• Title/Summary/Keyword: Cardiac ischemia

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Cardioprotective and Antihypertensive Effects of KR-31281, KR-31282 and KR-31299, Newly Synthesized $K_{ATP}$ Openers, in Conscious Rats and Isolated Ischemic Rat Hearts (신규 합성 $K_{ATP}$ 통로 개방제인 KR-31281, KR-31282 및 KR-31299의 흰쥐 적출 허혈 심장 및 비마취 흰쥐에 대한 심장보호 및 혈압강하 작용)

  • Lee, Sun-Sook;Yun, Yeo-Pyo;Shin, Hwa-Sup
    • Korean Journal of Clinical Pharmacy
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    • v.7 no.1
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    • pp.33-39
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    • 1997
  • Cardiac and antihypertensive effects of BMS-180448, a cardiac-selective ATP-sensitive potassium channel opener, and its newly synthesized derivatives KR-31281, KR-31282 and KR-31299 were evaluated in isolated perfused rat hearts (25 min global ischemia/30 min reperfusion) and conscious rats. Three new compounds $(10\;{\mu}M)$ induced positive inotropism as evidenced by increased LVDP (left ventricular developed pressure) and RPP (Rate-Pressure Product) in nonischemic rat heart. HR-31299 increased CF (coronary flow) and HR (heart rate) but the other two had no effects. KR-31282, KR-31281 and HR-31299 had a tendency to increase reperfusion LVDP and RPP compared with vehicle, while the latter two significantly reduced reperfusion EDP with a tendency to inclose TTC (time to contracture). All three KR-compounds had very weak effects on MBP and HR in conscious rats. These results indicate that KR-31281 and HR-31299 may have some cardioprotective effects, although weaker than BMS-180448, and their mode of action different from that of BMS-180448, despite the similarity in major structural moeity.

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Development of Realtime ECG Analysis and Monitoring System (실시간 심전도 분석 및 모니터링 시스템 개발)

  • Jeong, Gu-Young;Yoon, Myoung-Jong;Yu, Kee-Ho
    • Journal of Institute of Control, Robotics and Systems
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    • v.15 no.4
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    • pp.406-412
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    • 2009
  • ECG is used on purpose to keep good health or monitor cardiac function of aged person as well as on purpose to diagnose the disease of heart patients. The ambulatory ECG monitoring system under guarantee of safety and accuracy is very efficient to prevent the progress of heart disease and sudden death. These systems can detect the temporary change of ECG that is very significant to diagnose heart disease such as myocardial ischemia, arrhyamia and cardiac infarction. In this paper, we describe the ECG signal analysis algorithm and measurement device for ECG monitoring. The authors designed a small-size portable ECG device that consisted of instrumentation amplifier, micro-controller, filter and RF module. The device measures ECG with four electrodes on the body and detects QRS complex and ST level change in realtime. Also it transmits the measured signals to the personal computer. The developed software for ECG analysis in personal computer has the function to detect the feature points and ST level changes.

Pharmacological Approaches to Limit Ischemic and Reperfusion Injuries of the Heart: Analysis of Experimental and Clinical Data on P2Y12 Receptor Antagonists

  • Leonid N. Maslov;Sergey V. Popov;Alexandr V. Mukhomedzyanov;Ivan A. Derkachev;Vyacheslav V. Ryabov;Alla A. Boshchenko;N. Rajendra Prasad;Galina Z. Sufianova;Maria S. Khlestkina;Ilgiz Gareev
    • Korean Circulation Journal
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    • v.52 no.10
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    • pp.737-754
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    • 2022
  • Ischemic and reperfusion injuries of the heart underlie the pathogenesis of acute myocardial infarction (AMI) and sudden cardiac death. The mortality rate is still high and is 5-7% in patients with ST-segment elevation myocardial infarction. The review is devoted to pharmacological approaches to limitation of ischemic and reperfusion injuries of the heart. The article analyzes experimental evidence and the clinical data on the effects of P2Y12 receptor antagonists on the heart's tolerance to ischemia/reperfusion in animals with coronary artery occlusion and reperfusion and also in patients with AMI. Chronic administration of ticagrelor prevented adverse remodeling of the heart. There is evidence that sphingosine-1-phosphate is the molecule that mediates the infarct-reducing effect of P2Y12 receptor antagonists. It was discussed a role of adenosine in the cardioprotective effect of ticagrelor.

Normothermic Cardiac Surgery with Warm Blood Cardioplegia in Patient with Cold Agglutinins

  • Cho, Sang-Ho;Kim, Dae Hyun;Kwak, Young Tae
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.133-136
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    • 2014
  • Cold agglutinins are predominately immunoglobulin M autoantibodies that react at cold temperatures with surface antigens on the red blood cell. This can lead to hemagglutination at low temperatures, followed by complement fixation and subsequent hemolysis on rewarming. Development of hemagglutination or hemolysis in patients with cold agglutinins is a risk of cardiac surgery under hypothermia. In addition, there is the potential for intracoronary hemagglutination with inadequate distribution of cardioplegic solutions, thrombosis, embolism, ischemia, or infarction. We report a patient with incidentally detected cold agglutinin who underwent normothermic cardiac surgery with warm blood cardioplegia.

Complete Recovery of Perfusion Abnormalities in a Cardiac Arrest Patient Treated with Hypothermia: Results of Cerebral Perfusion MR Imaging

  • Kim, Min Jeong;Park, Yae Won;Lim, Soo Mee
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.1
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    • pp.56-60
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    • 2018
  • Therapeutic hypothermia in cardiac arrest patients is associated with favorable outcomes mediated via neuroprotective mechanisms. We report a rare case of a 32-year-old male who demonstrated complete recovery of signal changes on perfusion-weighted imaging after therapeutic hypothermia due to cardiac arrest. Brain MRI with perfusion-weighted imaging, performed three days after ending the hypothermia therapy, showed a marked decrease in relative cerebral blood flow (rCBF) and delay in mean transit time (MTT) in the bilateral basal ganglia, thalami, brain stem, cerebellum, occipitoparietal cortex, and frontotemporal cortex. However, no cerebral ischemia was not noted on diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) sequences. A follow-up brain MRI after one week showed complete resolution of the perfusion deficit and the patient was discharged without any neurologic sequelae. The mechanism and interpretation of the perfusion changes in cardiac arrest patients treated with therapeutic hypothermia are discussed.

Preservative Effect of Leukocyte-Depleted Blood Cardioplegic Myocardium during Cardiac Surgery

  • Park, Seok-Cheol
    • Biomedical Science Letters
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    • v.7 no.2
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    • pp.91-98
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    • 2001
  • The present study was prospectively designed to assess the clinical effect of leukocyte-depleted blood cardioplegic solution (BCS) on myocardium during cardiac surgery with cardiopulmonary bypass (CPB). 30 adult patients scheduled for elective cardiac surgery were divided into control group (n=15), which infused routine BCS, and leukocyte-depleted (LD) group (n=15), which infused leukocyte-depleted BCS. Total and differential leukocyte counts in BCS, malondialdehyde (MDA) and troponin-T (TnT) concentrations in coronary sinus blood, and cardiac index (CI) were measured at preoperative and postoperative period. The BCS in LD group had less total leukocyte counts with neutropenia than that in control group (P<0.01). MDA (3.70$\pm$0.35 vs 5.90$\pm$0.57 $\mu$mol/L, p<0.05) and TnT (0.42$\pm$0.03 vs 0.60$\pm$0.09 ng/mL, p<0.05) were significantly low in LD group compared with control group, while LD group had higher CI (3.28$\pm$0.16 L/min/$m^2$, p<0.05) than control group (2.69$\pm$0.18 L/min/$m^2$). These results suggest that leukocyte-depleted blood cardioplegic solution has a better myocardial protective effect with less generations of oxygen free radicals and ischemia/reperfusion injury.

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Involvement of Adenosine in Cardioprotective Effect of Catecholamine Preconditioning in Ischemia-Reperfused Heart of Rat

  • Kim, Young-Hoon;Kim, Chan-Hyung;Kim, Gi-Tae;Kim, In-Kyu;Park, Jong-Wan;Kim, Myung-Suk
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.6
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    • pp.753-761
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    • 1998
  • Preconditioning of a heart with small doses of catecholamines induces a tolerance against the subsequent lethal ischemia. The present study was performed to find a specific receptor pathway involved with the catecholamine preconditioning and to test if adenosine plays a role in this cardioprotective effect. Isolated rat hearts, pretreated with small doses of ${\alpha}-\;or\;{\beta}-adrenergic$ agonists/antagonists, were subjected to 20 minutes ischemia and 20 minutes reperfusion by Langendorff perfusion method. Cardiac mechanical functions, lactate dehydrogenase and adenosine release from the hearts were measured before and after the drug treatments and ischemia. In another series of experiments, adenosine $A_1\;or\;A_2$ receptor blockers were treated prior to administration of adrenergic agonists. Pretreatments of a ${\beta}-agonist,\;isoproterenol(10^{-9}{\sim}10^{-7}\;M)$ markedly improved the post-ischemic mechanical function and reduced the lactate dehydrogenase release. Similar cardioprotective effect was observed with an ?-agonist, phenylephrine pretreatment, but much higher $concentration(10^{-4}\;M)$ was needed to achieve the same degree of cardioprotection. The cardioprotective effects of isoproterenol and phenylephrine pretreatments were blocked by a ${\beta}_1-adrenergic$ receptor antagonist, atenolol, but not by an ${\alpha}_1-antagonist,$ prazosin. Adenosine release from the heart was increased by isoproterenol, and the increase was also blocked by atenolol, but not by prazosin. A selective $A_1-adenosine$ receptor antagonist, 1,3-dipropyl-8-cyclopentyl xanthine (DPCPX) blocked the cardioprotection by isoproterenol pretreatment. These results suggest that catecholamine pretreatment protects rat myocardium against ischemia and reperfusion injury by mediation of ${\beta}_1-adrenergic$ receptor pathway, and that adenosine is involved in this cardioprotective effect.

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Ginsenoside-Re ameliorates ischemia and reperfusion injury in the heart: a hemodynamics approach

  • Lim, Kyu Hee;Lim, Dae-Jun;Kim, Jong-Hoon
    • Journal of Ginseng Research
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    • v.37 no.3
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    • pp.283-292
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    • 2013
  • Ginsenosides are divided into two groups based on the types of the panaxadiol group (e.g., ginsenoside-Rb1 and -Rc) and the panaxatriol group (e.g., ginsenoside-Rg1 and -Re). Among them, ginsenoside-Re (G-Re) is one of the compounds with the highest content in Panax ginseng and is responsible for pharmacological effects. However, it is not yet well reported if G-Re increases the hemodynamics functions on ischemia (30 min)/reperfusion (120 min) (I/R) induction. Therefore, in the present study, we investigated whether treatment of G-Re facilitated the recovery of hemodynamic parameters (heart rate, perfusion pressure, aortic flow, coronary flow, and cardiac output) and left ventricular developed pressure (${\pm}dp/dt_{max}$). This research is designed to study the effects of G-Re by studying electrocardiographic changes such as QRS interval, QT interval and R-R interval, and inflammatory marker such as tissue necrosis factor-${\alpha}$ (TNF-${\alpha}$) in heart tissue in I/R-induced heart. From the results, I/R induction gave a significant increase in QRS interval, QT interval and R-R interval, but showed decrease in all hemodynamic parameters. I/R induction resulted in increased TNF-${\alpha}$ level. Treatment of G-Re at 30 and $100{\mu}M$ doses before I/R induction significantly prevented the decrease in hemodynamic parameters, ameliorated the electrocardiographic abnormality, and inhibited TNF-${\alpha}$ level. In this study, G-Re at $100{\mu}M$ dose exerted more beneficial effects on cardiac function and preservation of myocardium in I/R injury than $30{\mu}M$. Collectively, these results indicate that G-Re has distinct cardioprotectective effects in I/R induced rat heart.

Oxidative Stress Is Decreased in Off-pump Versus On-pump Coronary Artery Surgery

  • Gonenc, Aymelek;Haclsevki, Aysun;Bakkaloglu, Beyhan;Soyaglr, Aylin;Torun, Meral;Karagoz, Haldun;Simsek, Bolkan
    • BMB Reports
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    • v.39 no.4
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    • pp.377-382
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    • 2006
  • Oxidative stress occurs in patients undergoing coronary artery bypass operation. The aim of this study was to investigate the difference in oxidative stress in off-pump versus on-pump coronary artery bypass surgery. In the present study, in serial blood samples, plasma malondialdehyde (MDA) as index of lipid peroxidation, red blood cells glutathione peroxidase (GPx) and superoxide dismutase (SOD) were measured to compare the extent of oxidative stress in 30 patients undergoing OPCAB (off-pump coronary artery bypass grafting), 12 patients undergoing CABG (on-pump coronary artery bypass grafting) and 18 healthy controls. In CABG group, MDA levels increased significantly from $2.87{\pm}0.62\;nmol/mL$ before anesthesia and $2.87{\pm}0.65\;nmol/mL$ after anesthesia to $3.05{\pm}0.66\;nmol/mL$ after ischemia (p < 0.05). Similarly, SOD levels also elevated significantly from $661.58{\pm}78.70\;U/g$ Hb before anesthesia and $659.42{\pm}81.21\;U/g$ Hb anesthesia induction to $678.08{\pm}75.80\;U/g$ Hb after ischemia (p < 0.01, p < 0.01, respectively). In OPCAB group, only SOD levels increased from $581.73{\pm}86.24\;U/g$ Hb anesthesia induction to $590.90{\pm}88.90\;U/g$ Hb after reperfusion (p < 0.05). Glutathione peroxidase levels were not changed according to blood collection times in both of CABG group or OPCAB group (p > 0.05). Our results show that only mild signs of oxidative stress is found after reperfusion in OPCAB operation compared with CABG operation. Further studies are needed in order to confirm this hypothesis.

An Experimental Study on the Effect of Soojeomsan(Shou Nian San) on CPK and Na-K ATPase of Ischemic and Perfused Rat Heart (수념산(手拈散)이 허혈성(虛血性) 심장(心臟)의 심근(心筋) 효소(酵素)에 미치는 영향(影響))

  • Kang, Kwan-Ho;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Lee, Kyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.18 no.2
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    • pp.220-228
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    • 1997
  • Background The stenosis of the coronary artery may decrease myocardial oxygen supply and occur myocardial ischemia or infarction. Soojeomsan, one of analgesics is generally regarded to have the effect of vitalizing blood, expelling blood stasis and alleviation cardiac pain. Methods The purpose of this experimental study is to find the influence of Soojeomsan on cardiac enzyme (CPK, Na-K ATPase) of ischemic and reperfused rat hearts which are isolated under the Langendorff apparatus. Ischemia was induced In isolated hearts of Sprague-Dawley rats by ceasing the perfusion for 20 minutes. The experiments were divided into a normal saline orally administered group(control group), a Soojeomsan orally 20ml administered group(sample A) and a Soojeomsan orally 30ml administered group(sample B). The CPK (creatinine phosphokinase) and Na-K ATPase activity of this three group were measured and compared in order to assess the influence of Soojeomsan on protection of isolated rat hearts from ischemia. Results 1. CPK was significantly reduced in Sample A group and Sample B group in comparison with control group in reperfusion(P<0.01), and there were no significant difference between Sample A and B. 2. Na-K ATPase activity was significantly increased in Sample A group and Sample B group in comparison with control group in ischemia(P<0.001), and the activity was significantly higher in Sample B then in Sample A.(P<0.01) 3. There were no significant difference in Na-K ATPase activity of the three groups after reperfusion. Conclusion Soojeomsan has effects to decrease CPK activity and activate Na pump. This result in protection of the myocardium of isolated rat hearts from ischemia.

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