30 results on '"Acute myocardial ischemia"'
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2. Effects of electroacupuncture of acupoints of the neiguan and ximen on ischemic myocardium energy metabolism with acute myocardial ischemia rats
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Jing Zhou
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myocardial energy metabolism ,Medicine ,acute myocardial ischemia ,acupuncture - Abstract
Objective: To observe the effect of Electroacupuncture of Acupoints of the Neiguan(PC6) and Ximen(PC4) on its myocardial energy metabolism with acute myocardial ischemia rats caused by coronary artery ligation. Methods: Forty standard Spargue-Dawely(SD) rats were divided into four groups randomly, namely, group of Neiguan, group of Ximen, model group, sham group. The group of rats of myocardial ischemia were induced by coronary ligation, and the model rat of acute myocardial ischemia was prepared. The sham group had no ligation of the needle. After anesthesia was awakened, acupuncture was applied bilateral at Neiguan and Ximen of the group of Neiguan and Ximen, once a day at a fixed time for 14 days. The rats of model group and the sham group were not given acupunctured, but use the samely methods of Neiguan and Ximen groups to grap the rats at the same time everyday .After 14 days the experiment was over,observed the pathological changes of myocardial tissue by HE staining, detected the levels of free fatty acid (FFA), adenosine triphosphate (ATP) content, and the activities of Na+-K+-ATPase according to the reagents´demand. Results: Pathological results showed that acupuncuted at Neiguan and Ximen could improve the ischemic cardiomyocyte injury.Compared with the sham group, the levels of FFA in model group were increased (p more...
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- 2021
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3. Extensive mitochondrial proteome disturbance occurs during the early stages of acute myocardial ischemia
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Fangjing Xu, Ru Yan, Yucheng Fan, Ruhua He, Jie Wang, Qian Liu, and Jun He
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Cancer Research ,Disturbance (geology) ,Oncogene ,proteome ,Cell ,myocardial remodeling ,Cancer ,Articles ,General Medicine ,Biology ,Cell cycle ,medicine.disease ,Molecular medicine ,mitochondria ,medicine.anatomical_structure ,Immunology and Microbiology (miscellaneous) ,Apoptosis ,medicine ,Cancer research ,liquid chromatography-tandem mass spectrometry ,acute myocardial ischemia ,Gene - Abstract
Mitochondrial malfunction leads to the remodeling of myocardial energy metabolism during myocardial ischemia (MI). However, the alterations to the mitochondrial proteome profile during this period has not yet been clarified. An acute MI model was established by high position ligation of the left anterior descending artery in 8-week-old C57BL/6N mice. After 15 min of ligation, the animals were euthanized, and their hearts were collected. The myocardial ultrastructure was observed using transmission electron microscopy (TEM). The cardiac mitochondrial proteome profile was analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and bioinformatics analyses. TEM showed that the outer membrane of the mitochondria was dissolved, and the inner membrane (cristae) was corrupted and broken down extensively in the MI group. The mitochondrial membrane potential was decreased. More than 1,700 mitochondrial proteins were identified by LC-MS/MS analysis, and 119 were differentially expressed. Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes functional enrichment analysis showed that endopeptidase activity regulation, the mitochondrial inner membrane, oxidative phosphorylation, the hypoxia-inducible factor-1 signaling pathway, the pentose phosphate pathway and the peroxisome proliferator-activated receptor signaling pathway were involved in the pathophysiological process in the early stage of acute MI. Extensive and substantial changes in the mitochondrial proteins as well as mitochondrial microstructural damage occur in the early stages of acute MI. In the present study, the series of proteins crucially involved in the pathways of mitochondrial dysfunction and metabolism were identified. Further studies are needed to clarify the roles of these proteins in myocardial metabolism remodeling during acute MI injury. more...
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- 2021
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4. Contribution to the improvement of electrical therapies and to the comprehension of electrophysiological mechanisms in heart failure and acute ischemia using computational simulation
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Carpio Garay and Edison Fernando
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medicine.medical_specialty ,Acute myocardial ischemia ,medicine.medical_treatment ,Perforation (oil well) ,Terapia de resincronización cardíaca (TRC) ,Cardiac resynchronization therapy ,Ischemia ,Cardiomyopathy ,Fibras de Purkinje ,Heart failure ,Purkinje system ,Sudden cardiac death ,Isquemia aguda ,TECNOLOGIA ELECTRONICA ,Bloqueo de rama izquierda ,QRS complex ,Ventricular arrhythmias ,Modelo matematico ,Internal medicine ,medicine ,cardiovascular diseases ,Simulación computacional ,Left bundle branch block ,business.industry ,medicine.disease ,cardiovascular system ,Cardiology ,Computational simulation ,Mathematical modeling ,Isquemia miocárdica ,business ,Insuficiencia cardiaca - Abstract
[ES] Una mejor comprensión de los mecanismos subyacentes a las arritmias ventriculares, así como una mejora de las terapias eléctricas y farmacológicas asociadas, son un factor clave para prevenir la muerte súbita cardíaca en pacientes con cardiopatías estructurales y eléctricas. Una miocardiopatía importante que puede provocar arritmias ventriculares potencialmente mortales es la insuficiencia cardíaca (HF). Los pacientes con HF a menudo sufren también de bloqueo de rama izquierda (LBBB) que deteriora su condición. Actualmente, el tratamiento más eficaz para estos pacientes es la terapia de resincronización cardíaca (CRT). Sin embargo, no se alcanza una respuesta positiva en todos los casos, por lo que es necesario un mayor estudio para mejorar este tratamiento. Una segunda patología cardíaca que también produce arritmias letales es la isquemia miocárdica. Evidencia experimental ha demostrado que las alteraciones electrofisiológicas en el miocardio ventricular constituyen un sustrato para la generación de arritmias durante la fase aguda de isquemia. Estas alteraciones son inducidas por los tres componentes isquémicos principales: hipercalemia, hipoxia y acidosis. Sin embargo, la influencia de cada componente en los mecanismos de inicio y mantenimiento de las arritmias no se comprende aún con claridad. Una primera parte de esta tesis doctoral, se centra en la optimización de la CRT durante su aplicación en un corazón que padece HF y LBBB. Para esto, se modificó el modelo de potencial de acción (AP) de O'Hara para simular una velocidad de conducción realista tanto en condiciones sanas como patológicas. Además, se estimó e incorporó un sistema de His-Purkinje (HPS) dentro de un modelo biventricular/torso humano 3D para simular un LBBB realista. A continuación, se desarrolló un conjunto de simulaciones computacionales para diferentes configuraciones de la CRT a fin de determinar la posición y el instante de estimulación óptimo que conducen a la duración más corta del QRS. Posteriormente, los resultados se compararon con otros criterios de optimización. Los principales hallazgos de este estudio mostraron la necesidad de definir criterios de optimización mejores o complementarios, como un índice basado en el tiempo hasta alcanzar el 90% del área del QRS sugerido en este trabajo, para alcanzar la mejor sincronía eléctrica ventricular durante la aplicación de la CRT. Además, nuestros resultados también muestran que el septo superior cercano al tracto de salida es un sitio alternativo para la estimulación del ventrículo derecho, lo cual evita los problemas de perforación de la pared apical durante el procedimiento típico de la CRT. Por último, para obtener mejores resultados de la CRT se deben considerar protocolos de estimulación endocárdica en el ventrículo izquierdo. En la segunda parte de esta tesis se investigó los efectos de los tres componentes principales de la isquemia sobre la vulnerabilidad a una reentrada, así como el papel del HPS y sus mecanismos de acción en la generación y mantenimiento de arritmias ventriculares. Para lograr este objetivo, en primer lugar, se modificó el modelo AP ventricular para simular de forma realista las principales alteraciones provocadas por la isquemia miocárdica aguda. Las simulaciones se realizaron en un modelo biventricular humano 3D, acoplado en un torso virtual, que incluye una geometría realista de las zonas isquémicas central y de borde, así como un HPS detallado. Se simularon cuatro escenarios de severidad isquémica correspondientes a diferentes minutos de oclusión de la arteria coronaria para evaluar los efectos de la evolución de la isquemia en el tiempo. Luego, se evaluó la influencia individual de la hipercalemia, hipoxia y acidosis en el ancho de la ventana vulnerable (VW) a reentradas durante siete escenarios de isquemia aguda. Finalmente, se repitió este último conjunto de simulaciones isquémicas utilizando el modelo anatómico sin el HPS para evaluar el efecto de este último en la VW. Los resultados muestran que una condición isquémica moderada es el peor escenario para la generación de una reentrada. La hipoxia es el componente isquémico con el efecto más significativo en el ancho de la VW. Además, el flujo de corriente retrógrado desde el miocardio hacia el HPS en la región isquémica, los bloqueos de conducción en secciones discretas del HPS y el grado de hiperkalemia que afecta a las células de Purkinje, son sugeridos como mecanismos que podrían favorecer la aparición de arritmias ventriculares., [EN] A better understanding of the mechanisms underlying ventricular arrhythmias, as well as an improvement of the associated electrical and pharmacological therapies, are a key factor to prevent sudden cardiac death in patients with structural and electrical heart diseases. An important cardiomyopathy that can lead to life-threatening ventricular arrhythmias is heart failure (HF). Patients with HF also often suffer from left bundle branch block (LBBB), which worsens their condition. Currently, the most effective treatment to these patients is cardiac resynchronization therapy (CRT). However, many patients are non-responders, so further studies are needed to improve this treatment. A second cardiac pathology that also produces lethal arrhythmias is myocardial ischemia. Substantial experimental evidence has shown that electrophysiological alterations in the ventricular myocardium constitute a substrate for the generation of arrhythmias during the acute phase of ischemia. These alterations are induced by the three main ischemic components: hyperkalemia, hypoxia and acidosis. However, the influence of each component in the mechanisms of arrhythmia initiation and maintenance is still not completely understood. In the first section of this doctoral thesis, we focus on the optimization of CRT during its application in a heart suffering from HF and LBBB. For this purpose, we modified the O'Hara action potential (AP) model to simulate a realistic conduction velocity both in healthy and pathological conditions. In addition, a His-Purkinje system (HPS) was generated and incorporated into a 3D human biventricular/torso model to simulate realistic LBBB. A set of computational simulations were performed for different CRT configurations to determine the optimal pacing leads location and delay values leading to the shortest QRS duration. Subsequently, results were compared with other optimization criteria. The main findings of this study showed the need of better or complementary optimization criteria, such as an index based on the time to reach the 90% of the QRS area suggested in this work, to reach the best ventricular electrical synchrony during the CRT application. In addition, our results also show that the upper septum close to the outflow tract is an alternative site for the right ventricle (RV) stimulation, which avoids the perforation problems of the RV apical wall during the typical CRT procedure. Finally, protocols of left ventricle endocardial pacing should be considered to obtain better CRT results. In the second section of this thesis, we investigated the effects of the three main components of ischemia on the vulnerability to reentry, as well as the role of the HPS and its mechanisms of action in the generation and maintenance of ventricular arrhythmias. In order to achieve our goal, we first modified the ventricular AP model to realistically simulate the major alterations caused by acute myocardial ischemia. Simulations were performed in a 3D human biventricular model, embedded in a virtual torso, which includes a realistic geometry of the central and border ischemic zones, as well as a detailed HPS. Four scenarios of ischemic severity corresponding to different minutes after coronary artery occlusion were simulated to evaluate the effects of the evolution of ischemia over time. Then, the individual influence of hyperkalemia, hypoxia and acidosis in the width of the vulnerable window (VW) for reentry was assessed during seven scenarios of acute ischemia. Finally, this last set of ischemic simulations was repeated using the anatomical model without the HPS to evaluate the effect of the latter in the VW. Results show that a moderate ischemic condition is the worst scenario for reentry generation. Hypoxia is the ischemic component with the most significant effect on the width of the VW. Furthermore, the retrograde current flow from the myocardium to the HPS in the ischemic region, conduction blocks in discrete sections of the HPS, and the degree of hyperkalemia affecting the Purkinje cells, are suggested as HPS mechanisms that could favor the triggering of ventricular arrhythmias., [CA] Una millor comprensió dels mecanismes subjacents a les arrítmies ventriculars, així com una millora de les teràpies elèctriques i farmacològiques associades, són un factor clau per a previndre la mort sobtada cardíaca en pacients amb cardiopaties estructurals i elèctriques. Una miocardiopatia important que pot provocar arrítmies ventriculars potencialment mortals és la insuficiència cardíaca (HF). Els pacients amb HF sovint pateixen també de bloqueig de branca esquerra (LBBB) que deteriora la seua condició. Actualment, el tractament més eficaç per a aquests pacients és la teràpia de resincronització cardíaca (CRT). No obstant això, no s'aconsegueix una resposta positiva en tots els casos, per la qual cosa és necessari un major estudi per a millorar aquest tractament. Una segona patologia cardíaca que també produeix arrítmies letals és la isquèmia miocàrdica. Evidència experimental ha demostrat que les alteracions electrofisiològiques en el miocardi ventricular constitueixen un substrat per a la generació d'arrítmies durant la fase aguda d'isquèmia. Aquestes alteracions són induïdes pels tres components isquèmics principals: hipercalèmia, hipòxia i acidosi. No obstant això, la influència de cada component en els mecanismes d'inici i manteniment de les arrítmies no es comprén encara amb claredat. Una primera part d'aquesta tesi doctoral, se centra en l'optimització de la CRT durant la seua aplicació en un cor que pateix HF i LBBB. Per a això, es va modificar el model de potencial d'acció (AP) de O'Hara per a simular una velocitat de conducció realista tant en condicions sanes com patològiques. A més, es va estimar i es va incorporar un sistema de His-Purkinje (HPS) dins d'un model biventricular/tors humà 3D per a simular un LBBB realista. A continuació, es va desenvolupar un conjunt de simulacions computacionals per a diferents configuracions de la CRT a fi de determinar la posició i l'instant d'estimulació òptim que condueixen a la duració més curta del QRS. Posteriorment, els resultats es van comparar amb altres criteris d'optimització. Les principals troballes d'aquest estudi van mostrar la necessitat de definir millors o complementaris criteris d'optimització, com un índex basat en el temps fins a aconseguir el 90% de l'àrea del QRS suggerida en aquest treball, per a aconseguir la millor sincronia elèctrica ventricular durant l'aplicació de la CRT. A més, els nostres resultats també mostren que el septe superior pròxim al tracte d'eixida és un lloc alternatiu per a l'estimulació del ventricle dret, la cual cosa evita els problemes de perforació de la paret apical durant el procediment típic de la CRT. Finalment, per a obtindre millors resultats de la CRT s'han de considerar protocols d'estimulació endocárdica en el ventricle esquerre. En la segona part d'aquesta tesi es va investigar els efectes dels tres components principals de la isquèmia sobre la vulnerabilitat a una reentrada, així com el paper del HPS i els seus mecanismes d'acció en la generació i manteniment d'arrítmies ventriculars. Per a aconseguir aquest objectiu, en primer lloc es va modificar el model AP ventricular per a simular de manera realista les principals alteracions provocades per la isquèmia miocàrdica aguda. Les simulacions es van realitzar en un model biventricular humà 3D, acoblat en un tors virtual, que inclou una geometria realista de les zones isquèmiques central i de vora, així com un HPS detallat. Es van simular quatre escenaris de severitat isquèmica corresponents a diferents minuts d'oclusió de l'artèria coronària per a avaluar els efectes de l'evolució de la isquèmia en el temps. Després, es va avaluar la influència individual de la hipercalèmia, hipòxia i acidosi en l'ample de la finestra vulnerable (VW) a reentradas durant set escenaris d'isquèmia aguda. Finalment, es va repetir aquest últim conjunt de simulacions isquèmiques utilitzant el model anatòmic sense el HPS per a avaluar l'efecte d'aquest últim en la VW. Els resultats mostren que una condició isquèmica moderada és el pitjor escenari per a la generació d'una reentrada. La hipòxia és el component isquèmic amb l'efecte més significatiu en l'ample de la VW. A més, el flux de corrent retrògrad des del miocardi cap al HPS a la regió isquèmica, els bloquejos de conducció en seccions discretes del HPS i el grau d'hiperkalèmia que afecta les cèl·lules de Purkinje, són suggerits com a mecanismes que podrien afavorir l'aparició d'arrítmies ventriculars. more...
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- 2021
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5. Perturbations in cardiac metabolism in a human model of acute myocardial ischaemia
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Sohaib Haseeb, Magdi El-Omar, Mamas A. Mamas, Sanoj Chacko, David Simon, Ludwig Neyses, Warwick B. Dunn, Bernard Clarke, and F Fath-Ordoubadi
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medicine.medical_specialty ,Acute myocardial ischemia ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Clinical Biochemistry ,Ischemia ,Coronary Artery Disease ,Biochemistry ,Metabolomics ,Percutaneous Coronary Intervention ,Internal medicine ,Occlusion ,Medicine ,Humans ,Coronary sinus ,Coronary sinus serum ,business.industry ,Percutaneous coronary intervention ,PCI ,medicine.disease ,R1 ,Metabolism ,Coronary Occlusion ,Coronary occlusion ,Docosahexaenoic acid ,Conventional PCI ,Cardiology ,Metabolome ,Original Article ,business ,RD - Abstract
Introduction Acute myocardial ischaemia and the transition from reversible to irreversible myocardial injury are associated with abnormal metabolic patterns. Advances in metabolomics have extended our capabilities to define these metabolic perturbations on a metabolome-wide scale. Objectives This study was designed to identify cardiac metabolic changes in serum during the first 5 min following early myocardial ischaemia in humans, applying an untargeted metabolomics approach. Methods Peripheral venous samples were collected from 46 patients in a discovery study (DS) and a validation study (VS) (25 for DS, 21 for VS). Coronary sinus venous samples were collected from 7 patients (4 for DS, 3 for VS). Acute myocardial ischaemia was induced by transient coronary occlusion during percutaneous coronary intervention (PCI). Plasma samples were collected at baseline (prior to PCI) and at 1 and 5 min post-coronary occlusion. Samples were analyzed by Ultra Performance Liquid Chromatography-Mass Spectrometry in an untargeted metabolomics approach. Results The study observed changes in the circulating levels of metabolites at 1 and 5 min following transient coronary ischaemia. Both DS and VS identified 54 and 55 metabolites as significant (P Conclusion Using an untargeted metabolomics approach, the study identified important cardiac metabolic changes in peripheral and coronary sinus plasma, in a human model of controlled acute myocardial ischaemia. Distinct classes of metabolites were shown to be involved in the rapid cardiac response to ischemia and provide insights into diagnostic and interventional targets. more...
- Published
- 2020
6. An initial exploration of subtraction electrocardiography to detect myocardial ischemia in the prehospital setting
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Laura Burattini, Robbert J. de Winter, Ron J.G. Peters, Arie C. Maan, Peter W. Macfarlane, Pieter G. Postema, Eduard Bleijenberg, Martin J. Schalij, Sumche Man, Rob Adams, Agnese Sbrollini, Cees A. Swenne, Cornelia Cato ter Haar, Jan Bosch, Charles J. H. J. Kirchhof, Roderick W.C. Scherptong, Sophia Gripenstedt, Reza Alizadeh Dehnavi, Cardiology, ACS - Atherosclerosis & ischemic syndromes, and ACS - Heart failure & arrhythmias more...
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Adult ,Male ,Emergency Medical Services ,medicine.medical_specialty ,serial electrocardiography ,Electrocardiographic myocardial ischemia ,Myocardial ischemia ,Adolescent ,New Technologies ,Myocardial Ischemia ,030204 cardiovascular system & hematology ,Logistic regression ,Electrocardiography ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,ECG analysis ,030212 general & internal medicine ,cardiovascular diseases ,Prehospital triage ,Aged ,Retrospective Studies ,Aged, 80 and over ,subtraction electrocardiography ,medicine.diagnostic_test ,business.industry ,Subtraction ,Reproducibility of Results ,Retrospective cohort study ,General Medicine ,Middle Aged ,vectorcardiogram ,Cardiology ,Female ,Triage ,Cardiology and Cardiovascular Medicine ,business ,acute myocardial ischemia - Abstract
Background In the prehospital triage of patients presenting with symptoms suggestive of acute myocardial ischemia, reliable myocardial ischemia detection in the electrocardiogram (ECG) is pivotal. Due to large interindividual variability and overlap between ischemic and nonischemic ECG‐patterns, incorporation of a previous elective (reference) ECG may improve accuracy. The aim of the current study was to explore the potential value of serial ECG analysis using subtraction electrocardiography. Methods SUBTRACT is a multicenter retrospective observational study, including patients who were prehospitally evaluated for acute myocardial ischemia. For each patient, an elective previously recorded reference ECG was subtracted from the ambulance ECG. Patients were classified as myocardial ischemia cases or controls, based on the in‐hospital diagnosis. The diagnostic performance of subtraction electrocardiography was tested using logistic regression of 28 variables describing the differences between the reference and ambulance ECGs. The Uni‐G ECG Analysis Program was used for state‐of‐the‐art single‐ECG interpretation of the ambulance ECG. Results In 1,229 patients, the mean area‐under‐the‐curve of subtraction electrocardiography was 0.80 (95%CI: 0.77–0.82). The performance of our new method was comparable to single‐ECG analysis using the Uni‐G algorithm: sensitivities were 66% versus 67% (p‐value > .05), respectively; specificities were 80% versus 81% (p‐value > .05), respectively. Conclusions In our initial exploration, the diagnostic performance of subtraction electrocardiography for the detection of acute myocardial ischemia proved equal to that of state‐of‐the‐art automated single‐ECG analysis by the Uni‐G algorithm. Possibly, refinement of both algorithms, or even integration of the two, could surpass current electrocardiographic myocardial ischemia detection. more...
- Published
- 2020
7. Analysis of vulnerability to reentry in acute myocardial ischemia using a realistic human heart model
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Juan F. Gomez, Jose M Ferrero, Jose F Rodriguez-Matas, Edison F. Carpio, and Beatriz Trenor
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medicine.medical_specialty ,Acute myocardial ischemia ,Hyperkalemia ,Myocardial Ischemia ,Ischemia ,Health Informatics ,TECNOLOGIA ELECTRONICA ,Ventricular arrhythmias ,Heart Conduction System ,Internal medicine ,medicine ,Humans ,03.- Garantizar una vida saludable y promover el bienestar para todos y todas en todas las edades ,His-purkinje system ,cardiovascular diseases ,Artery occlusion ,Acidosis ,Vulnerability to reentry ,business.industry ,Myocardium ,Arrhythmias, Cardiac ,Heart ,Computational modeling ,Reentry ,Hypoxia (medical) ,medicine.disease ,Computer Science Applications ,Electrophysiology ,Cardiology ,medicine.symptom ,Electrical conduction system of the heart ,business - Abstract
[EN] Electrophysiological alterations of the myocardium caused by acute ischemia constitute a pro-arrhythmic substrate for the generation of potentially lethal arrhythmias. Experimental evidence has shown that the main components of acute ischemia that induce these electrophysiological alterations are hyperkalemia, hypoxia (or anoxia in complete artery occlusion), and acidosis. However, the influence of each ischemic component on the likelihood of reentry is not completely established. Moreover, the role of the His-Purkinje system (HPS) in the initiation and maintenance of arrhythmias is not completely understood. In the present work, we investigate how the three components of ischemia affect the vulnerable window (VW) for reentry using computational simulations. In addition, we analyze the role of the HPS on arrhythmogenesis. A 3D biventricular/torso human model that includes a realistic geometry of the central and border ischemic zones with one of the most electrophysiologically detailed model of ischemia to date, as well as a realistic cardiac conduction system, were used to assess the VW for reentry. Four scenarios of ischemic severity corresponding to different minutes after coronary artery occlusion were simulated. Our results suggest that ischemic severity plays an important role in the generation of reentries. Indeed, this is the first 3D simulation study to show that ventricular arrhythmias could be generated under moderate ischemic conditions, but not in mild and severe ischemia. Moreover, our results show that anoxia is the ischemic component with the most significant effect on the width of the VW. Thus, a change in the level of anoxia from moderate to severe leads to a greater increment in the VW (40 ms), in comparison with the increment of 20 ms and 35 ms produced by the individual change in the level of hyperkalemia and acidosis, respectively. Finally, the HPS was a necessary element for the generation of approximately 17% of reentries obtained. The retrograde conduction from the myocardium to HPS in the ischemic region, conduction blocks in discrete sections of the HPS, and the degree of ischemia affecting Purkinje cells, are suggested as mechanisms that favor the generation of ventricular arrhythmias., This work was supported by the Secretaría de Educacion ¿ Superior, Ciencia, Tecnología e Innovacion ¿ (SENESCYT) of Ecuador CIBAE-023- 2014, by Grant PID2019-104356RB-C41 funded by MCIN/AEI/ 10.13039/501100011033, by the European Union¿s Horizon 2020 research and innovation programme under grant agreement No 101016496, by Direccion ¿ General de Política Científica de la Generalitat Valenciana (PROMETEO 2020/043), and by the ¿Programa Salvador de Madariaga 2018¿¿ of the Spanish Ministry of Science, Innovation and Universities (Grant Reference PRX18/00489). more...
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- 2022
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8. Electroacupuncture modulates the activity of the hippocampus-nucleus tractus solitarius-vagus nerve pathway to reduce myocardial ischemic injury
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Jian Cao, Kun Wang, Shengbing Wu, Meiqi Zhou, Shuai Cui, Guoqi Zhu, and Yi-Ping Zhou
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medicine.medical_specialty ,Electroacupuncture ,hippocampus ,medicine.medical_treatment ,Ischemia ,030204 cardiovascular system & hematology ,autonomic nerve ,lcsh:RC346-429 ,03 medical and health sciences ,0302 clinical medicine ,Developmental Neuroscience ,Internal medicine ,Heart rate ,electroacupuncture ,medicine ,nerve regeneration ,nucleus tractus solitarius ,lcsh:Neurology. Diseases of the nervous system ,vagus nerve discharge ,Autonomic nerve ,business.industry ,medicine.disease ,Vagus nerve ,Autonomic nervous system ,medicine.anatomical_structure ,Endocrinology ,nervous system ,Shenmen (HT7) ,Hypothalamus ,Tongli (HT5) ,Neuron ,business ,acute myocardial ischemia ,neural regeneration ,030217 neurology & neurosurgery ,Research Article - Abstract
The hippocampus is involved in the regulation of the autonomic nervous system, together with the hypothalamus and brainstem nuclei, such as the paraventricular nucleus and nucleus tractus solitarius. The vagus nerve-nucleus tractus solitarius pathway has an important role in cardiovascular reflex regulation. Myocardial ischemia has been shown to cause changes in the autonomic nervous system, affecting the dynamic equilibrium of the sympathetic and vagal nerves. However, it remains poorly understood how the hippocampus communicates with brainstem nuclei to regulate the autonomic nervous system and alleviate myocardial ischemic tissue damage. A rat model of acute myocardial ischemia (AMI) was made by ligating the left anterior descending branch of the coronary artery. Three days before ischemia, the hippocampal CA1 region was damaged. Then, 3 days after ischemia, electroacupuncture (EA) at Shenmen (HT7)-Tongli (HT5) was performed (continuous wave, 1 mA, 2 Hz, duration of 30 minutes). Cluster analysis of firing patterns showed that one type of neuron was found in rats in the sham and AMI groups. Three types of neurons were observed in the AMI + EA group. Six types of neurons were found in the AMI + EA + Lesion group. Correlation analysis showed that the frequency of vagus nerve discharge in each group was negatively correlated with heart rate (HR) (P < 0.05, r = −0.424), and positively correlated with mean arterial pressure (MAP) (P < 0.05, r = 0.40987) and the rate-pressure product (RPP) (P < 0.05, r = 0.4252). The total frequency of the nucleus tractus solitarius discharge in each group was positively correlated with vagus nerve discharge (P < 0.01, r = 0.7021), but not with hemodynamic index (HR: P > 0.05, r = −0.03263; MAP: P > 0.05, r = −0.08993; RPP: P > 0.05, r = −0.03263). Some neurons (Neuron C) were negatively correlated with vagus nerve discharge, HR, MAP and RPP in the AMI + EA group (vagus nerve discharge: P < 0.05, r = −0.87749; HR: P < 0.01, r = −0.91902; MAP: P < 0.05, r = −0.85691; RPP: P < 0.01, r = −0.91902). Some neurons (Neurons C, D and E) were positively correlated with vagus nerve discharge, HR, MAP and RPP in the AMI + EA + Lesion group (vagus nerve discharge: P < 0.01, r = 0.8905, P < 0.01, r = 0.9725, P < 0.01, r = 0.9054; HR: P < 0.01, r = 0.9347, P < 0.01, r = 0.9089, P < 0.05, r = 0.8247; MAP: P < 0.05, r = 0.8474, P < 0.01, r = 0.9691, P < 0.01, r = 0.9027; RPP: P < 0.05, r = 0.8637, P < 0.01, r = 0.9407, P < 0.01, r = 0.9027). These findings show that the hippocampus-nucleus tractus solitarius-vagus nerve pathway is involved in the cardioprotective effect of EA at the heart meridian. Some interneurons in the nucleus tractus solitarius may play a particularly important role in the cardiomodulatory process. more...
- Published
- 2018
9. Metabolic risk factors associated with sudden cardiac death (SCD) during acute myocardial ischemia
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Xingxing Wang, Ruibing Su, Xiaojun Yu, Jing Kong, Dian Wang, and Jiayan Wu
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0301 basic medicine ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Taurine ,030204 cardiovascular system & hematology ,Biochemistry, Genetics and Molecular Biology (miscellaneous) ,sudden cardiac death ,tissue metabolomics ,Pathology and Forensic Medicine ,Analytical Chemistry ,Sudden cardiac death ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Metabolome ,Choline ,cardiovascular diseases ,Physical and Theoretical Chemistry ,Cause of death ,business.industry ,Phosphorylcholine ,forensic pathology ,medicine.disease ,Psychiatry and Mental health ,030104 developmental biology ,metabolic risk ,chemistry ,Anthropology ,Cardiology ,Original Article ,Forensic science ,acute myocardial ischemia ,Ligation ,business ,Atrioventricular block - Abstract
Sudden cardiac death (SCD) is the leading cause of death worldwide. Myocardial ischemia (MI) is the most common underlying causal disorder for SCD. Metabolic risks leading to SCD during acute MI are still not fully understood. Here, using tissue metabolomics, we aimed to investigate myocardial metabolic alterations relevant to SCD events in an acute MI rat model induced by coronary artery ligation (CAL). Thirty-four rats were successfully performed CAL, of which 13 developed lethal ventricular tachyarrhythmia (LVTA)-SCD and 7 developed severe atrioventricular block (AB)-SCD. Fourteen rats that survived within 70 min after the ligation were served as peer controls. The partial least squares-discriminant analysis plots demonstrated clear separations between the SCD rats and controls, indicating obvious differences in myocardial metabolome between these rats. The levels of isoleucine, lactate, glutamate choline, phosphorylcholine, taurine and asparagine in ischemic myocardia were positively associated with LVTA-SCD events; in contrast, the levels of alanine, urea, phenylalanine, linoleic acid, elaidic acid and stearic acid were inversely correlated with LVTA-SCD events. The levels of glutamate and urea were positively and negatively relevant to AB-SCD events, respectively. The dangerous metabolites indicated that lower levels of energy substrates, severe hypoxia, the inhibition of transamination and hyper sympathetic excitement and reactive oxygen species in myocardia were vulnerable to SCD during acute MI. The results suggest fatal metabolic alterations correlated with SCD events during acute MI, which could offer novel clues for the prevention or treatment of acute MI-related SCD. more...
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- 2017
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10. Role of Cardio-Specific Micro-Ribonucleic Acids and Correlation with Cardiac Biomarkers in Acute Coronary Syndrome: A Comprehensive Systematic Review
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Sajid Hameed, Rabia Mushtaque, Farah Siraj, Raja S Mushtaque, and Muhammad Idrees
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medicine.medical_specialty ,Acute coronary syndrome ,microrna ,Cardiac biomarkers ,Cardiology ,Healthcare Technology ,030204 cardiovascular system & hematology ,acs ,acute coronary syndrome ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Troponin complex ,cardiac biomarkers ,Internal medicine ,microRNA ,Troponin I ,Medicine ,cardiovascular diseases ,biology ,business.industry ,General Engineering ,medicine.disease ,cardiovascular system ,biology.protein ,Creatine kinase ,acute myocardial ischemia ,business ,Family/General Practice ,030217 neurology & neurosurgery ,mirna ,Kidney disease - Abstract
Acute coronary syndrome (ACS) is an acute and severe manifestation of coronary artery disease (CAD); thus, timely diagnosis can save a life. Commonly, cardiac troponin T (CTnT), cardiac troponin I (CTnI) or creatine kinase muscle/brain subtype (CK-MB) have been used as cardiac biomarkers to assess ACS with certain limitations, such as increased time to rise for diagnosis and increased levels in the patients with chronic kidney disease (CKD). Recently, micro-ribonucleic acids (miRNAs) have become potential candidates as biomarkers for cardiac ischemia due to their remarkable stability and reproducibility. Certain miRNAs, for instance, miR-1, miR-133a/b, miR-208a/b, and miR-499a, strongly increase in the serum or plasma of patients with acute cardiac ischemia, making them as cardio-specific miRNAs and prospective biomarkers in ACS. This literature review gives enlightenment about the regulation of cardio-specific miRNA in acute myocardial ischemia (AMI) and correlation with common cardiac biomarkers and time at which they increase in the blood. more...
- Published
- 2019
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11. Cecal Gut Microbiota and Metabolites Might Contribute to the Severity of Acute Myocardial Ischemia by Impacting the Intestinal Permeability, Oxidative Stress, and Energy Metabolism
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Lili Sun, Zhong-Mei Zou, Hong-Mei Jia, Dong Tian, Jiaojiao Li, Yong Yang, Hong-Wu Zhang, and Meng Yu
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Microbiology (medical) ,Rikenellaceae ,Firmicutes ,lcsh:QR1-502 ,UPLC-Q-TOF/MS ,Prevotellaceae ,Gut flora ,medicine.disease_cause ,Microbiology ,digestive system ,lcsh:Microbiology ,Pathogenesis ,03 medical and health sciences ,medicine ,16S rRNA gene sequencing ,Original Research ,030304 developmental biology ,0303 health sciences ,Intestinal permeability ,biology ,gut microbiota ,030306 microbiology ,biology.organism_classification ,medicine.disease ,metabolomics ,Bacteroides ,acute myocardial ischemia ,Oxidative stress - Abstract
Emerging evidence highlights the role of gut microbiota in regulating the pathogenesis of coronary heart disease. Here, we performed 16S rRNA gene sequencing and UPLC-Q-TOF/MS-based metabolomics to investigate the gut microbiome and metabolomes of cecal contents in the isoproterenol (ISO)-induced acute myocardial ischemia (AMI) rats. As expected, considerable gut microbiota alterations were observed in the AMI rats compared with the control rats, paralleling with intestinal inflammation and apoptosis. At phylum level, the abundance of Firmicutes was significantly decreased, whereas the abundance of Bacteroidetes and Spirochaetae was strikingly enriched in the AMI group. At genus level, the significant alteration of genera Treponema 2, Rikenellaceae RC9 gut group, Prevotellaceae UCG-003, and Bacteroides may contribute to the pathogenesis of AMI. These altered microbiota might influence the intestinal permeability and subsequently impair intestinal barrier and stimulate gut inflammation. Consistently, significantly metabolic differences of cecal contents between the AMI and control groups were revealed, and threonic acid, L-urobilin and L-urobilinogen were considered the most associated cecal metabolites with AMI. These strikingly altered metabolites were mainly related to energy metabolism and oxidative stress which could lead to apoptosis and further affect gut barrier. Ultimately, we revealed the potential link of these altered gut microbiota/metabolomes and intestinal inflammatory factors and apoptotic proteins and further confirmed their intimate connections with intestinal inflammation and gut barrier. Our findings depict uncovered potential relationship among the gut microbiome, cecal metabolomes and AMI. more...
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- 2019
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12. Reintroducing Heart Sounds for Early Detection of Acute Myocardial Ischemia in a Porcine Model – Correlation of Acoustic Cardiography With Gold Standard of Pressure-Volume Analysis
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Francesco Maisano, Patricia Arand, Evelyn Regar, Paul Erne, Nikola Cesarovic, Peter T. Bauer, Michel Zuber, Marco Luciani, Shingo Kuwata, Andrea Guidotti, Matteo Saccocci, Miriam Lipiski, University of Zurich, and Luciani, Marco more...
- Subjects
medicine.medical_specialty ,Cardiac output ,Fourth heart sound ,Physiology ,Diastole ,Hemodynamics ,610 Medicine & health ,030204 cardiovascular system & hematology ,hemodynamics ,lcsh:Physiology ,acute coronary syndrome ,heart sound ,03 medical and health sciences ,0302 clinical medicine ,2737 Physiology (medical) ,Physiology (medical) ,Internal medicine ,acute coronary syndrome acute myocardial ischemia animal model heart sound hemodynamics ,Heart rate ,Medicine ,030212 general & internal medicine ,Third heart sound ,Original Research ,lcsh:QP1-981 ,business.industry ,animal model ,1314 Physiology ,medicine.disease ,10020 Clinic for Cardiac Surgery ,Acute coronary syndrome ,Acute myocardial ischemia ,Heart sound ,Animal model ,Coronary occlusion ,Heart sounds ,Cardiology ,medicine.symptom ,business ,acute myocardial ischemia - Abstract
Background: Acoustic cardiography is a hybrid technique that couples heart sounds recording with ECG providing insights into electrical-mechanical activity of the heart in an unsupervised, non-invasive and inexpensive manner. During myocardial ischemia hemodynamic abnormalities appear in the first minutes and we hypothesize a putative diagnostic role of acoustic cardiography for prompt detection of cardiac dysfunction for future patient management improvement. Methods and Results: Ten female Swiss large white pigs underwent permanent distal coronary occlusion as a model of acute myocardial ischemia. Acoustic cardiography analyses were performed prior, during and after coronary occlusion. Pressure-volume analysis was conducted in parallel as an invasive method of hemodynamic assessment for comparison. Similar systolic and diastolic intervals obtained with the two techniques were significantly correlated [Q to min dP/dt vs. Q to second heart sound (r2 = 0.9583, p < 0.0001), PV diastolic filling time vs. AC perfusion time (r2 = 0.9686, p < 0.0001)]. Indexes of systolic and diastolic impairment correlated with quantifiable features of heart sounds [Tau vs. fourth heart sound Display Value (r2 = 0.2721, p < 0.0001) cardiac output vs. third heart sound Display Value (r2 = 0.0791 p = 0.0023)]. Additionally, acoustic cardiography diastolic time (AUC 0.675, p = 0.008), perfusion time (AUC 0.649, p = 0.024) and third heart sound Display Value (AUC 0.654, p = 0.019) emerged as possible indicators of coronary occlusion. Finally, these three parameters, when joined with heart rate into a composite joint-index, represent the best model in our experience for ischemia detection (AUC 0.770, p < 0.001). Conclusion: In the rapidly evolving setting of acute myocardial ischemia, acoustic cardiography provided meaningful insights of mechanical dysfunction in a prompt and non-invasive manner. These findings should propel interest in resurrecting this technique for future translational studies as well as reconsidering its reintroduction in the clinical setting., Frontiers in Physiology, 10, ISSN:1664-042X more...
- Published
- 2019
13. Investigating the effects and possible mechanisms of danshen- honghua herb pair on acute myocardial ischemia induced by isoproterenol in rats
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Fang Wang, Su Gao, Peng-Fei Wang, Yun-Dong Xie, Jin Wang, Xiao-Ping Wang, Li-Na Quan, Xiao-Ting Wang, Ya-Heng Wang, and Ji-Qing Bai
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0301 basic medicine ,Male ,Carthamustinctorius ,Carthamus tinctorius ,Myocardial Ischemia ,Apoptosis ,Salvia miltiorrhiza ,Blood stasis ,Pharmacology ,Rats, Sprague-Dawley ,chemistry.chemical_compound ,0302 clinical medicine ,Creatine Kinase, MB Form ,Myocytes, Cardiac ,bcl-2-Associated X Protein ,biology ,General Medicine ,030220 oncology & carcinogenesis ,medicine.symptom ,Protective effects ,Acute myocardial ischemia ,Ischemia ,Inflammation ,RM1-950 ,Superoxide dismutase ,03 medical and health sciences ,Troponin T ,Lactate dehydrogenase ,medicine ,Animals ,Aspartate Aminotransferases ,L-Lactate Dehydrogenase ,business.industry ,Interleukin-6 ,Superoxide Dismutase ,Tumor Necrosis Factor-alpha ,Myocardium ,Herb pair ,Isoproterenol ,Transcription Factor RelA ,medicine.disease ,030104 developmental biology ,chemistry ,Hemorheology ,biology.protein ,Creatine kinase ,Therapeutics. Pharmacology ,business ,Potential ,Drugs, Chinese Herbal - Abstract
Danshen (salvia miltiorrhiza) and honghua(Carthamus tinctorius) were traditional herb pair with promoting blood circulation and removing blood stasis actions, in China. Both were widely used to treat cardiovascular diseases (CVD) for hundreds years, especially shown definite advantage in the treatment of ischemic heart disease (IHD). However, the mechanism of danshen-honghua herb pair (DHHP) in the treatment of IHD was still unclear. This study was focused on examining the effects and possible mechanisms of DHHP in rats with acute myocardial ischemia induced by isoproterenol (ISO). The results suggested that DHHP significantly ameliorated the myocardial tissue abnormalities, notablely inhibited the elevation of lactate dehydrogenase (LDH), creatine kinase (CK), aspartate aminotransferase (AST), creatinekinase isoenzyme (CK-MB) and cardiac troponin T (CTn-T) in plasma, obviously decreased the plasma levels of Tumor Necrosis Factor α (TNF-α), outstandingly inhibited the reduction of superoxide dismutase (SOD), catalase (CAT) caused by ISO, significantly inhibited the high expression of Bcl-2 assaciated X protein (Bax) and nuclear transcriptionfactor-κBP65 (NF-κBP65) protein, significantly induced the low expression of B-cell lymphoma-2 (Bcl-2) protein in acute myocardial ischemia rats. DHHP can obviously ameliorate hemodynamic parameters. In summary, DHHP can significantly improve myocardial ischemia in acute myocardial ischemia model rats caused by ISO. Anti-free radicals, anti-peroxidation, inhibition of cell apoptosis and anti- inflammation maybe are the potential mechanisms of DHHP anti-myocardial ischemia in acute myocardial ischemia rats in duced by ISO. more...
- Published
- 2019
14. Intravenous high mobility group box 1 upregulates the expression of HIF-1α in the myocardium via a protein kinase B-dependent pathway in rats following acute myocardial ischemia
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Qian‑Feng Han, Min Zhou, Yan-Hong Zhou, Lei Wu, Tao Liu, Heng‑Chen Yao, Ke‑Li Tian, Lan‑Hua Wang, Mei Zhang, and De‑Yong Zhang
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0301 basic medicine ,Cancer Research ,high mobility group box 1 ,030204 cardiovascular system & hematology ,Biochemistry ,Phosphatidylinositol 3-Kinases ,0302 clinical medicine ,Troponin I ,hypoxia inducible factor-1α ,Myocardial infarction ,HMGB1 Protein ,Phosphoinositide-3 Kinase Inhibitors ,ischemia reperfusion injury ,biology ,Kinase ,Articles ,Oncogene Protein v-akt ,Oncology ,Molecular Medicine ,medicine.symptom ,acute myocardial ischemia ,Signal Transduction ,medicine.medical_specialty ,Morpholines ,Ischemia ,Myocardial Reperfusion Injury ,chemical and pharmacologic phenomena ,HMGB1 ,03 medical and health sciences ,Internal medicine ,Genetics ,medicine ,Animals ,Humans ,Molecular Biology ,PI3K/AKT/mTOR pathway ,Tumor Necrosis Factor-alpha ,business.industry ,Akt/PKB signaling pathway ,Myocardium ,Hypoxia (medical) ,Hypoxia-Inducible Factor 1, alpha Subunit ,medicine.disease ,Rats ,030104 developmental biology ,Endocrinology ,Gene Expression Regulation ,Chromones ,Immunology ,biology.protein ,business ,Proto-Oncogene Proteins c-akt - Abstract
The effects of intravenous high mobility group box 1 (HMGB1) on myocardial ischemia/reperfusion (I/R) injury remains to be elucidated. The purpose of the present study was to investigate the effects of intravenous HMGB1 on the expression of hypoxia inducible factor-1α (HIF-1α) in the myocardium of rats following acute myocardial ischemia, and to examine the effects of intravenous HMGB1 on myocardial I/R injury. Male Wistar rats were divided into the following groups: Sham operation group (n=10), a group exposed to ischemia for 30 min and reperfusion for 4 h (I/R group) as a control (n=10), an HMGB group, in which 100 ng/kg HMGB was administered intravenously 30 min prior to ischemia (n=10), an LY group, in which LY294002, an inhibitor of phosphoinositide 3-kinase (PI3K), was administered intravenously (0.3 mg/kg) 40 min prior to ischemia (n=10), and the HMGB1+LY group, in which HMGB1 (100 ng/kg) and LY294002 (0.3 mg/kg) were administered intravenously 30 min and 40 min prior to ischemia, respectively (n=10). The serum levels of cardiac troponin I (cTnI) and tumor necrosis factor-α (TNF-α), and myocardial infarct size were measured. The expression levels of phosphorylated Akt and HIF-1α were investigated using western blot analyses. The results showed that pre-treatment with HMGB1 significantly decreased serum levels of cTnI, and TNF-α, and reduced myocardial infarct size following 4 h reperfusion (all P more...
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- 2015
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15. Trichosanthes pericarpium Aqueous Extract Enhances the Mobilization of Endothelial Progenitor Cells and Up-regulates the Expression of VEGF, eNOS, NO, and MMP-9 in Acute Myocardial Ischemic Rats
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Qitao Zhao, Dongmei Gao, Jingchang Sun, Hang Li, Liying Xun, and Nini Fu
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0301 basic medicine ,medicine.medical_specialty ,Physiology ,Chloral hydrate ,030204 cardiovascular system & hematology ,Matrix metalloproteinase ,lcsh:Physiology ,Nitric oxide ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Enos ,Physiology (medical) ,Internal medicine ,matrix metalloproteinase-9 ,medicine ,cardiovascular diseases ,Progenitor cell ,Trichosanthes ,Original Research ,endothelial progenitor cells ,Mobilization ,biology ,lcsh:QP1-981 ,vascular endothelial growth factor ,business.industry ,biology.organism_classification ,Vascular endothelial growth factor ,030104 developmental biology ,Endocrinology ,chemistry ,endothelial nitric oxide syntheses ,business ,acute myocardial ischemia ,Trichosanthes pericarpium ,medicine.drug - Abstract
Trichosanthes pericarpium (TP) had been widely used to cure patients of cardiovascular disease for 2,000 years in China. This study aims to extend our previous work to explore the mechanism underlying the protective effect of TP on acute myocardial ischemia (AMI). We hypothesized that TP may display its protective effect on AMI by promoting the mobilization of endothelial progenitor cells (EPC) via up-regulating the expression level of vascular endothelial growth factor (VEGF), endothelial nitric oxide syntheses (eNOS), nitric oxide (NO), and matrix metalloproteinase 9 (MMP-9) in AMI rats. To confirm this hypothesis, we treated AMI model rats with intragastrical administration of TP aqueous extract (TPAE), and examined both changes in the number of CEPC, and the expression levels of VEGF, eNOS, NO, and MMP-9 in myocardial tissue and their plasma content in these rats. Rats in each group were randomly divided into seven subgroups. From day 1 to 7 following AMI modeling, rats in these subgroups was sequentially phlebotomized from their celiac artery after being anesthetized by chloral hydrate. We found that, compared with the AMI model rats, in rats treated by TPAE, the CEPC counts, the expression of VEGF, eNOS, NO, and MMP-9 in myocardial tissue and their plasma content all increased more rapidly 7 days after AMI and remained at higher level (P < 0.05 or P < 0.01). Our results showed that, in AMI rats, the TPAE could significantly promote the mobilization of EPC and up-regulate the expression level of VEGF, eNOS, NO, and MMP-9 in myocardium and their plasma content. Therefore, our results suggest that TAPE may regulate EPC mobilization through up-regulating the expression level of VEGF, eNOS, NO and MMP-9 in the myocardium of AMI rats. more...
- Published
- 2018
16. Effect of hydrogen sulfide on inflammatory cytokines in acute myocardial ischemia injury in rats
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Lan‑Fang Li, Fang Liu, Gang Zhang, Jian‑Xin Zhang, Guang‑Jie Liu, and Na Liu
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Cancer Research ,Pathology ,medicine.medical_specialty ,hydrogen sulfide ,Ischemia ,Sodium hydrosulfide ,Nitric oxide ,Proinflammatory cytokine ,chemistry.chemical_compound ,Immunology and Microbiology (miscellaneous) ,Internal medicine ,Medicine ,rat ,business.industry ,Interleukin ,inflammatory factor ,Articles ,General Medicine ,medicine.disease ,Endocrinology ,chemistry ,Apoptosis ,Tumor necrosis factor alpha ,Sample collection ,acute myocardial ischemia ,business - Abstract
Hydrogen sulfide (H2S) is believed to be involved in numerous physiological and pathophysiological processes, and now it is recognized as the third endogenous signaling gasotransmitter, following nitric oxide and carbon monoxide; however, the effects of H2S on inflammatory factors in acute myocardial ischemia injury in rats have not been clarified. In the present study, sodium hydrosulfide (NaHS) was used as the H2S donor. Thirty-six male Sprague Dawley rats were randomly divided into five groups: Sham, ischemia, ischemia + low-dose (0.78 mg/kg) NaHS, ischemia + medium-dose (1.56 mg/kg) NaHS, ischemia + high-dose (3.12 mg/kg) NaHS and ischemia + propargylglycine (PPG) (30 mg/kg). The rats in each group were sacrificed 6 h after the surgery for sample collection. Compared with the ischemia group, the cardiac damage in the rats in the ischemia + NaHS groups was significantly reduced, particularly in the high-dose group; in the ischemia + PPG group, the myocardial injury was aggravated compared with that in the ischemia group. Compared with the ischemia group, the levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) in the serum of rats in the ischemia + medium- and high-dose NaHS groups were significantly reduced, and the expression of intercellular adhesion molecule-1 (ICAM-1) mRNA and nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) protein in the myocardial tissues of rats was significantly reduced. In the ischemia + PPG group, the TNF-α, IL-1β and IL-6 levels in the serum were significantly increased, the expression of ICAM-1 mRNA was increased, although without a significant difference, and the expression of NF-κB was increased. The findings of the present study provide novel evidence for the dual effects of H2S on acute myocardial ischemia injury via the modulation of inflammatory factors. more...
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- 2015
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17. Left ventricular longitudinal function assessment in rabbits after acute occlusion of left anterior descending coronary artery by two-dimensional speckle tracking imaging
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Jun Huang, Li Fan, Yi-Fei Rui, Xiang-Ting Song, and Zi-Ning Yan
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Male ,0301 basic medicine ,Cardiac function curve ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Time Factors ,Acute myocardial ischemia ,Rotation ,Acute occlusion ,030204 cardiovascular system & hematology ,Anterior Descending Coronary Artery ,Ventricular Function, Left ,Strain ,Ventricular Dysfunction, Left ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Image Interpretation, Computer-Assisted ,Animals ,Medicine ,cardiovascular diseases ,Longitudinal function ,Endocardium ,Angiology ,business.industry ,Strain rate ,Stroke Volume ,Myocardial Contraction ,Echocardiography, Doppler ,Biomechanical Phenomena ,Cardiac surgery ,Disease Models, Animal ,030104 developmental biology ,medicine.anatomical_structure ,Coronary Occlusion ,lcsh:RC666-701 ,Longitudinal ,cardiovascular system ,Cardiology ,Female ,Rabbits ,Stress, Mechanical ,Cardiology and Cardiovascular Medicine ,business ,Research Article ,Artery - Abstract
Abstact Background To evaluate the left ventricular (LV) longitudinal function changes in rabbits after acute occlusion of the left anterior descending artery (LAD) by two-dimensional speckle tracking imaging (2D–STI). Methods Forty-eight New Zealand white rabbits underwent echocardiography examination. EchoPAC was used to measure LV peak systolic longitudinal strain (LS) of the endocardium, middle myocardium, and epicardium, peak longitudinal strain rate (LSr), segmental and global longitudinal rotation (LR) degrees. Ligated the LAD and repeated all measurements after 10 min. Results Peak LS and LSr were significantly different between the preoperative and postoperative rabbits among most LV walls (P more...
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- 2017
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18. Diagnostic Accuracy of a New Cardiac Electrical Biomarker for Detection of Electrocardiogram Changes Suggestive of Acute Myocardial Ischemic Injury
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Robert D. Fishberg and David M. Schreck
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Male ,medicine.medical_specialty ,chest pain ,electrocardiography ,medicine.medical_treatment ,Myocardial Infarction ,acute myocardial infarction ,Chest pain ,Sensitivity and Specificity ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Single-Blind Method ,myocardial injury ,Myocardial infarction ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Signal Processing, Computer-Assisted ,Retrospective cohort study ,Ischemic injury ,Original Articles ,General Medicine ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,ROC Curve ,Case-Control Studies ,Cardiology ,biomarker ,Biomarker (medicine) ,Female ,medicine.symptom ,Cardiac monitoring ,acute myocardial ischemia ,Cardiology and Cardiovascular Medicine ,business ,Electrocardiography ,Biomarkers - Abstract
Objective A new cardiac “electrical” biomarker (CEB) for detection of 12-lead electrocardiogram (ECG) changes indicative of acute myocardial ischemic injury has been identified. Objective was to test CEB diagnostic accuracy. Methods This is a blinded, observational retrospective case-control, noninferiority study. A total of 508 ECGs obtained from archived digital databases were interpreted by cardiologist and emergency physician (EP) blinded reference standards for presence of acute myocardial ischemic injury. CEB was constructed from three ECG cardiac monitoring leads using nonlinear modeling. Comparative active controls included ST voltage changes (J-point, ST area under curve) and a computerized ECG interpretive algorithm (ECGI). Training set of 141 ECGs identified CEB cutoffs by receiver-operating-characteristic (ROC) analysis. Test set of 367 ECGs was analyzed for validation. Poor-quality ECGs were excluded. Sensitivity, specificity, and negative and positive predictive values were calculated with 95% confidence intervals. Adjudication was performed by consensus. Results CEB demonstrated noninferiority to all active controls by hypothesis testing. CEB adjudication demonstrated 85.3–94.4% sensitivity, 92.5–93.0% specificity, 93.8–98.6% negative predictive value, and 74.6–83.5% positive predictive value. CEB was superior against all active controls in EP analysis, and against ST area under curve and ECGI by cardiologist. Conclusion CEB detects acute myocardial ischemic injury with high diagnostic accuracy. CEB is instantly constructed from three ECG leads on the cardiac monitor and displayed instantly allowing immediate cost-effective identification of patients with acute ischemic injury during cardiac rhythm monitoring. more...
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- 2013
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19. Nitric Oxide and its Metabolites in the Critical Phase of Illness: Rapid Biomarkers in the Making
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Mayank Aranke, Nathan S. Bryan, and Asad Mian
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medicine.medical_specialty ,Acute myocardial ischemia ,Nitrite ,Disease ,Nitrate ,Nitric Oxide ,Article ,General Biochemistry, Genetics and Molecular Biology ,Nitric oxide ,Sepsis ,chemistry.chemical_compound ,Shock ,Acute care ,Medicine ,Intensive care medicine ,Acute respiratory illness ,Emergency department ,business.industry ,Septic shock ,Acute kidney injury ,medicine.disease ,Asthma ,Critical care ,chemistry ,Biomarker (medicine) ,business - Abstract
The potential of nitric oxide (NO) as a rapid assay biomarker, one that could provide a quantum leap in acute care, remains largely untapped. NO plays a crucial role as bronchodilator, vasodilator and inflammatory mediator. The main objective of this review is to demonstrate how NO is a molecule of heavy interest in various acute disease states along the emergency department and critical care spectrum: respiratory infections, central nervous system infections, asthma, acute kidney injury, sepsis, septic shock, and myocardial ischemia, to name just a few. We discuss how NO and its oxidative metabolites, nitrite and nitrate, are readily detectable in several body compartments and fluids, and as such they are associated with many of the pathophysiological processes mentioned above. With methods such as high performance liquid chromatography and chemiluminescence these entities are relatively easy and inexpensive to analyze. Emphasis is placed on diagnostic rapidity, as this relates directly to quality of care in acute care situations. Further, a rationale is provided for more bench, translational and clinical research in the field of NO biomarkers for such settings. Developing standard protocols for the aforementioned disease states, centered on concentrations of NO and its metabolites, can prove to revolutionize diagnostics and prognostication along a spectrum of clinical care. We present a strong case for developing these biomarkers more as point-of-care assays with potential of color gradient test strips for rapid screening of disease entities in acute care and beyond. This will be relevant to global health. more...
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- 2013
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20. The Impact of Different Plasma Glucose Levels on Heart Rate in Experimental Rats With Acute Myocardial Infarction
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Jing Xie, Guo-Zhong Pan, Xiao-Fang Tian, Yujie Zhou, and Shi-Wei Yang
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medicine.medical_specialty ,Plasma glucose ,Acute myocardial ischemia ,business.industry ,Insulin ,medicine.medical_treatment ,Heart rate ,Hypoglycemia ,medicine.disease ,medicine.anatomical_structure ,Endocrinology ,Internal medicine ,Hyperglycemia ,Troponin I ,medicine ,Cardiology ,Tonicity ,Original Article ,Myocardial infarction ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Background: The aim of the study was to evaluate the impact of different plasma glucose levels on heart rate (HR) in experimental rats with acute myocardial infarction (AMI). Methods: One hundred and twenty-one male Wistar rats were randomly divided into AMI group (n = 70) and sham-operation group (n = 51). Both groups had low, normal and high glucose levels, respectively. In the former group, hypertonic glucose was injected into the rats to make their blood glucose levels above 16 mmol/L and insulin below 3.3 mmol/L; then, the left anterior descending artery was ligated. In the later group, the models of different blood glucose levels were the same as the former ones, but false operations, thread without ligating, were given to the rats. Electrocardiogram and troponin I (TnI) confirmed that the models were prepared successfully. Electrocardiogram expression of AMI was the formation of Q-wave in over three adjacent leads and abnormal elevation of TnI. Results: The HR of the rats in the hypoglycemic group is higher than that of the hyperglycemic group and normal blood glucose group before AMI (P < 0.05). The HR of the hyperglycemic rats is higher than that of the hypoglycemic group and normal blood glucose group after AMI (P < 0.05). In the hypoglycemic group, the HR of the rats who suffered from AMI was lower than that of the rats of the sham group (P < 0.05). Conclusion: Hypoglycemia allows faster HR and the HR in the rats with hyperglycemia is higher than that in the rats with hypoglycemia among the AMI rats. Cardiol Res. 2016;7(4):146-151 doi: http://dx.doi.org/10.14740/cr488w more...
- Published
- 2016
21. High mobility group box 1 protein attenuates myocardial ischemia reperfusion injury via inhibition of the p38 mitogen-activated protein kinase signaling pathway
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Lan‑Hua Wang, Xiao‑Yan Meng, De‑Yong Zhang, Lei Wu, Tao Liu, Yue‑Ru Jiao, Yan-Hong Zhou, Heng‑Chen Yao, Tai Li, and Qian‑Feng Han
- Subjects
0301 basic medicine ,MAPK/ERK pathway ,Cancer Research ,medicine.medical_specialty ,p38 mitogen-activated protein kinases ,chemical and pharmacologic phenomena ,hypoxia inducible factor 1α ,HMGB1 ,03 medical and health sciences ,chemistry.chemical_compound ,Immunology and Microbiology (miscellaneous) ,Internal medicine ,Troponin I ,medicine ,Protein kinase A ,high mobility group box 1 protein ,ischemia reperfusion injury ,biology ,p38 mitogen-activated protein kinase ,General Medicine ,Articles ,Malondialdehyde ,medicine.disease ,Molecular biology ,rats ,030104 developmental biology ,Endocrinology ,chemistry ,biology.protein ,Tumor necrosis factor alpha ,acute myocardial ischemia ,Reperfusion injury - Abstract
The present study aimed to determine the effects of high mobility group box 1 protein (HMGB1) on myocardial ischemia reperfusion (I/R) injury in rats following acute myocardial ischemia and investigate the underlying molecular mechanisms of these effects. Male Wistar rats were randomly divided into the following groups (n=10/group): Sham operation; I/R; HMGB50 (50 ng/kg HMGB1 before I/R); HMGB100 (100 ng/kg HMGB1 before I/R); and HMGB200 (200 ng/kg HMGB1 before I/R). Serum cardiac troponin I (cTnI), interleukin (IL)-6 and tumor necrosis factor (TNF)-α levels were subsequently measured. Myocardial levels of malondialdehyde (MDA) and superoxide dismutase (SOD) were also determined. Myocardial infarction size (IS) was determined by 2,3,5-triphenyltetrazolium chloride staining. Myocardial expression of hypoxia inducible factor (HIF)-1α and phosphorylated p38 mitogen-activated protein kinase (P-p38 MAPK) protein was measured using western blotting. The results demonstrated that HMGB1 significantly decreased serum levels of cTnI, IL-6 and TNF-α and myocardial IS in I/R rats compared with the sham group (all P more...
- Published
- 2016
22. Cardiac cephalgia
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T. Ferrante, Giorgio Lambru, Paola Torelli, Andrea Evangelista, Annamaria Bini, Paola Castellini, and Gian Camillo Manzoni
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Cardiovascular event ,medicine.medical_specialty ,Acute myocardial ischemia ,Migraine Disorders ,Myocardial Ischemia ,Clinical Neurology ,Review ,Coronary Angiography ,Diagnosis, Differential ,Electrocardiography ,Headache attributed to disorder of homoeostasis ,Cephalalgia ,Internal medicine ,Secondary headache ,Headache Disorders, Secondary ,medicine ,Humans ,Cardiac cephalgia ,book ,book.periodical ,Past medical history ,Coronary event ,business.industry ,Tension-Type Headache ,Electroencephalography ,General Medicine ,medicine.disease ,Exertional headache ,Anesthesiology and Pain Medicine ,Migraine ,Cardiology ,International Classification of Headache Disorders ,Neurology (clinical) ,Headaches ,medicine.symptom ,business ,Medical literature - Abstract
The purpose of this review was to provide a critical evaluation of medical literature on so-called “cardiac cephalgia” or “cardiac cephalalgia”. The 2004 International Classification of Headache Disorders codes cardiac cephalgia to 10.6 in the group of secondary headaches attributed to disorder of homoeostasis. This headache is hardly recognizable and is associated to an ischaemic cardiovascular event, of which it may be the only manifestation in 27% of cases. It usually occurs after exertion. Sometimes routine examinations, cardiac enzymes, ECG and even exercise stress test prove negative. In such cases, only a coronary angiogram can provide sufficient evidence for diagnosis. Cardiac cephalgia manifests itself without a specific pattern of clinical features: indeed, in this headache subtype there is a high variability of clinical manifestations between different patients and also within the same patient. It “mimics” sometimes a form of migraine either accompanied or not by autonomic symptoms, sometimes a form of tension-type headache; on other occasions, it exhibits characteristics that can hardly be interpreted as typical of primary headache. Pain location is highly variable. When the headache occurs as the only manifestation of an acute coronary event, the clues for suspicion are a) older age at onset, b) no past medical history of headache, c) presence of risk factors for vascular disorders and d) onset of headache under stress. Knowledge of cardiac cephalgia is scarce, due to its rare clinical occurrence and to the scant importance given to headache as a symptom concomitantly with an ischaemic cardiac event. more...
- Published
- 2009
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23. Hydrosulfide attenuates acute myocardial ischemic injury through the glycogen synthase kinase-3β/β-catenin signaling pathway
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Jianxin Zhang, Li-Jun Xie, Na Hao, Qin-zeng Zhang, Ning Ge, Guofeng Li, Li-ping Li, and Chao Liu
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0301 basic medicine ,Male ,Mean arterial pressure ,Blood Pressure ,Myocardial Reperfusion Injury ,030204 cardiovascular system & hematology ,Pharmacology ,Bioinformatics ,glycogen synthase kinase-3β ,03 medical and health sciences ,Necrosis ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Downregulation and upregulation ,GSK-3 ,Genetics ,medicine ,Animals ,Myocardial infarction ,Hydrogen Sulfide ,Phosphorylation ,Glycogen synthase ,GSK3B ,beta Catenin ,Glycogen Synthase Kinase 3 beta ,biology ,business.industry ,Myocardium ,apoptosis ,General Medicine ,Articles ,β-catenin ,medicine.disease ,Rats ,hydrosulfide ,Disease Models, Animal ,030104 developmental biology ,Apoptosis ,biology.protein ,Apoptotic signaling pathway ,SB216763 ,business ,acute myocardial ischemia ,Biomarkers ,Signal Transduction - Abstract
The endogenous signaling gasotransmitter, hydrosulfide (H2S), has been shown to exert cardioprotective effects against acute myocardial infarction (AMI) due to ischemic injury. However, the mechanisms responsible for these effects are not yet fully understood. In this study, we investigated whether sodium hydrogen sulfide (NaHS), an H2S donor, attenuates acute myocardial ischemic injury through glycogen synthase kinase-3β (GSK-3β)/β-catenin signaling. For this purpose, we utilized an in vivo rat model of AMI by occluding the left anterior descending coronary artery. NaHS (0.39, 0.78 or 1.56 mg/kg, intraperitoneally), the GSK-3β inhibitor, SB216763 (0.6 mg/kg, intravenously), or 1% dimethylsulfoxide (2 ml/kg, intravenously) were administered to the rats. The results demonstrated that the administration of medium- and high-dose NaHS and SB216763 significantly improved rat cardiac function, as evidenced by an increase in the mean arterial pressure, left ventricular developed pressure, contraction and relaxation rates, as well as a decrease in left ventricular end-diastolic pressure. In addition, the administration of NaHS and SB216763 attenuated myocardial injury as reflected by a decrease in apoptotic cell death and in the serum lactate dehydrogenase concentrations, and prevented myocardial structural changes. The administration of NaHS and SB216763 increased the concentrations of phosphorylated (p-)GSK-3β, the p-GSK-3β/t-GSK-3β ratio and downstream protein β-catenin. Moreover, western blot and immunohistochemical analyses of apoptotic signaling pathway proteins further established the cardioprotective potential of NaHS, as reflected by the upregulation of Bcl-2 expression, the downregulation of Bax expression, and a decrease in the number of TUNEL-positive stained cells. These findings suggest that hydrosulfide exerts cardioprotective effects against AMI-induced apoptosis through the GSK-3β/β-catenin signaling pathway. more...
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- 2015
24. Estimation of microinhomogeneity of conduction impairment by wavelet analysis during early phase of myocardial ischemia in pigs
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Tetsuo Furukawa, Toshiyuki Ishibashi, Kazuhira Maehara, Shuichi Saito, and Yukio Maruyama
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Male ,medicine.medical_specialty ,Swine ,Myocardial Ischemia ,Anterior Descending Coronary Artery ,QRS complex ,Basal (phylogenetics) ,Electrocardiography ,Wavelet ,493.23 ,Heart Conduction System ,Heart Rate ,Internal medicine ,Heart rate ,Medicine ,Animals ,Ventricular Fibrillation ,business.industry ,wavelet analysis ,General Medicine ,medicine.disease ,Thermal conduction ,Female ,Coronary occlusion ,Ventricular fibrillation ,Cardiology ,business ,inhomogeneous conduction ,acute myocardial ischemia - Abstract
Ventricular fibrillation (VF) is most frequent in the very early phase in acute coronary occlusion, and is triggered by the re-entrant mechanism in this phase. An inhomogeneous conduction in the ischemic myocardium would be substrates for re-entry. The aim of this study was to examine the relationship between the severity of irregularities of the QRS complex and VF. Eleven pigs were analyzed, and the heart was fixed in the pericardial cradle. Ag-AgCI bipolar electrodes were fixed on the epicardium in ischemic and non-ischemic regions. The proximal portion of the left anterior descending coronary artery was occluded for one hour. Electrocardiograms (ECGs) were continuously recorded on a magnetic tape, and wavelet analysis was performed on signal-averaged ECG (25 beats) every 60 sec after the experiment. The number of local maxima (N) and the duration between the first and the last local maximum (D) were automatically measured. Nand D significantly increased in the ischemic area, but not in the non-ischemic area. Nand D increased approximately twofold just before the occurrence of VF in 8 fibrillated pigs (p < 0.01, each). There were significant positive linear relationships between the rate of increase in Nand D to VF and basal heart rate before coronary occlusion (r = 0.90, P < 0.01 in N, r = 0.84, P < 0.01 in D at 160 Hz). These results suggest that there would be a threshold inhomogeneous conduction for the occurrence of VF and an increase in heart rate would accelerate the inhomogeneous conduction in acute myocardial ischemia. more...
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- 2006
25. Protective effect of active perfusion in porcine models of acute myocardial ischemia
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Zhifu Mao, Baohui Liu, Shengjun Dong, and Zanxiang Feng
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Male ,Cancer Research ,medicine.medical_specialty ,Pathology ,Swine ,Ischemia ,Coronary Artery Bypass, Off-Pump ,Myocardial Ischemia ,Apoptosis ,Constriction, Pathologic ,030204 cardiovascular system & hematology ,Creatine ,Biochemistry ,Constriction ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Troponin I ,Genetics ,medicine ,Animals ,Molecular Biology ,business.industry ,Caspase 3 ,Myocardium ,animal model ,Articles ,medicine.disease ,active perfusion ,Perfusion ,Stenosis ,Disease Models, Animal ,medicine.anatomical_structure ,Oncology ,chemistry ,Proto-Oncogene Proteins c-bcl-2 ,030220 oncology & carcinogenesis ,Cardiology ,Aortic pressure ,Molecular Medicine ,business ,acute myocardial ischemia ,shunt perfusion ,Artery - Abstract
Mortality rates associated with off‑pump coronary artery bypass (CAB) are relatively high, as the majority of patients requiring CAB are at a high risk for cardiac events. The present study aimed to establish porcine models of acute myocardial ischemia, and evaluate the protective role of shunt and active perfusion. A total of 30 pigs were randomly assigned to five groups, as follows: i) Sham (control); ii) A1 (shunt; stenosis rate, 55%); iii) A2 (shunt; stenosis rate, 75%); iv) B1 (active perfusion; stenosis rate, 55%); and v) B2 (active perfusion; stenosis rate, 75%) groups. Aortic pressure (P0), left anterior descending coronary pressure (P1), and coronary effective perfusion pressure (P1/P0) were measured. The expression levels of tumor necrosis factor‑α (TNF‑α), cardiac troponin (cTnI), creatine kinase‑myocardial band (CK‑MB), interleukin (IL)‑6, IL‑10, B‑cell lymphoma 2 (Bcl‑2), and caspase‑3 were detected using enzyme‑linked immunosorbent assay or western blotting. The myocardial apoptosis rate was determined using the terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Ischemia models with stenosis rates of 55 and 75% were successfully constructed following suturing of the descending artery. Compared with the control, the 55 and 75% stenosis groups demonstrated significantly decreased P1/P0, increased expression levels of TNF‑α, cTnI, CK‑MB, IL‑6, IL‑10 and caspase‑3, an increased rate of myocardial apoptosis, and a decreased expression level of anti‑apoptotic protein, Bcl‑2. At 30 min following successful establishment of the model (ST segment elevation to 1 mm), group B demonstrated significantly increased P1/P0, decreased expression levels of TNF‑α, cTnI, CK‑MB, IL‑6, IL‑10 and caspase‑3, a decreased rate of myocardial apoptosis, and an increased expression level of anti-apoptotic protein, Bcl‑2. Furthermore, the current study indicated that active perfusion was more efficacious in maintaining myocardial perfusion and alleviating ischemic injury when compared with traditional shunt perfusion. more...
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- 2015
26. Plasma ProBNP Is Not a Specific Marker for Transient Myocardial Ischemia
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Khawar Maqsood, Amir Lotfi, James R. Cook, Gregory R. Giugliano, and Muhammad Tariq Shakoor
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medicine.medical_specialty ,Radiographic contrast media ,Acute myocardial ischemia ,business.industry ,medicine.medical_treatment ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Diagnostic catheterization ,Surgery ,Angina ,ProBNP ,Internal medicine ,Conventional PCI ,medicine ,Cardiology ,Ventricular pressure ,Original Article ,Myocardial infarction ,cardiovascular diseases ,business ,hormones, hormone substitutes, and hormone antagonists ,Cardiac catheterization - Abstract
Background: Plasma proBNP levels are increased in patients with acute myocardial infarction. Previous studies have shown conflicting data on the effect of transient myocardial ischemia on plasma BNP levels. We designed the current study to examine plasma proBNP levels in patients with transient myocardial ischemia during a percutaneous coronary intervention (PCI). This study was to study plasma proBNP as a marker of transient myocardial ischemia. Methods: We enrolled 49 consecutive patients with a history of angina or abnormal stress test who presented for cardiac catheterization. We obtained plasma proBNP levels in all patients at 1) arterial access (proBNP-1), 2) the end of the procedure (proBNP-2) and 3) 4 hours after procedure (proBNP-3). Hotelling’s T-squared test was used to evaluate the equality of means. Log transforms of proBNP were used to impart data normality. Results: Twenty-two patients underwent diagnostic catheterization (DCA group) and 27 underwent PCI (PCI group). Both groups had normal left ventricular function and a baseline creatinine < 2 mg/dL. Baseline log (proBNP) was 4.7 + 0.99 (units) and rose significantly at 4 hours in both groups (P < 0.02), with no difference in rate of change. Conclusions: Plasma proBNP was increased in both DCA and PCI groups which limits its utility to identify transient myocardial ischemia. The etiology of increase in proBNP in both groups is speculative and may be related to injection of radiographic contrast media into the coronary artery which leads to microcirculatory impairment resulting in myocardial tissue hypoxia and transient increase in left ventricular pressure; however, further evaluation is required. J Clin Med Res. 2015;7(7):506-510 doi: http://dx.doi.org/10.14740/jocmr2024w more...
- Published
- 2014
27. Roles of arterial baroreceptor reflex during bezold-jarisch reflex
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Koji Kashihara
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Bradycardia ,medicine.medical_specialty ,Baroreceptor ,Infarction ,Sympathetic nerve activity ,Baroreflex ,central pathway ,Article ,Internal medicine ,medicine ,cardiovascular diseases ,cardiopulmonary reflex ,business.industry ,Apnea ,acute myocardial ischemia ,General Medicine ,medicine.disease ,Blood pressure ,Bezold–Jarisch reflex ,Anesthesia ,Reflex ,Cardiology ,cardiovascular system ,medicine.symptom ,arterial pressure ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology - Abstract
Among the many cardiopulmonary reflexes, this review specifically examines the roles of the arterial baroreflex during the Bezold-Jarisch reflex (BJR). Activation of cardiopulmonary vagal afferent C-fibers induces hypotension, bradycardia, and apnea, which are known collectively as the BJR; myocardial ischemia and infarction might induce the BJR. Arterial baroreflex has been established as an important negative feedback system that stabilizes arterial blood pressure against exogenous pressure perturbations. Therefore, understanding the functions of the arterial baroreflex during the BJR is crucial for elucidating its pathophysiological implications. The main central pathways of the BJR and the baroreflex are outlined herein, particularly addressing the common pathway between the reflexes. Furthermore, the pathophysiological roles of the arterial baroreflex during the BJR are described along with a brief discussion of pathophysiological merits and shortcomings of the reflexes. more...
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- 2008
28. Effects of propranolol and diltiazem on carnitine derivatives and acyl CoA in ischemic myocardium
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Jun Kamiya, Akira Kobayashi, and Noboru Yamazaki
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Male ,medicine.medical_specialty ,Acute myocardial ischemia ,Long chain acyl CoA ,Physiology ,Coronary Disease ,Propranolol ,Diltiazem ,chemistry.chemical_compound ,Acyl-CoA ,Adenosine Triphosphate ,Dogs ,Carnitine ,Internal medicine ,medicine ,Animals ,chemistry.chemical_classification ,biology ,Chemistry ,Myocardium ,Fissipedia ,Fatty acid ,Arrhythmias, Cardiac ,Benzazepines ,biology.organism_classification ,Endocrinology ,Coronary occlusion ,cardiovascular system ,Female ,Acyl Coenzyme A ,Carnitine derivatives ,Cardiology and Cardiovascular Medicine ,Oxidation-Reduction ,Adenosine triphosphate ,medicine.drug - Abstract
The accumulation of intermediates subsequent to impaired β-oxidation of free fatty acid (FFA) has been suggested as a cause of cellular damage in ischemic myocardium. ^ We investigated the effects of propranolol and diltiazem on carnitine metabolism in ischemic myocardium. Propranolol (0.2 mg/kg/min, i.v.) and diltiazem (0.1 mg/kg/min, i.v.) were administered for 5 min, the administration started 10 min before coronary occlusion. ECGs were continuously recorded throughout the experiment. Myocardial samples were prepared from both the non-ischemic and ischemic areas 40 min after coronary ligation. Adenosine triphosphate (ATP), free carnitine, long chain acyl carnitine and long chain acyl CoA were assayed. Propranolol reduced the decrease of ATP and the accumulation of long chain acyl CoA, induced by myocardial ischemia. Diltiazem reduced the decrease of ATP and free carnitine, and the accumulation of long chain acyl carnitine in the ischemic area. Propranolol and diltiazem significantly reduced the grade of ventricular arrhythmia. These results suggest that the protective mechanisms of propranolol and diltiazem on myocardium are based, at least in part, on their beneficial effects upon myocardial carnitine metabolism more...
- Published
- 1985
- Full Text
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29. EFFECTS OF L-CARNITINE ON VENTRICULAR ARRHYTHMIAS IN DOGS WITH ACUTE MYOCARDIAL ISCHEMIA AND A SUPPLEMENT OF EXCESS FREE FATTY ACIDS
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Noboru Yamazaki, Tadashi Kamikawa, and Yoshikazu Suzuki
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medicine.medical_specialty ,Acute myocardial ischemia ,Physiology ,Myocardial Infarction ,Anterior Descending Coronary Artery ,Fatty Acids, Nonesterified ,Excess free fatty acids ,chemistry.chemical_compound ,Bolus (medicine) ,Adenosine Triphosphate ,Dogs ,Ventricular arrhythmias ,Internal medicine ,Carnitine ,medicine ,L-carnitine ,Animals ,cardiovascular diseases ,business.industry ,Arrhythmias, Cardiac ,Heparin ,medicine.disease ,chemistry ,Coronary occlusion ,Cardiology ,cardiovascular system ,Myocardial infarction complications ,lipids (amino acids, peptides, and proteins) ,Cardiology and Cardiovascular Medicine ,Ligation ,business ,Adenosine triphosphate ,medicine.drug - Abstract
The effects of L-carnitine on ventricular arrhythmias were evaluated in dogs with acute myocardial ischemia and a supplement of excess free fatty acids (FFA). Acute myocardial ischemia was induced by ligation of left anterior descending coronary artery. After 80 minutes of coronary occlusion, high plasma FFA was induced by intravenous injection of heparin 200 mu/kg and Intralipid 5 ml/kg as a bolus. After additional 60 minutes, beating hearts were removed from animals and tissue levels of free carnitine, short and long chain acyl carnitine, FFA and adenosine triphosphate (ATP) were determined. L-carnitine 100 mg/kg was administered intravenously 5 minutes before coronary artery ligation. Electrocardiograms were recorded continuously by a Holter electrocardiographic recorder during the experiment and ventricular arrhythmias were quantified by an arbitrary scoring system. In ischemic and excess FFA supplemented myocardium, free carnitine and ATP decreased, whereas long chain acyl carnitine and FFA increased. And these metabolic changes tended to be reduced by L-carnitine. Pretreatment of L-carnitine also reduced the grade of ventricular arrhythmias induced both by acute myocardial ischemia and by supplemented of excess FFA. These results suggest that the administration of L-carnitine may be beneficial to prevent serious arrhythmias in ischemic heart disease, presumably by restoring the imparied FFA oxidation. more...
- Published
- 1980
30. Assessment of the length of sick leave in patients with ischemic heart disease
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Jordi Real Gatius, Leonardo Galván Santiago, Catalina Serna Arnaiz, Nausica Català Tella, Oriol Yuguero Torres, [Català-Tella N, Serna-Arnaiz C] Centre d’Atenció Primària (CAP) Eixample, Institut Català de la Salut, Lleida, Spain. [Real-Gatius J] Unitat de Suport a la Recerca Lleida, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Lleida, Spain. Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat, Barcelona, Spain. [Yuguero-Torres O] Servicio de Urgencias, Hospital Universitari Arnau de Vilanova, Lleida, Spain. [Galvan L] Unitat de Farmàcia, Departament Català de la Salut, Lleida, Spain, and IDIAP Jordi Gol more...
- Subjects
Male ,Time Factors ,Características de la Población::factores socioeconómicos::renta::salarios y retribuciones en especie::licencia por enfermedad [ATENCIÓN DE SALUD] ,Heart diseases ,Myocardial Ischemia ,Disease ,Efficiency ,030204 cardiovascular system & hematology ,Malalties del cor ,Angina ,0302 clinical medicine ,Ischemia ,Risk Factors ,Absenteeism ,Sick leave ,Isquèmia ,Medicine ,030212 general & internal medicine ,Myocardial infarction ,Population Characteristics::Socioeconomic Factors::Income::Salaries and Fringe Benefits::Sick Leave [HEALTH CARE] ,Anxiety/depression ,Age Factors ,Health Care Costs ,Middle Aged ,ambiente y salud pública::salud pública::métodos epidemiológicos::características de los estudios epidemiológicos::estudios epidemiológicos::estudios de cohortes [ATENCIÓN DE SALUD] ,Antidepressive Agents ,Cardiac surgery ,Coronary heart disease ,Cardiology ,Female ,Raonament basat en casos ,Acute coronary syndrome ,Cardiology and Cardiovascular Medicine ,Baixa mèdica ,Research Article ,Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia [DISEASES] ,medicine.medical_specialty ,Acute myocardial ischemia ,Cost ,Ischemic heart disease ,enfermedades cardiovasculares::enfermedades cardíacas::isquemia miocárdica [ENFERMEDADES] ,Malalties coronàries ,Drug Prescriptions ,03 medical and health sciences ,Internal medicine ,Humans ,Angiology ,Retrospective Studies ,business.industry ,Retrospective cohort study ,medicine.disease ,Anti-Anxiety Agents ,Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics::Epidemiologic Studies::Cohort Studies [HEALTH CARE] ,business - Abstract
Acute coronary syndrome; Coronary heart disease; Sick leave Síndrome Coronario Agudo; Enfermedad Coronaria; Ausencia por enfermedad Síndrome coronari agut; Malaltia coronària; Absència per malaltia BACKGROUND The prevalence of ischemic heart disease is high. Few recent studies have investigated the periods of sick leave of these patients. Our aim is to determine the length of sick leave after an acute coronary syndrome, its costs, associated factors and to assess the use of antidepressants and/or anxiolytics. METHODS An observational study of a retrospective cohort of patients on sick leave due to ischemic heart disease in a health region between 2008-2011, with follow-up until the first return to work, death, or end of the study (31/12/2012). MEASUREMENTS length of sick leave, sociodemographic variables and medical prescriptions. RESULTS Four hundred and ninety-seven patients (mean age 53 years, 90.7% male), diagnosed with acute myocardial infarction (60%), angina pectoris (20.7%) or chronic form of ischemic heart disease (19.1%). Thirty-seven per cent of patients took anxiolytics the year after diagnosis and 15% took antidepressants. The average duration of sick leave was 177 days (95% CI: 163-191 days). Patients diagnosed with acute myocardial infarction returned to work after a mean of 192 days, compared to 128 days in cases with angina pectoris. Patients who took antidepressants during the year after diagnosis returned to work after a mean of 240 days. The mean work productivity loss was estimated to be 9,673 euros/person. CONCLUSIONS The mean duration of sick leave due to ischemic heart disease was almost six months. Consumption of psychotropic medication doubled after the event. Older age, suffering an acute myocardial infarction and taking antidepressants were associated with a longer sick leave period. more...
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