Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion

Abstract Mechanical unloading of the left ventricle reduces infarct size after acute myocardial infarction by reducing cardiac work. Left ventricular veno-occlusive unloading reduces cardiac work and may reduce ischemia and reperfusion injury. In a porcine model of myocardial ischemia–reperfusion in...

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Autores principales:	Esben Søvsø Szocska Hansen, Tobias Lynge Madsen, Gregory Wood, Asger Granfeldt, Nikolaj Bøgh, Bawer Jalal Tofig, Peter Agger, Jakob Lykke Lindhardt, Christian Bo Poulsen, Hans Erik Bøtker, Won Yong Kim
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Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1e4a139a230345a3b0ababf1aba60b3c
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spelling	oai:doaj.org-article:1e4a139a230345a3b0ababf1aba60b3c2021-12-02T15:53:58ZVeno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion10.1038/s41598-021-84025-y2045-2322https://doaj.org/article/1e4a139a230345a3b0ababf1aba60b3c2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84025-yhttps://doaj.org/toc/2045-2322Abstract Mechanical unloading of the left ventricle reduces infarct size after acute myocardial infarction by reducing cardiac work. Left ventricular veno-occlusive unloading reduces cardiac work and may reduce ischemia and reperfusion injury. In a porcine model of myocardial ischemia–reperfusion injury we randomized 18 pigs to either control or veno-occlusive unloading using a balloon engaged from the femoral vein into the inferior caval vein and inflated at onset of ischemia. Evans blue and 2,3,5-triphenyltetrazolium chloride were used to determine the myocardial area at risk and infarct size, respectively. Pressure–volume loops were recorded to calculate cardiac work, left ventricular (LV) volumes and ejection fraction. Veno-occlusive unloading reduced infarct size compared with controls (Unloading 13.9 ± 8.2% versus Control 22.4 ± 6.6%; p = 0.04). Unloading increased myocardial salvage (54.8 ± 23.4% vs 28.5 ± 14.0%; p = 0.02), while the area at risk was similar (28.4 ± 6.7% vs 27.4 ± 5.8%; p = 0.74). LV ejection fraction was preserved in the unloaded group, while the control group showed a reduced LV ejection fraction. Veno-occlusive unloading reduced myocardial infarct size and preserved LV ejection fraction in an experimental acute ischemia–reperfusion model. This proof-of-concept study demonstrated the potential of veno-occlusive unloading as an adjunctive cardioprotective therapy in patients undergoing revascularization for acute myocardial infarction.Esben Søvsø Szocska HansenTobias Lynge MadsenGregory WoodAsger GranfeldtNikolaj BøghBawer Jalal TofigPeter AggerJakob Lykke LindhardtChristian Bo PoulsenHans Erik BøtkerWon Yong KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Esben Søvsø Szocska Hansen Tobias Lynge Madsen Gregory Wood Asger Granfeldt Nikolaj Bøgh Bawer Jalal Tofig Peter Agger Jakob Lykke Lindhardt Christian Bo Poulsen Hans Erik Bøtker Won Yong Kim Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion
description	Abstract Mechanical unloading of the left ventricle reduces infarct size after acute myocardial infarction by reducing cardiac work. Left ventricular veno-occlusive unloading reduces cardiac work and may reduce ischemia and reperfusion injury. In a porcine model of myocardial ischemia–reperfusion injury we randomized 18 pigs to either control or veno-occlusive unloading using a balloon engaged from the femoral vein into the inferior caval vein and inflated at onset of ischemia. Evans blue and 2,3,5-triphenyltetrazolium chloride were used to determine the myocardial area at risk and infarct size, respectively. Pressure–volume loops were recorded to calculate cardiac work, left ventricular (LV) volumes and ejection fraction. Veno-occlusive unloading reduced infarct size compared with controls (Unloading 13.9 ± 8.2% versus Control 22.4 ± 6.6%; p = 0.04). Unloading increased myocardial salvage (54.8 ± 23.4% vs 28.5 ± 14.0%; p = 0.02), while the area at risk was similar (28.4 ± 6.7% vs 27.4 ± 5.8%; p = 0.74). LV ejection fraction was preserved in the unloaded group, while the control group showed a reduced LV ejection fraction. Veno-occlusive unloading reduced myocardial infarct size and preserved LV ejection fraction in an experimental acute ischemia–reperfusion model. This proof-of-concept study demonstrated the potential of veno-occlusive unloading as an adjunctive cardioprotective therapy in patients undergoing revascularization for acute myocardial infarction.
format	article
author	Esben Søvsø Szocska Hansen Tobias Lynge Madsen Gregory Wood Asger Granfeldt Nikolaj Bøgh Bawer Jalal Tofig Peter Agger Jakob Lykke Lindhardt Christian Bo Poulsen Hans Erik Bøtker Won Yong Kim
author_facet	Esben Søvsø Szocska Hansen Tobias Lynge Madsen Gregory Wood Asger Granfeldt Nikolaj Bøgh Bawer Jalal Tofig Peter Agger Jakob Lykke Lindhardt Christian Bo Poulsen Hans Erik Bøtker Won Yong Kim
author_sort	Esben Søvsø Szocska Hansen
title	Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion
title_short	Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion
title_full	Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion
title_fullStr	Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion
title_full_unstemmed	Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion
title_sort	veno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1e4a139a230345a3b0ababf1aba60b3c
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Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia–reperfusion

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