Ultrastructural Characteristics of Myocardial Reperfusion Injury and Effect of Selective Intracoronary Hypothermia: An Observational Study in Isolated Beating Porcine Hearts
El Farissi, Mohamed; Buscone, Serena; Bax, Noortje A M; van Rijswijk, Jan Willem; Veenendaal, Tineke; Keulards, Danielle C J; Zelis, Jo M; van Tuijl, Sjoerd; Eerdekens, Rob; Demandt, Jesse; Vervaat, Fabienne; Zimmermann, Frederik M; Bouwmeester, Sjoerd; Rave, Yahav; Zhu, Kwankwan S; Conrad, Cecile; van 't Veer, Marcel; Pijls, Nico H J; Klumperman, Judith; Bouten, Carlijn V C; Otterspoor, Luuk C
(2022) Therapeutic hypothermia and temperature management, volume 12, issue 2, pp. 129 - 137
(Article)
Abstract
In acute myocardial infarction (AMI), myocardial reperfusion injury may undo part of the recovery after revascularization of the occluded coronary artery. Selective intracoronary hypothermia is a novel method aimed at reducing myocardial reperfusion injury, but its presumed protective effects in AMI still await further elucidation. This proof-of-concept study assesses the
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potential protective effects of selective intracoronary hypothermia in an ex-vivo, isolated beating heart model of AMI. In four isolated Langendorff perfused beating pig hearts, an anterior wall myocardial infarction was created by inflating a balloon in the mid segment of the left anterior descending (LAD) artery. After one hour, two hearts were treated with selective intracoronary hypothermia followed by normal reperfusion (cooled hearts). In the other two hearts, the balloon was deflated after one hour, allowing normal reperfusion (control hearts). Biopsies for histologic and electron microscopic evaluation were taken from the myocardium at risk at different time points: before occlusion (t = BO); 5 minutes before reperfusion (t = BR); and 10 minutes after reperfusion (t = AR). Electron microscopic analysis was performed to evaluate the condition of the mitochondria. Histological analyses included evaluation of sarcomeric collapse and intramyocardial hematoma. Electron microscopic analysis revealed intact mitochondria in the hypothermia treated hearts compared to the control hearts where mitochondria were more frequently damaged. No differences in the prespecified histological parameters were observed between cooled and control hearts at t = AR. In the isolated beating porcine heart model of AMI, reperfusion was associated with additional myocardial injury beyond ischemic injury. Selective intracoronary hypothermia preserved mitochondrial integrity compared to nontreated controls.
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Keywords: STEMI, myocardial reperfusion injury, selective intracoronary hypothermia, Critical Care and Intensive Care Medicine, Anesthesiology and Pain Medicine, Journal Article
ISSN: 2153-7658
Publisher: Mary Ann Liebert Inc.
Note: Publisher Copyright: © Copyright 2022, Mary Ann Liebert, Inc., publishers 2022.
(Peer reviewed)