Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia-reperfusion

Esben Søvsø Szocska Hansen; Tobias Lynge Madsen; Gregory Wood; Asger Granfeldt; Nikolaj Bøgh; Bawer Jalal Tofig; Peter Agger; Jakob Lykke Lindhardt; Christian Bo Poulsen; Hans Erik Bøtker; Won Yong Kim

doi:10.1038/s41598-021-84025-y

Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia-reperfusion

Esben Søvsø Szocska Hansen, Tobias Lynge Madsen, Gregory Wood, Asger Granfeldt, Nikolaj Bøgh, Bawer Jalal Tofig, Peter Agger, Jakob Lykke Lindhardt, Christian Bo Poulsen, Hans Erik Bøtker, Won Yong Kim^*

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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Abstract

Mechanical unloading of the left ventricle reduces infarct size after acute myocardial infarction by reducing cardiac work. Left ventricular veno-occlusive unloading reduces cardiac work and may reduce ischemia and reperfusion injury. In a porcine model of myocardial ischemia-reperfusion injury we randomized 18 pigs to either control or veno-occlusive unloading using a balloon engaged from the femoral vein into the inferior caval vein and inflated at onset of ischemia. Evans blue and 2,3,5-triphenyltetrazolium chloride were used to determine the myocardial area at risk and infarct size, respectively. Pressure-volume loops were recorded to calculate cardiac work, left ventricular (LV) volumes and ejection fraction. Veno-occlusive unloading reduced infarct size compared with controls (Unloading 13.9 ± 8.2% versus Control 22.4 ± 6.6%; p = 0.04). Unloading increased myocardial salvage (54.8 ± 23.4% vs 28.5 ± 14.0%; p = 0.02), while the area at risk was similar (28.4 ± 6.7% vs 27.4 ± 5.8%; p = 0.74). LV ejection fraction was preserved in the unloaded group, while the control group showed a reduced LV ejection fraction. Veno-occlusive unloading reduced myocardial infarct size and preserved LV ejection fraction in an experimental acute ischemia-reperfusion model. This proof-of-concept study demonstrated the potential of veno-occlusive unloading as an adjunctive cardioprotective therapy in patients undergoing revascularization for acute myocardial infarction.

Original language	English
Article number	4483
Journal	Scientific Reports
Volume	11
Issue	1
Number of pages	9
ISSN	2045-2322
DOIs	https://doi.org/10.1038/s41598-021-84025-y
Publication status	Published - Dec 2021

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@article{a65ae76b7bd4426794f2ade964c46250,

title = "Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia-reperfusion",

abstract = "Mechanical unloading of the left ventricle reduces infarct size after acute myocardial infarction by reducing cardiac work. Left ventricular veno-occlusive unloading reduces cardiac work and may reduce ischemia and reperfusion injury. In a porcine model of myocardial ischemia-reperfusion injury we randomized 18 pigs to either control or veno-occlusive unloading using a balloon engaged from the femoral vein into the inferior caval vein and inflated at onset of ischemia. Evans blue and 2,3,5-triphenyltetrazolium chloride were used to determine the myocardial area at risk and infarct size, respectively. Pressure-volume loops were recorded to calculate cardiac work, left ventricular (LV) volumes and ejection fraction. Veno-occlusive unloading reduced infarct size compared with controls (Unloading 13.9 ± 8.2% versus Control 22.4 ± 6.6%; p = 0.04). Unloading increased myocardial salvage (54.8 ± 23.4% vs 28.5 ± 14.0%; p = 0.02), while the area at risk was similar (28.4 ± 6.7% vs 27.4 ± 5.8%; p = 0.74). LV ejection fraction was preserved in the unloaded group, while the control group showed a reduced LV ejection fraction. Veno-occlusive unloading reduced myocardial infarct size and preserved LV ejection fraction in an experimental acute ischemia-reperfusion model. This proof-of-concept study demonstrated the potential of veno-occlusive unloading as an adjunctive cardioprotective therapy in patients undergoing revascularization for acute myocardial infarction.",

author = "Hansen, {Esben S{\o}vs{\o} Szocska} and Madsen, {Tobias Lynge} and Gregory Wood and Asger Granfeldt and Nikolaj B{\o}gh and Tofig, {Bawer Jalal} and Peter Agger and Lindhardt, {Jakob Lykke} and Poulsen, {Christian Bo} and B{\o}tker, {Hans Erik} and Kim, {Won Yong}",

year = "2021",

month = dec,

doi = "10.1038/s41598-021-84025-y",

language = "English",

volume = "11",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Publishing Group",

number = "1",

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Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia-reperfusion. / Hansen, Esben Søvsø Szocska; Madsen, Tobias Lynge; Wood, Gregory et al.
In: Scientific Reports, Vol. 11, No. 1, 4483, 12.2021.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia-reperfusion

AU - Hansen, Esben Søvsø Szocska

AU - Madsen, Tobias Lynge

AU - Wood, Gregory

AU - Granfeldt, Asger

AU - Bøgh, Nikolaj

AU - Tofig, Bawer Jalal

AU - Agger, Peter

AU - Lindhardt, Jakob Lykke

AU - Poulsen, Christian Bo

AU - Bøtker, Hans Erik

AU - Kim, Won Yong

PY - 2021/12

Y1 - 2021/12

N2 - Mechanical unloading of the left ventricle reduces infarct size after acute myocardial infarction by reducing cardiac work. Left ventricular veno-occlusive unloading reduces cardiac work and may reduce ischemia and reperfusion injury. In a porcine model of myocardial ischemia-reperfusion injury we randomized 18 pigs to either control or veno-occlusive unloading using a balloon engaged from the femoral vein into the inferior caval vein and inflated at onset of ischemia. Evans blue and 2,3,5-triphenyltetrazolium chloride were used to determine the myocardial area at risk and infarct size, respectively. Pressure-volume loops were recorded to calculate cardiac work, left ventricular (LV) volumes and ejection fraction. Veno-occlusive unloading reduced infarct size compared with controls (Unloading 13.9 ± 8.2% versus Control 22.4 ± 6.6%; p = 0.04). Unloading increased myocardial salvage (54.8 ± 23.4% vs 28.5 ± 14.0%; p = 0.02), while the area at risk was similar (28.4 ± 6.7% vs 27.4 ± 5.8%; p = 0.74). LV ejection fraction was preserved in the unloaded group, while the control group showed a reduced LV ejection fraction. Veno-occlusive unloading reduced myocardial infarct size and preserved LV ejection fraction in an experimental acute ischemia-reperfusion model. This proof-of-concept study demonstrated the potential of veno-occlusive unloading as an adjunctive cardioprotective therapy in patients undergoing revascularization for acute myocardial infarction.

AB - Mechanical unloading of the left ventricle reduces infarct size after acute myocardial infarction by reducing cardiac work. Left ventricular veno-occlusive unloading reduces cardiac work and may reduce ischemia and reperfusion injury. In a porcine model of myocardial ischemia-reperfusion injury we randomized 18 pigs to either control or veno-occlusive unloading using a balloon engaged from the femoral vein into the inferior caval vein and inflated at onset of ischemia. Evans blue and 2,3,5-triphenyltetrazolium chloride were used to determine the myocardial area at risk and infarct size, respectively. Pressure-volume loops were recorded to calculate cardiac work, left ventricular (LV) volumes and ejection fraction. Veno-occlusive unloading reduced infarct size compared with controls (Unloading 13.9 ± 8.2% versus Control 22.4 ± 6.6%; p = 0.04). Unloading increased myocardial salvage (54.8 ± 23.4% vs 28.5 ± 14.0%; p = 0.02), while the area at risk was similar (28.4 ± 6.7% vs 27.4 ± 5.8%; p = 0.74). LV ejection fraction was preserved in the unloaded group, while the control group showed a reduced LV ejection fraction. Veno-occlusive unloading reduced myocardial infarct size and preserved LV ejection fraction in an experimental acute ischemia-reperfusion model. This proof-of-concept study demonstrated the potential of veno-occlusive unloading as an adjunctive cardioprotective therapy in patients undergoing revascularization for acute myocardial infarction.

UR - http://www.scopus.com/inward/record.url?scp=85101509596&partnerID=8YFLogxK

U2 - 10.1038/s41598-021-84025-y

DO - 10.1038/s41598-021-84025-y

M3 - Journal article

C2 - 33627745

SN - 2045-2322

VL - 11

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 4483

ER -

Veno-occlusive unloading of the heart reduces infarct size in experimental ischemia-reperfusion

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