US showed better thrombolytic effects than short-pulsed US (1,000, 5,000 cycles >500 cycles, >5 cycles, and control) (P < 0.01). 1,000 cycles group showed the optimal thrombolytic effect, but microvascular hemorrhage was observed in 50,000 cycles group. In conclusion, long-tone-burst US-enhanced MB therapy mediated successful thrombolysis and may offer a powerful approach for the treatment for microvascular obstruction within a certain pulse length.

Optical coherence tomography-assisted interventional treatment of a woven coronary artery: a case report

sBackgroundA woven coronary artery is a rare feature on coronary angiography. Distinguishing woven-like change and recanalization of an occluded artery is difficult.Case presentationA 59-year-old man was admitted to the hospital for chest tightness. Coronary angiography showed a woven coronary artery at the middle segment of the left anterior descending branch (LAD). The middle segment of the right coronary artery (RCA) exhibited 99% occlusion. A 3.5 × 26-mm drug-eluting stent was implanted in the middle segment of the RCA. One week later, we examined the LAD using optical coherence tomography (OCT). Considering the patient’s medical history and the results of OCT, a 2.7 × 38-mm drug-eluting stent was inserted into the LAD. Re-examination by OCT indicated that the stent was well attached to the wall, with no dissection at the edge of the stent. Antiplatelet therapy and statin-based plaque stabilization were continued. No obvious abnormality was found during follow-up one year later.ConclusionsOCT can help distinguish woven-like change and recanalization of an occluded coronary artery. The evaluation and formulation of treatment strategies for a woven coronary artery are important.

MiR-375-3p Promotes Cardiac Fibrosis by Regulating the Ferroptosis Mediated by GPX4.

Although coronary artery recanalization after myocardial infarction improves patient outcomes, inadequate ventricular remodeling following ischemia-reperfusion (IR) injury and secondary cardiac fibrosis (CF) are common and can lead to heart failure. MicroRNAs (miRNAs) play an important role in cardiovascular disorders. However, the underlying molecular mechanism of miRNAs in the occurrence and progression of CF has not been fully elucidated. Herein, through the construction of an I/R rat model and an angiotensin II-induced CF cell model, we evaluated the role of miR-375-3p in the progression of CF. In the I/R rat model and CF cell model, miR-375-3p promoted fibrosis by accelerating the ferroptosis of cardiomyocytes through mediating glutathione peroxidase 4 (GPX4). Furthermore, we treated the rats or cell model with miR-375-3p antagomir (or inhibitor) and ferroptosis inhibitor Ferrostatin-1 (Fer-1). The results showed that miR-375-3p antagomir (or inhibitor) and Fer-1 promoted the antioxidant capacity of cardiac fibroblasts, reduced GPX4-mediated ferroptosis process and alleviated I/R-induced CF. In conclusion, this study revealed that miR-375-3p directly targeted GPX4—an inhibitor of the ferroptosis pathway. Meanwhile, miR-375-3p can be a new potential biomarker for the prevention and treatment of CF.

TCTAP C-139 Successful Bailout From Blow-Out Bleeding From Descending Branch of Left Lateral Circumflex Femoral Artery by Balloon Inflation via Trans-Radial R2P System and Polytetrafluoroethylene-Covered Viabahn Stent Placement via Ipsilateral RIKISHI, a Side-grooved Guiding Sheath, System After Successful Recanalization of Left Main Coronary Artery in a Patient With Post-cardiac Arrest Syndrome Under PCPS Support

TCTAP C-139 Successful Bailout From Blow-Out Bleeding From Descending Branch of Left Lateral Circumflex Femoral Artery by Balloon Inflation via Trans-Radial R2P System and Polytetrafluoroethylene-Covered Viabahn Stent Placement via Ipsilateral RIKISHI, a Side-grooved Guiding Sheath, System After Successful Recanalization of Left Main Coronary Artery in a Patient With Post-cardiac Arrest Syndrome Under PCPS Support

Periprocedural Plasma Fibrinogen level and Clinical Outcome of Coronary Stent Implantation

Coronary artery disease (CAD) is the leading cause of mortality and morbidity both in developed and developing countries. Percutaneous recanalization of occluded coronary artery is one of the treatment options and reinfarction and restenosis negatively affect the outcome following procedure. Although various factors including fibrinogen are suspected as risk factors for this but its role in adverse outcome after stent implantation is controversial. The aim of this study was to determine the impact &amp; relation of periprocedural fibrinogen level on outcome after coronary stent implantation. This prospective study was conducted in the Department of Cardiology, University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University (BSMMU), Hospital, Dhaka over a period of one year between July 2016 to June 2017. Total 53 patients of chronic stable angina (CSA) undergoing elective PTCA followed by stenting were included in this study as per inclusion and exclusion criteria. Plasma fibrinogen level was measured by collecting venous blood samples at three timed points in relation to stenting – 24 h before, 24 h after and 72 h after stenting. Recurrence of angina, myocardial infarction, repeat revascularization (either PCI or Cardiac surgery), and death were considered as adverse outcome during follow up at 1, 3 and 6 months after intervention. During the 6 months follow up period 1 (one) patient developed UA (at 1 month), 2 developed MI (1 at 3 month and 1 at 6 month) and 2 died (1 at 3 month and 1 at 6 month). Patients were grouped on the basis of four outcomes: favorable outcome (those who did not develop any of the four outcomes) and unfavorable or adverse outcome (those who developed any of the four outcomes). The mean age of study population was 53.92 years and 39 (73.6%) were male. Regarding cardiovascular risk factors, 43.4% patients had diabetes mellitus, 88.6% had dyslipidaemia, 56.6% were non-smokers. Baseline plasma fibrinogen level were significantly higher in patients who developed complications following PCI than those who did not develop the complications (394.4 ± 16.0 Vs 271.5 ± 21.8 mg/dl) &amp; remained high after 24 hours and 72 hours following PCI (p &lt; 0.001). Angiographic profiles of the study population reveals 84.9% LAD, 16.9% RCA &amp; 15% LCX involvement but there was no association of post-PCI adverse outcomes with vessels involved, number of stents deployed and types of stents used (p &gt; 0.05). Study showed that the risk of developing unfavorable outcome following PCI in patients with pre-PCI &amp; post-PCI high serum fibrinogen was estimated to be 5.7 times &amp; 12 times higher than those who have had serum fibrinogen lower than 350 mg/ dl respectively (p = 0.023 &amp; 0.025 respectively). High serum fibrinogen can therefore be used as a marker for predicting adverse outcome following PCI.&#x0D; University Heart Journal Vol. 17, No. 2, Jul 2021; 122-127

Long-Term Angiographic Results of Recanalization of Small Diameter Coronary Arteries in Patients with Coronary Heart Disease

One of the most serious problems of modern times are cardiovascular diseases, and these are the leading cause of death worldwide. The main contribution to the structure thereof belongs to coronary heart disease (CHD) which has become the greatest threat to the health of the population all over the world.&#x0D; The aim. To study the results of endovascular procedures in revascularization of small diameter coronary arteries.&#x0D; Materials and methods. The study included 417 patients aged 59 to 78 years with a mean diameter of the true in-ternal lumen of the arteries of 2.75±0.016 mm who underwent revascularization of the myocardium through stenting or percutaneous transluminal balloon coronary angioplasty (PTCA).&#x0D; In patients undergoing stenting of coronary artery (N=269), the mean diameter of the true internal lumen of the arteries was 2.68±0.03 mm. In the group of patients who underwent PTCA (N=148), this indicator was found to be 2.61±0.09 mm. The average degree of stenosis was 81.3±4.07%. The length of the artery stenosis was 12.4±0.71 mm.&#x0D; All the patients had the history of Q wave myocardial infarction (MI) more than 3 months ago, which made it possible to diagnose postinfarction cardiosclerosis. Ischemic history of more than 5 years was noted in 46 patients of this group (11.03% of cases), up to one year in 221 patients (70.2% of cases), from 1 to 2 years in 41 patients (9.83% cases), and 3 to 4 years in 38 people (9.11% of cases).&#x0D; Results and discussion. As a result of the studies, it was found that in patients with eccentric type of stenosis who used balloon angioplasty, restenosis in the remote postoperative period was 21% more frequent compared to a similar contingent of patients with implanted stents. In addition, restenosis of the stenosed area of the coronary artery &gt; 1.5 mm in the distant period was 14.9% more common when PTCA was performed. And the frequency of remote restenosis (with complex morphology of initial damage of the arteries) in the stenting group was 14.2% lower than in the group of PTCA. Additionally, in the group of patients who underwent stenting, neoatherosclerosis in the treated segment was found in 92 patients (34.2 %). Patients with PTCA had a less progress of atherosclerosis (44 patients 29.72%)&#x0D; Conclusions. Restenosis in the remote postoperative period was 25.4 % less frequent in patients with eccentric ste-nosis who underwent stenting than in patients with balloon angioplasty. At the same time, restenosis of the stenosed area of CA &gt;15 mm in the distant period was 10.43% more frequent during PTCA. In the coronary angioplasty group, patients with complicated morphology of basal damage of arteries had a 21.67% higher incidence of restenosis than in the coro-nary stenting group. Thus, we plan to carry out further study and analysis of immediate and long-term results of X-ray and endovascular operations in patients with coronary artery disease and small coronary artery diameter.

Algorithm for Recanalization of Chronic Totally Occluded (CTO) Native Coronary Arteries Through a Diseased or Occluded Saphenous Vein Graft in Post Bypass Patients.

Chronic total occlusion (CTO) desobstruction of a native coronary artery in a post coronary artery bypass graft (CABG) patient can be a challenging procedure. In principle, the 3 basic approaches of recanalization of occluded native coronary arteries can be used: antegrade wire escalation (AWE), antegrade dissection re-entry (ADR) and a retrograde technique. On the other hand, a previous implanted saphenous vein graft (SVG) – even when occluded – can be used as a conduit for retrograde access. Moreover, access through a graft might be less complex compared to the use of septal or epicardial collaterals. If the graft is still open or has a tapered stump, this should be considered as a suitable conduit. Literature on recanalization of occluded native coronary arteries trough a diseased or occluded SVG is limited. A flowchart with an algorithm in post CABG patients is proposed and illustrated by 3 clinical cases.

Ендотеліальна дисфункція та шляхи її профілактики при проведенні рентгенендоваскулярних процедур по реканалізації коронарних артерій

Ендотеліальна дисфункція та шляхи її профілактики при проведенні рентгенендоваскулярних процедур по реканалізації коронарних артерій

MicroRNA-374a protects against myocardial ischemia-reperfusion injury in mice by targeting the MAPK6 pathway

AimsClinical treatment strategies for patients with myocardial ischemia typically include coronary artery recanalization to restore myocardial blood supply. However, myocardial reperfusion insult often induces oxidative stress and inflammation, which further leads to apoptosis and necrosis of myocardial cells. Increasing evidence suggests that microRNAs (miRNAs) participate in the pathological and physiological processes associated with myocardial ischemia reperfusion. Main methodsIn this study, we established a myocardial H/R H9C2 cell model and a mouse I/R model to detect molecules implicated in myocardial I/R regulation and to determine the underlying signal transduction pathways. Key findingsHerein, we showed that the expression of miR-374a-5p decreased in a myocardial cell model (H9C2 cells) of hypoxia/reoxygenation (H/R) and mouse model of ischemia/reperfusion (I/R). Alternatively, overexpression of miR-374a-5p was found to ameliorate myocardial cell damage within both in vivo and in vitro models of ischemia. Further, mitogen-activated protein kinase 6 (MAPK6) was identified as a direct target of miR-374a-5p. Thus, by targeting MAPK6, miR-374a-5p was found to negatively regulate MAPK6 expression. However, up-regulation of MAPK6 functioned to inhibit the previously observed protective effect of miR-374a-5p in the H9C2 H/R model. SignificanceTaken together, our study suggests that miR-374a-5p may have protective effects against cardiac I/R injury in vivo, and H/R injury in vitro, thereby providing novel insights into the molecular mechanisms associated with ischemia/reperfusion injury and a potential novel therapeutic target.

Risk factors for complications during recanalization of chronic coronary artery occlusions in patients with coronary artery disease

The aim — to analyze the risk factors for periprocedural complications during recanalization of chronic coronary artery (CA) occlusions in patients with coronary artery disease.Materials and methods. The study included 365 patients with chronic of CA occlusions, which, on the basis of X‑ray angiography department of M. M. Amosov National Institute of Cardiovascular Surgery of National Academy of Medical Sciences of Ukraine underwent diagnostic and therapeutic intervention procedures for this pathology. The patients’ age was from 62 to 73 years old (average age — 66.96 ± 1.81 years). Occlusions were localized mainly in the proximal (167 (45.8 %) cases) and middle (198 (54.2 %) CA segments. The duration of occlusion was determined from the time of myocardial infarction in the infarct‑related CA pool. Occlusion duration from 3 to 6 months was recorded in 98 (26.8 %) patients, from 6 to 12 months — in 137 (37.5 %) patients, from 1 to 3 years — in 130 (35.6 %) patients. Chronic occlusion of one CA was detected in 93 (25.5 %) persons, two CA — in 127 (34.79 %) persons, three CA — in 56 (15.3 %) persons. In 89 (24.38 %) patients, multiple atherosclerotic lesions of the coronary bed were diagnosed. Mean number of affected CA in one patient was 2.17 ± 0.34.Results and discussion. Out of 235 patients with the term of occlusion up to 1 year, a good angiographic result was achieved in 87.2 %, out of 130 persons with occlusion duration of 1— 3 years — in 72.3 %. The average number of implanted stents was 2.12 ± 0.3 per one patient. 51 (13.97 %) patients had periprocedural complications. The development of «big» complications of X‑ray endovascular coronary interventions for chronic occlusion of CA was statistically significantly influenced by the patient’s age and smoking (p &lt; 0.05), the probability of developing «small» periprocedural complications — by body mass index and diabetes.Conclusions. Risk factors for the development of «big» complications are femoral access, the duration of the procedure and fluoroscopy, the amount of contrast material used during the procedure.

Repeat stent implementation for recanalization of the proximal right coronary artery: a case report

BackgroundA stent in a false lumen is a common cause of stent occlusion after coronary percutaneous coronary artery intervention therapy, particularly in the culprit lesion of acute myocardial infarction. Here, we present an unusual case of successful recanalization of the proximal right coronary artery with implementation of another stent to crush the previous stent in the false lumen.Case presentationA 40-year-old Chinese man underwent coronary stent implementation in the proximal right coronary artery due to acute inferior wall myocardial infarction at another hospital. Six months later, he underwent coronary angiography re-examination for recurrent symptomatic angina at our hospital. Coronary angiography and intravascular ultrasound confirmed that the previous stent was deployed in the false lumen of the right coronary artery. Then, intravascular ultrasound was used to guide the wire to re-enter the true lumen of the proximal right coronary artery, and another stent was deployed into the true lumen to crush the previous stent.ConclusionIntravascular ultrasound proved to be a pivotal tool in confirming false or true lumen, as well as determining favorable proximal site entry points to avoid rewiring the mesh of the previous stent.

Deletion of Extra Domain A of Fibronectin Reduces Acute Myocardial Ischaemia/Reperfusion Injury in Hyperlipidaemic Mice by Limiting Thrombo-Inflammation

Fibronectin splicing variant containing extra domain A (Fn-EDA), which is an endogenous ligand for Toll-like receptor 4 (TLR4), is present in negligible amounts in the plasma of healthy humans, but markedly elevated in patients with co-morbid conditions including diabetes and hyperlipidaemia, which are risk factors for myocardial infarction (MI). Very little is known about the role of Fn-EDA in the pathophysiology of acute MI under these co-morbid conditions. We determined the role of Fn-EDA in myocardial ischaemia/reperfusion (I/R) injury in the hyperlipidaemic apolipoprotein E-deficient (ApoE-/-) mice. Infarct size, plasma cardiac troponin I (cTnI) levels, intravascular thrombosis (CD41-positive), neutrophil infiltration (Ly6 B.2-positive), neutrophil extracellular traps (citrullinated H3-positive) and myocyte apoptosis (terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling-positive) were assessed in myocardial I/R injury model (1-hour ischaemia/23 hours of reperfusion). Irrespective of gender, Fn-EDA-/-ApoE-/- mice exhibited smaller infarct size and decreased cTnI levels concomitant with reduced post-ischaemic intra-vascular thrombi, neutrophils influx, neutrophil extracellular traps and myocyte apoptosis (p < 0.05 vs. ApoE-/- mice). Genetic deletion of TLR4 attenuated myocardial I/R injury in ApoE-/- mice (p < 0.05 vs. ApoE-/- mice), but did not further reduce in Fn-EDA-/- ApoE-/- mice suggesting that Fn-EDA requires TLR4 to mediate myocardial I/R injury. Bone marrow transplantation experiments revealed that Fn-EDA exacerbates myocardial I/R injury through TLR4 expressed on the haematopoietic cells. Infusion of a specific inhibitor of Fn-EDA, 15 minutes post-reperfusion, into ApoE-/- mice attenuated myocardial I/R injury. Fn-EDA exacerbates TLR4-dependent myocardial I/R injury by promoting post-ischaemic thrombo-inflammatory response. Targeting Fn-EDA may reduce cardiac damage following coronary artery re-canalization after acute MI.

Фармакологические подходы к ограничению размера инфаркта у пациентов с острым инфарктом миокарда. Анализ клинических данных

Антагонисты β-адренорецепторов ограничивают размер зоны инфаркта, снижают риск возникновения фибрилляции желудочков и внезапной сердечной смерти в отдаленные сроки после перенесённого острого инфаркта миокарда (ОИМ), однако они не влияют на госпитальную смертность. Перспективным препаратом для ограничения инфаркта миокарда является левосимендан. Ингибиторы Na+/H+-обмена увеличивают летальность при коронарном шунтировании, а их эффективность при ОИМ сомнительна. Циклоспорин не влияет на частоту неблагоприятных событий при ОИМ. Антагонист пуриновых P2Y12 рецепторов клопидогрел оказывает инфаркт-лимитирующий эффект у пациентов с ОИМ, но не влияет на показатели смертности этих пациентов. Аторвастатин не влияет на функцию левого желудочка и размер инфаркта у пациентов с ОИМ. Аденозин при внутривенном введении оказывает инфаркт-лимитирующий эффект и уменьшает проявления феномена no-reflow. Инфаркт-лимитирующий эффект триметазидина сомнителен. Указанные препараты оказывали кардиопротекторные эффекты только в том случае, если их применяли до реканализации инфаркт-связанной коронарной артерии. Все перечисленные препараты не влияют на показатели госпитальной смертности пациентов с ОИМ.

Factor XI contributes to myocardial ischemia-reperfusion injury in mice

Key Points Inhibiting contact activation of factor XI during reperfusion of acute myocardial ischemia reduces infarct size in mice. Factor XII/XI contact axis inhibition may improve the outcome of coronary artery recanalization in acute myocardial infarction.

Віддалені клініко-ангіографічні результати реканалізації коронарних артерій малого діаметру у пацієнтів з ішемічною хворобою серця

Віддалені клініко-ангіографічні результати реканалізації коронарних артерій малого діаметру у пацієнтів з ішемічною хворобою серця

A New Secretory Peptide of Natriuretic Peptide Family, Osteocrin, Suppresses the Progression of Congestive Heart Failure After Myocardial Infarction.

An increase of severe ischemic heart diseases results in an increase of the patients with congestive heart failure (CHF). Therefore, new therapies are expected in addition to recanalization of coronary arteries. Previous clinical trials using natriuretic peptides (NPs) prove the improvement of CHF by NPs. We aimed at investigating whether OSTN (osteocrin) peptide potentially functioning as an NPR (NP clearance receptor) 3-blocking peptide can be used as a new therapeutic peptide for treating CHF after myocardial infarction (MI) using animal models. We examined the effect of OSTN on circulation using 2 mouse models; the continuous intravenous infusion of OSTN after MI and the OSTN-transgenic (Tg) mice with MI. In vitro studies revealed that OSTN competitively bound to NPR3 with atrial NP. In both OSTN-continuous intravenous infusion model and OSTN-Tg model, acute inflammation within the first week after MI was reduced. Moreover, both models showed the improvement of prognosis at 28 days after MI by OSTN. Consistent with the in vitro study binding of OSTN to NPR3, the OSTN-Tg exhibited an increased plasma atrial NP and C-type NP, which might result in the improvement of CHF after MI as indicated by the reduced weight of hearts and lungs and by the reduced fibrosis. OSTN might suppress the worsening of CHF after MI by inhibiting clearance of NP family peptides.

Influence about the flow of distal branch after intervention of the right coronary artery chronic total occlusion.

Limited data are available for the clinical outcomes after the recanalization of right coronary artery (RCA) chronic total occlusion (CTO). The study aims to assess the clinical outcomes in the antegrade flow of the distal branch after successful RCA CTO percutaneous coronary intervention (PCI). Between January 2002 and December 2012, 538 patients who underwent RCA CTO PCI were enrolled. The clinical outcomes as myocardial infarction (MI), target vessel revascularization, cardiac death, major adverse cardiac events, and all-cause mortality, were compared to the antegrade flow of distal branch after successful RCA CTO PCI. The CTOs were located in proximal segments (57.6%), mid segments (27.5%) and distal segments (14.9%). The average Syntax score was 18.4±9.6 and 47.8% patients had a Syntax score greater than 27.5. A total of 62.8% patients had final thrombolysis of myocardial infarction (TIMI)-3 flow of distal branch, 16.9% patients had final TIMI-3 flow of only one major branch, 11.3% patients had TIMI-1-2 flow, and 8.9% patients had no antegrade flow. The incidence of periprocedural MI was lower in both side branches were preserved (13.9% vs. 23.0% and 18.8%, p=0.01). The clinical outcomes were similar between the groups with and without good antegrade flow of distal side branch. End stage renal disease (ESRD) and left ventricular ejection fraction (LVEF) <40% predicted three-year cardiac death. There is no significant difference of clinical outcomes when distal side branches of RCA are recanalized successfully. ESRD and LVEF <40% were the predictors for three-year cardiac death.

Влияние цитофлавина на параметры систолической функции левого желудочка у больных острым инфарктом миокарда

Изучали влияние цитофлавина на параметры систолической функции левого желудочка при остром инфаркте миокарда. На фоне стандартной терапии 46 больных получали препарат цитофлавин (ООО НТФФ «ПОЛИСАН», Санкт-Петербург, Россия) внутривенно капельно 20 мл раствора, разведенного в 250 мл 5 % раствора глюкозы, 1 раз в сутки за 30 мин до реканализации коронарной артерии (КА); 60 пациентов (контрольная группа) получали только стандартную терапию. Эффективность препарата оценивали по показателям систолической функции левого желудочка: фракции выброса, конечному диастолическому объему, конечному систолическому объему. Введение пациентам цитофлавина способствовало увеличению фракции выброса левого желудочка на 7,9 % в сравнении с аналогичным показателем у пациентов контрольной группы, снижению конечного диастолического и конечного систолического объема левого желудочка на 10,6 и 17,9 %, соответственно, на 7 сут госпитализации (p ≤ 0,05). Дополнение стандартной терапии цитофлавином достоверно снижало уровень тропонина I плазмы крови у больных острым инфарктом миокарда на 7 сут на 81 % относительно контроля, активность креатинфосфокиназы плазмы крови – на 35 % (p ≤ 0,05). Включение цитофлавина в схему лечения больных острым инфарктом миокарда следует считать патогенетически обоснованным, клинически оправданным и перспективным.

Humanin exerts cardioprotection against cardiac ischemia/reperfusion injury through attenuation of mitochondrial dysfunction

Myocardial reperfusion via the re-canalization of occluded coronary arteries is gold standard for the treatment of acute myocardial infarction. However, reperfusion itself can cause myocardial damage due to increased reactive oxygen species (ROS) production, a process known as ischemia/reperfusion (I/R) injury. Cardiac mitochondria are the major organelle of ROS production in the heart. Cardiac mitochondrial dysfunction caused by an increased ROS production can increase cardiac arrhythmia incidence, myocardial infarct size, and cardiac dysfunction. Thus, preservation of cardiac mitochondrial function is a promising pharmacological approach to reduce cardiac I/R injury. Humanin (HN), a newly discovered 24-amino acid polypeptide, has been shown to exert antioxidative stress and antiapoptotic effects. Although the cardioprotective effects of HN against I/R injury has been reported, the effect of HN on cardiac mitochondrial function has not yet been investigated. Thus, we tested the hypothesis that HN exerts its cardioprotective effects against I/R injury through the attenuation of cardiac mitochondrial dysfunction. I/R protocol was carried out using a 30-minutes occlusion of a left anterior descending coronary artery followed by a 120-minutes of reperfusion. The plasma HN level, infarct size, arrhythmia incidence, left ventricular function, and cardiac mitochondrial function were determined. Endogenous HN level before I/R injury showed no difference between groups, but was markedly decreased after I/R injury. HN analogue pretreatment decreased arrhythmia incidence and infarct size, improved cardiac mitochondrial function, and attenuated cardiac dysfunction. Humanin analogue pretreatment exerted cardioprotective effects against I/R injury through the attenuation of cardiac mitochondrial dysfunction.

Ultrasound and Microbubbles for Coronary Artery Recanalization in Acute Myocardial Infarction

Ultrasound and Microbubbles for Coronary Artery Recanalization in Acute Myocardial Infarction