Abstract:
BACKGROUND:Reopening of the infarct-related coronary artery is the treatment of choice in the clinical setting of acute myocardial infarction. Nevertheless the removal of the total occlusion obtained either by thrombolysis or by primary angioplasty is followed by the ischemia/reperfusion sequelae. One of many proposed mechanisms playing a role in ischemia/reperfusion damage is a persistent increase in vasoconstrictor tone, which reduces cardiac function and impairs myocardial blood flow during primary percutaneous coronary intervention in acute myocardial infarction (PAMI). METHODS:To investigate early neurohumoral changes during PAMI we enrolled 18 patients, who were collated to 13 patients with stable angina undergoing elective PTCA. To evaluate angiotensin II (AngII), endothelin-1 (ET-1), vasopressin (AVP), norepinephrine (NE), troponin T (TNT), creatinephosphate kinase (CPKM) and isoenzyme MB (CPKMB), we collected blood from the pulmonary artery before and immediately after the infarct-related artery (IRA; TIMI 0 --> 2-3) or culprit lesion revascularization. Hemodynamic and angiographic LV-function parameters were compared to biochemical data. Corrected TIMI-frame count (CTFC) was used as an index of coronary blood flow and correlated to the biochemical measurements. RESULTS:CTFC in the IRA correlated inversely (p = 0.03; r = -0.51) with left ventricular ejection fraction measured after 10 days, and positively (p = 0.03; r = 0.54) with the maximal amount of LDH released after onset of AMI. There was an abrupt and long lasting rise in ET-1 (+65 %; p < 0.001) and an instant short lasting increase in AVP (+37 %; p < 0.05), whereas NE concentrations were elevated prior to PAMI and remained elevated during reperfusion. Correlations with CTFC were found for ET-1 (p = 0.01; r = 0.61) and NE (p = 0.01; r = 0.58) during reperfusion. The extent of left ventricular dysfunction correlated with the concentrations of AVP and NE during reperfusion. CONCLUSIONS:There is evidence for a distinct pattern of neurohumoral activation during early reperfusion in acute myocardial infarction. In particular, we documented substantial increases in AVP and ET-1. Left ventricular wall-stress appears to be involved in the release of AVP. Elevated levels of ET-1 and NE are associated with impaired angiographic reperfusion and increased myocardial damage after mechanical recanalization.
journal_name
Basic Res Cardioljournal_title
Basic research in cardiologyauthors
Schäfer U,Kurz T,Jain D,Hartmann F,Dendorfer A,Tölg R,Raasch W,Dominiak P,Katus H,Richardt Gdoi
10.1007/s003950200049keywords:
subject
Has Abstractpub_date
2002-09-01 00:00:00pages
399-408issue
5eissn
0300-8428issn
1435-1803journal_volume
97pub_type
杂志文章abstract::In situ hearts and isolated cardiomyocytes from heterozygous connexin 43-deficient (Cx43+/-) mice cannot be protected by ischemic preconditioning or diazoxide. We have now addressed the role of connexin 43 in ischemic postconditioning (PC). Wild type (WT) and Cx43+/- mice were subjected to 30 min coronary occlusion an...
journal_title:Basic research in cardiology
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journal_title:Basic research in cardiology
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doi:10.1007/BF01935807
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journal_title:Basic research in cardiology
pub_type: 杂志文章,评审
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journal_title:Basic research in cardiology
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journal_title:Basic research in cardiology
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doi:
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journal_title:Basic research in cardiology
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF02190546
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/978-3-642-72461-9_10
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00794074
更新日期:1997-01-01 00:00:00
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/s00395-006-0592-5
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01907132
更新日期:1990-07-01 00:00:00
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01906456
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journal_title:Basic research in cardiology
pub_type: 杂志文章
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01908132
更新日期:1982-01-01 00:00:00
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01907580
更新日期:1980-03-01 00:00:00
abstract::The focal adhesion and microfilament-associated protein VASP is a major substrate of both cAMP- and cGMP-dependent protein kinase in intact human platelets. The recent elucidation of the primary VASP structure and identity of VASP binding proteins suggest that VASP is an important component of focal contacts which lin...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00788712
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00798259
更新日期:1993-03-01 00:00:00
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/s00395-019-0773-7
更新日期:2020-01-09 00:00:00
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journal_title:Basic research in cardiology
pub_type: 临床试验,杂志文章
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更新日期:1983-11-01 00:00:00
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journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00788632
更新日期:1997-06-01 00:00:00