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- Berg, JonathanLund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Cardiac MR Group,Lund University Research Groups,Syntach AB,Skåne University Hospital (författare)
Mild hypothermia attenuates ischemia/reperfusion injury - insights from serial non-invasive pressure-volume loops
- Artikel/kapitelEngelska2023
Förlag, utgivningsår, omfång ...
- 2023-02-03
- Oxford University Press (OUP),2023
Nummerbeteckningar
- LIBRIS-ID:oai:lup.lub.lu.se:7d10ea8c-a7ba-4731-96b3-74b8f1dd129e
- https://lup.lub.lu.se/record/7d10ea8c-a7ba-4731-96b3-74b8f1dd129eURI
- https://doi.org/10.1093/cvr/cvad028DOI
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- Språk:engelska
- Sammanfattning på:engelska
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- BACKGROUND: Mild hypothermia, 32-35°C, reduces infarct size in experimental studies, potentially mediating reperfusion injuries, but human trials have been ambiguous. To elucidate the cardioprotective mechanisms of mild hypothermia, we analyzed cardiac performance in a porcine model of ischemia/reperfusion, with serial cardiovascular magnetic resonance (CMR) imaging throughout one week using non-invasive pressure-volume loops.METHODS AND RESULTS: Normothermia and Hypothermia groups sessions (n=7+7 pigs, nonrandom allocation) were imaged with CMR at baseline and subjected to 40 minutes of normothermic ischemia by catheter intervention. Thereafter, the Hypothermia group was rapidly cooled (mean 34.5°C) for 5 minutes before reperfusion. Additional CMR sessions at two hours, 24 hours, and seven days acquired ventricular volumes and ischemic injuries (unblinded analysis).Stroke volume (-24%; p=0.029; Friedmans test) and ejection fraction (-20%; p=0.068) were notably reduced at 24h in the Normothermia group compared to baseline. In contrast, the decreases were ameliorated in the Hypothermia group (stroke volume: -6%; p=0.77; ejection fraction: -6%; p=0.13). Mean arterial pressure remained stable in Normothermic animals (-3%, p=0.77) but dropped two hours post-reperfusion in hypothermic animals (-18%, p=0.007). Both groups experienced a decrease and partial recovery pattern for PV loop-derived variables over one week, but the adverse effects tended attenuated in the Hypothermia group. Infarct sizes were 10±8% in Hypothermic and 15±8% in Normothermic animals (p=0.32). Analysis of covariance at 24 hours indicated that hypothermia has cardioprotective properties incremental to reducing infarct size, such as higher external power (p=0.061) and lower arterial elastance (p=0.015).CONCLUSION: Using non-invasive pressure-volume loops by CMR, we observed that mild hypothermia at reperfusion alleviates the heart's work after ischemia/reperfusion injuries during the first week and preserves short-term cardiac performance. This hypothesis-generating study suggests hypothermia to have cardioprotective properties, incremental to reducing infarct size. The primary cardioprotective mechanism was likely an afterload reduction acutely unloading the left ventricle.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
- Jablonowski, RobertSkåne University Hospital(Swepub:lu)med-rjb (författare)
- Nordlund, DavidSkåne University Hospital(Swepub:lu)med-dnn (författare)
- Ryd, DanielSkåne University Hospital(Swepub:lu)da6014sa (författare)
- Heiberg, EinarSkåne University Hospital(Swepub:lu)klin-eh0 (författare)
- Carlsson, MarcusSkåne University Hospital(Swepub:lu)klin-mca (författare)
- Arheden, HåkanSkåne University Hospital(Swepub:lu)klfy-har (författare)
- Klinisk fysiologi, LundSektion V (creator_code:org_t)
Sammanhörande titlar
- Ingår i:Cardiovascular Research: Oxford University Press (OUP)119:12, s. 2230-22431755-32450008-6363
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- Cardiovascular Research (Sök värdpublikationen i LIBRIS)
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