A novel intracoronary hypothermia device reduces myocardial reperfusion injury in pigs
10.1097/CM9.0000000000003033
- VernacularTitle:A novel intracoronary hypothermia device reduces myocardial reperfusion injury in pigs
- Author:
Zhiqiang PEI
1
;
Jin QIU
;
Yongchao ZHAO
;
Shuai SONG
;
Rui WANG
;
Wei LUO
;
Xingxing CAI
;
Bin LIU
;
Han CHEN
;
Jiasheng YIN
;
Xinyu WENG
;
Yizhe WU
;
Chenguang LI
;
Li SHEN
;
Junbo GE
Author Information
1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Keywords:
Acute myocardial infarction;
Cardioprotection;
Hypothermia;
Inflammation;
Left ventricular systolic function;
Percutaneous coronary intervention;
Cardiac ma
- From:
Chinese Medical Journal
2024;137(20):2461-2472
- CountryChina
- Language:Chinese
-
Abstract:
Background::Hypothermia therapy has been suggested to attenuate myocardial necrosis; however, the clinical implementation as a valid therapeutic strategy has failed, and new approaches are needed to translate into clinical applications. This study aimed to assess the feasibility, safety, and efficacy of a novel selective intracoronary hypothermia (SICH) device in mitigating myocardial reperfusion injury.Methods::This study comprised two phases. The first phase of the SICH was performed in a normal porcine model for 30 minutes ( n = 5) to evaluate its feasibility. The second phase was conducted in a porcine myocardial infarction (MI) model of myocardial ischemia/reperfusion which was performed by balloon occlusion of the left anterior descending coronary artery for 60 minutes and maintained for 42 days. Pigs in the hypothermia group ( n = 8) received hypothermia intervention onset reperfusion for 30 minutes and controls ( n = 8) received no intervention. All animals were followed for 42 days. Cardiac magnetic resonance analysis (five and 42 days post-MI) and a series of biomarkers/histological studies were performed. Results::The average time to lower temperatures to a steady state was 4.8 ± 0.8 s. SICH had no impact on blood pressure or heart rate and was safely performed without complications by using a 3.9 F catheter. Interleukin-6 (IL-6), tumor necrosis factor-α, C-reactive protein (CRP), and brain natriuretic peptide (BNP) were lower at 60 min post perfusion in pigs that underwent SICH as compared with the control group. On day 5 post MI/R, edema, intramyocardial hemorrhage, and microvascular obstruction were reduced in the hypothermia group. On day 42 post MI/R, the infarct size, IL-6, CRP, BNP, and matrix metalloproteinase-9 were reduced, and the ejection fraction was improved in pigs that underwent SICH.Conclusions::The SICH device safely and effectively reduced the infarct size and improved heart function in a pig model of MI/R. These beneficial effects indicate the clinical potential of SICH for treatment of myocardial reperfusion injury.
