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Journal of Cardiovascular Translational Research

Erschienen in:

07.05.2018 | Original Article

Mechano-chronotropic Unloading During the Acute Phase of Myocardial Infarction Markedly Reduces Infarct Size via the Suppression of Myocardial Oxygen Consumption

verfasst von: Genya Sunagawa, Keita Saku, Takahiro Arimura, Takuya Nishikawa, Hiroshi Mannoji, Kazuhiro Kamada, Kiyokazu Abe, Takuya Kishi, Hiroyuki Tsutsui, Kenji Sunagawa

Erschienen in: Journal of Cardiovascular Translational Research | Ausgabe 2/2019

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Abstract

The oxygen supply-demand imbalance is the fundamental pathophysiology of myocardial infarction (MI). Reducing myocardial oxygen consumption (MVO₂) in acute MI (AMI) reduces infarct size. Since left ventricular (LV) mechanical work and heart rate are major determinants of MVO₂, we hypothesized that the combination of LV mechanical unloading and chronotropic unloading during AMI can reduce infarct size via synergistic suppression of MVO₂. In a dog model of ischemia-reperfusion, as we predicted, the combination of mechanical unloading by Impella and bradycardic agent, ivabradine (IVA), synergistically reduced MVO₂. This was translated into the striking reduction of infarct size with Impella + IVA administered 60 min after the onset of ischemia compared to no treatment (control) and Impella groups (control 56.3 ± 6.5, Impella 39.9 ± 7.4 and Impella + IVA 23.7 ± 10.6%, p < 0.001). In conclusion, Impella + IVA during AMI reduced infarct size via marked suppression of MVO₂. The mechano-chronotropic unloading may serve as a powerful therapeutic option for AMI.

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Titel: Mechano-chronotropic Unloading During the Acute Phase of Myocardial Infarction Markedly Reduces Infarct Size via the Suppression of Myocardial Oxygen Consumption
verfasst von: Genya Sunagawa
Keita Saku
Takahiro Arimura
Takuya Nishikawa
Hiroshi Mannoji
Kazuhiro Kamada
Kiyokazu Abe
Takuya Kishi
Hiroyuki Tsutsui
Kenji Sunagawa
Publikationsdatum: 07.05.2018
Verlag: Springer US
Erschienen in: Journal of Cardiovascular Translational Research / Ausgabe 2/2019
Print ISSN: 1937-5387
Elektronische ISSN: 1937-5395
DOI: https://doi.org/10.1007/s12265-018-9809-x

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Springer Medizin

Mechano-chronotropic Unloading During the Acute Phase of Myocardial Infarction Markedly Reduces Infarct Size via the Suppression of Myocardial Oxygen Consumption

Abstract

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