scholarly journals Therapeutic Potential of Tacrolimus on Acute Myocardial Infarction in Minipigs: Analysis with Serial Cardiac Magnetic Resonance and Changes at Histological and Protein Levels

2014 ◽  
Vol 2014 ◽  
pp. 1-13
Author(s):  
Sheung-Fat Ko ◽  
Hon-Kan Yip ◽  
Steve Leu ◽  
Chen-Chang Lee ◽  
Jiunn-Jye Sheu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Therapeutic Potential ◽  
Treated Group ◽  
Left Ventricular ◽  
Artery Ligation ◽  
Protein Levels

This study investigates the therapeutic potential of intracoronary tacrolimus against acute myocardial infarction (AMI) in minipigs with serial cardiac magnetic resonance (CMR) and changes at histological and protein levels. Twelve minipigs subjected to permanent left anterior descending artery ligation were randomized as tac-treated group (n=6, with intracoronary tacrolimus treatment) and controls(n=6). CMR with cine and late gadolinium enhancement (LGE) studies were performed on postoperative days 2, 5, and 21. There were no significant differences in left ventricular function (LVF), contractility, and LGE between the two groups on day 2. On day 5, the tac-treated group showed a significantly higher ejection fraction, smaller infarct, and lower day-5/day-2 infarct ratio than controls. On day 21, the controls demonstrated further deterioration of LVF and infarct. Contrastingly, the tac-treated animals demonstrated preservation of LVF, contractility, significantly smaller infarct, and lower day-21/day-2 infarct ratios compared with those on day 5 and controls. Thein vivoCMR results were correlated within vitrofindings on histology, immunostaining, and Western blotting which revealed significantly less fibrosis, higher vascularities, less CD68+ and CD40+ inflammatory cells, lower expressions of inflammatory (MMP-9, NF-κB, and TNF-α), and apoptotic (Bax, Caspase-3, c-PARP) biomarkers, respectively, in tac-treated AMI minipigs than controls.

Cardiac magnetic resonance detection of left ventricular thrombus in acute myocardial infarction

2013 ◽  
Vol 15 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Chiara Lanzillo ◽  
Mauro Di Roma ◽  
Alessandro Sciahbasi ◽  
Monia Minati ◽  
Luciano Maresca ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus ◽  
Resonance Detection

scholarly journals Cardiac Magnetic Resonance Left Ventricular Mechanical Uniformity Alterations for Risk Assessment After Acute Myocardial Infarction

2019 ◽  
Vol 8 (16) ◽  
Author(s):  
Thomas Stiermaier ◽  
Sören J. Backhaus ◽  
Torben Lange ◽  
Alexander Koschalka ◽  
Jenny‐Lou Navarra ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Assessment ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricular

scholarly journals P262 Left ventricular pseudoaneurism due to a non-reperfused myocardial infarction: multi-modality cardiac imaging approach

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J A Fuentes Mendoza ◽  
O A Mondaca Garcia ◽  
N G Espinola Zavaleta
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Left Ventricular ◽  
Medical Attention ◽  
Inferior Wall ◽  
Risk Of Rupture ◽  
The Right

Abstract Introduction Cardiac rupture has been one of the most frequent fatal complications of acute myocardial infarction in cases series reported since 1977. However, in exceptional cases, the rupture of the left ventricle is contained by the pericardium and by fibrous tissue, forming a pseudoaneurysm, which is characterized by the absence of myocardial tissue in its wall and a relatively narrow neck between the ventricle and the ventricular chamber. Although there is no estimated time for rupture, it is well established that the risk of rupture is 30 to 40% and mortality up to 10%. Pseudoaneurysm is a rarer entity than rupture and is usually diagnosed incidentally by imaging methods in up to 48% of cases. The most frequent imaging method for their diagnosis is 2D echocardiography, followed by cardiac catheterization and finally cardiac magnetic resonance. The most frequent location of the pseudoaneurysm secondary to acute myocardial infarction is the inferior wall and the posterolateral wall of the left ventricle. Case Report We present 72-year-old male patient with a history of type 2 diabetes and smoking, who started symptoms with sudden onset of oppressive chest pain of 20 minutes duration, he did not attend medical attention. A month later, he went for a valuation with a first-contact physician, who referred him to our institution with a diagnosis of acute myocardial infarction without reperfusion therapy. At the initial assessment, it was found asymptomatic, in the resting ECG was found QS pattern with reversal of the T wave in leads DII, DIII and AVF. Cardiac SPECT was performed and showed an inferior transmural infarction, which extended as non-transmural to the inferolateral and inferoseptal walls, without ischemia. (Img. 1 and 2). A 2D and 3D transthoracic echocardiogram was performed, in which akinesia of the inferoseptal and apical walls was documented, as well as a saccular pseudoaneurysm of 5.6 X 4.7 cm in the basal and middle segment of the inferior and inferolateral walls, with an entrance orifice. 2.6 X 2.4 cm, as well as pericardial effusion. (Fig. 3 and 4). Coronary angiography was performed, demonstrating chronic total occlusion of the right coronary in its proximal segment and ostial obstruction of the left anterior descending. Cardiac magnetic resonance revealed inferior infarction and the presence of a pseudoaneurysm with lamellar thrombus was corroborated. (Img. 5). The patient was taken to surgical treatment, by reconstruction of the left ventricle with the Dor technique and CABG of the right coronary artery and the anterior descending artery. Receives medical treatment and a 1-month follow-up is in class I of the NYHA. Conclusion It is a clinical case about a potentially fatal complication of acute myocardial infarction, which in our case was detected incidentally since the patient had remained asymptomatic, there lies the importance of obtaining an accurate diagnosis in order to impact on the patient survival. Abstract P262 Figure. Pseudoaneurysm multi-modality images

scholarly journals Superiority of cardiac magnetic resonance derived left-ventricular ejection fraction in the identification of true acute myocardial infarction among MINOCA patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Mantzouranis ◽  
I Leontsinis ◽  
A Sakalidis ◽  
D Klettas ◽  
D Avramidis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricular Ejection Fraction ◽  
Treatment Approach ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
History Of

Abstract Background/Introduction MINOCA constitutes a clinical entity characterized by heterogeneous and poorly understood pathophysiological substrate, whereas current knowledge leaves significant gaps regarding the identification, risk stratification and therapeutical approach of these patients. Purpose The aim of our study is to investigate the potential role of clinical, hemodynamic, laboratory and imaging parameters in the early identification of true acute myocardial infarction (AMI) among patients with a working diagnosis of MINOCA. Methods Our study population included 62 patients admitted with acute coronary syndrome (ACS) fulfilling the diagnostic criteria of MINOCA. A subsequent cardiac magnetic resonance (CMR) performed at 54 patients demonstrated an ischemic pattern of late gadolinium enhancement (LGE) confirming the diagnosis of true AMI in 15 cases (27.8%). Other findings included Takotsubo syndrome (n=19; 35.2%) and myocarditis (n=4; 7.4%), whereas CMR failed to reveal abnormal findings at 16 cases (29.8%). Results Focusing on the combined population of true AMI and clear CMR groups (n=31; 51.6% male; mean age: 58±12 years old; 42% hypertensives (HTN), 16% with history of diabetes mellitus (DM), 28.6% smokers) no significant difference was observed regarding classic cardiovascular risk factors (HTN, DM, smoking, age, dyslipidemia) except for a tendency of overrepresentation of female sex (r=0.354; p=0.051) in the true AMI group. Coronary angiographic (CA) findings did not differ between the two groups: clear vessels: 16/31 (51.6%); lesions causing ≤50% stenosis: 7/31 (22.6%); bridges: 4/31 (12.9%); spontaneous coronary artery dissection (SCAD): 2/31 (6.5%); slow flow phenomenon or spontaneous epicardial spasm: 2/31 (6.5%). No difference was observed in treatment approach with beta-blockers, renin-angiotensin system blockers, statins or the selection of no, single or dual antiplatelet strategy. Univariate regression analysis demonstrated that CMR derived left-ventricular ejection fraction (CMR-LVEF) (OR, 0.846; CI 95%: 0.742–0.965; p=0.012), as well as admission ECG abnormalities (OR, 0.154; CI 95%: 0.026–0.914; p=0.04), admission (OR, 5.689; CI 95%: 1.374–23.553; p=0.016) and peak troponin levels (OR, 15.874; CI 95%: 2.486–101.367; p=0.003) were the only parameters significantly related to a true AMI. Statistical significance was retained in multivariate models adjusted for age, gender, history of HTN and DM. On the contrary echocardiography derived LVEF failed to predict true AMI. Conclusions These preliminary results further highlight the need of an early CMR evaluation of MINOCA patients. A timely identification of true AMI is expected to improve patient outcomes by guiding the treatment approach. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Cardiac magnetic resonance derived global longitudinal strain outperfoms established functional parameters in prognostication after ST-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Holzknecht ◽  
M Reindl ◽  
C Tiller ◽  
I Lechner ◽  
T Hornung ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Independent Predictor ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
St Elevation

Abstract Background Left ventricular ejection fraction (LVEF) is the parameter of choice for left ventricular (LV) function assessment and risk stratification of patients with ST-elevation myocardial infarction (STEMI); however, its prognostic value is limited. Other measures of LV function such as global longitudinal strain (GLS) and mitral annular plane systolic excursion (MAPSE) might provide additional prognostic information post-STEMI. However, comprehensive investigations comparing these parameters in terms of prediction of hard clinical events following STEMI are lacking so far. Purpose We aimed to investigate the comparative prognostic value of LVEF, MAPSE and GLS by cardiac magnetic resonance (CMR) imaging in the acute stage post-STEMI for the occurrence of major adverse cardiac events (MACE). Methods This observational study included 407 consecutive acute STEMI patients treated with primary percutaneous coronary intervention (PCI). Comprehensive CMR investigations were performed 3 [interquartile range (IQR): 2–4] days after PCI to determine LVEF, GLS and MAPSE as well as myocardial infarct characteristics. Primary endpoint was the occurrence of MACE defined as composite of death, re-infarction and congestive heart failure. Results During a follow-up of 21 [IQR: 12–50] months, 40 (10%) patients experienced MACE. LVEF (p=0.005), MAPSE (p=0.001) and GLS (p<0.001) were significantly related to MACE. GLS showed the highest prognostic value with an area under the curve (AUC) of 0.71 (95% CI 0.63–0.79; p<0.001) compared to MAPSE (AUC: 0.67, 95% CI 0.58–0.75; p=0.001) and LVEF (AUC: 0.64, 95% CI 0.54–0.73; p=0.005). After multivariable analysis, GLS emerged as sole independent predictor of MACE (HR: 1.22, 95% CI 1.11–1.35; p<0.001). Of note, GLS remained associated with MACE (p<0.001) even after adjustment for infarct size and microvascular obstruction. Conclusion CMR-derived GLS emerged as strong and independent predictor of MACE after acute STEMI with additive prognostic validity to LVEF and parameters of myocardial damage. Funding Acknowledgement Type of funding source: None

scholarly journals Adropin-based dual treatment enhances the therapeutic potential of mesenchymal stem cells in rat myocardial infarction

2021 ◽  
Vol 12 (6) ◽  
Author(s):  
HuiYa Li ◽  
DanQing Hu ◽  
Guilin Chen ◽  
DeDong Zheng ◽  
ShuMei Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Therapeutic Potential ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Paracrine Factors ◽  
Dual Treatment

AbstractBoth weak survival ability of stem cells and hostile microenvironment are dual dilemma for cell therapy. Adropin, a bioactive substance, has been demonstrated to be cytoprotective. We therefore hypothesized that adropin may produce dual protective effects on the therapeutic potential of stem cells in myocardial infarction by employing an adropin-based dual treatment of promoting stem cell survival in vitro and modifying microenvironment in vivo. In the current study, adropin (25 ng/ml) in vitro reduced hydrogen peroxide-induced apoptosis in rat bone marrow mesenchymal stem cells (MSCs) and improved MSCs survival with increased phosphorylation of Akt and extracellular regulated protein kinases (ERK) l/2. Adropin-induced cytoprotection was blocked by the inhibitors of Akt and ERK1/2. The left main coronary artery of rats was ligated for 3 or 28 days to induce myocardial infarction. Bromodeoxyuridine (BrdU)-labeled MSCs, which were in vitro pretreated with adropin, were in vivo intramyocardially injected after ischemia, following an intravenous injection of 0.2 mg/kg adropin (dual treatment). Compared with MSCs transplantation alone, the dual treatment with adropin reported a higher level of interleukin-10, a lower level of tumor necrosis factor-α and interleukin-1β in plasma at day 3, and higher left ventricular ejection fraction and expression of paracrine factors at day 28, with less myocardial fibrosis and higher capillary density, and produced more surviving BrdU-positive cells at day 3 and 28. In conclusion, our data evidence that adropin-based dual treatment may enhance the therapeutic potential of MSCs to repair myocardium through paracrine mechanism via the pro-survival pathways.

Interferon-gamma inducible protein IP-10 and left ventricular remodelling post-acute myocardial infarction: a longitudinal cardiovascular magnetic resonance imaging substudy of CAPRI clinical trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Sopova ◽  
C Park ◽  
A Al-Atta ◽  
K Bennaceur ◽  
A Mohammad ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Regression Analysis ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Linear Regression Analysis ◽  
Left Ventricular ◽  
Lv Remodeling ◽  
Inducible Protein ◽  
Cmr Imaging

Abstract Background Adverse left ventricular (LV) remodelling is associated with development of heart failure and poor outcomes in patients with acute myocardial infarction (AMI). Understanding the immunomodulatory mechanisms of LV remodelling is an essential step for the development of novel therapies. Interferon-γ-inducible protein-10 (IP-10)/CXCL10 is a chemokine involved in the recruitment of activated T cells into sites of tissue inflammation. Although IP-10 was reported to reduce adverse LV remodeling in a preclinical myocardial infarction model, its role in LV remodeling in humans with AMI remains unknown. Purpose To determine the clinical predictive value of serum IP-10 in LV remodeling in patients with ST-segment elevation myocardial infarction (STEMI). Methods This is a substudy of the double-blind, randomised controlled trial “Evaluating the effectiveness of intravenous ciclosporin on reducing reperfusion injury in patients undergoing primary percutaneous coronary intervention” (CAPRI; ClinicalTrials.gov registry number NCT02390674), which enrolled 52 acute STEMI patients. LV remodeling was assessed by cardiovascular magnetic resonance (CMR) imaging and was defined as the 12-week vs. the 3-day post-myocardial infarction change of the left ventricular ejection fraction (ΔLVEF), LV end-diastolic volume (ΔEDV) or LV end-systolic volume (ΔESV). Serum IP-10 was measured before and 5min, 15min, 30min, 90min and 24h after reperfusion by ELISA. Linear regression analysis was used to determine the independent association of IP-10 with the endpoints of the study. Results Serum IP-10 concentration peaked at 30min after reperfusion followed by a 2-fold decrease at the 24h post reperfusion compared to pre-reperfusion levels (P<0.001 for all). Comparison of the 12-week CMR to the baseline CMR imaging revealed that baseline pre-reperfusion as well as 5min, 15min, 30min and 90min, but not 24h, post-reperfusion IP-10 serum levels associated with increased LVEF and decreased ESV at 12-weeks (range correlation coefficient r=[0.35–0.41], P<0.05 with ΔLVEF and r=[−0.33 to −0.44], P<0.05 with ΔESV) indicating that the increase of IP-10 at the acute phase of myocardial infarction confers a cardioprotective role. Multivariable linear regression analysis for ΔLVEF showed that in a model including baseline pre-reperfusion or 5min or 15min or 30min or 90min post-reperfusion IP-10 and age, gender, traditional risk factors (arterial hypertension, body-mass index, hyperlipoproteinemia, diabetes mellitus, smoking, family history of CAD), infarct location, admission high-sensitivity troponin T, door-to-balloon time and ciclosporin treatment, only IP-10 was the independent determinant of ΔLVEF. Conclusions Increased serum IP-10 levels early after reperfusion are associated with reverse LV remodeling in patients with STEMI undergoing primary PCI. The clinical application of IP-10 as a novel biomarker of LV remodeling post-AMI should be further explored and validated. Funding Acknowledgement Type of funding source: None

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