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Mar-May 2008 Volume 9 | Issue 1
Page Nos. 2-51
Online since Thursday, June 17, 2010
Accessed 35,865 times.
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CARDIOVASCULAR NEWS |
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Cardiovascular News |
p. 2 |
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ORIGINAL ARTICLE |
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Reduction of microvascular obstruction and myocardial infarct size with hypothermia |
p. 6 |
Matthias Gotberg, Goran K Olivecrona, Henrik Engblom, Martin Ugander, Jesper van der Pals, Einar Heiberg, Hakan Arheden, David Erlinge Background: The aim of this study was to evaluate the combination of a rapid intravenous infusion of cold saline and endovascular hypothermia in a closed chest pig infarct model.
Methods: Pigs were randomized to pre-reperfusion hypothermia (n = 7), post-reperfusion hypothermia (n = 7) or normothermia (n = 5). A percutaneous coronary intervention balloon was inflated in the left anterior descending artery for 40 min. Hypothermia was started after 25 min of ischemia or immediately after reperfusion by infusion of 1000 ml of 4C saline and endovascular hypothermia. Area at risk was evaluated by in vivo SPECT. Infarct size was evaluated by ex vivo MRI.
Results: Pre-reperfusion hypothermia reduced infarct size/area at risk by 43% (46 ± 8%) compared to post-reperfusion hypothermia (80 ± 6%, p < 0.05) and by 39% compared to normothermia (75 ± 5%, p < 0.05). Pre-reperfusion hypothermia infarctions were patchier in appearance with scattered islands of viable myocardium. Pre-reperfusion hypothermia abolished (0%, p < 0.001), and post-reperfusion hypothermia significantly reduced microvascular obstruction (10.3 ± 5%; p < 0.05), compared to normothermia: (30.2 ± 5%).
Conclusion: Rapid hypothermia with cold saline and endovascular cooling before reperfusion reduces myocardial infarct size and microvascular obstruction. A novel finding is that hypothermia at the onset of reperfusion reduces microvascular obstruction without reducing myocardial infarct size. Intravenous administration of cold saline combined with endovascular hypothermia provides a method for a rapid induction of hypothermia suggesting a potential clinical application. |
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REVIEW ARTICLE |
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Aneurysm of the sinuses of valsalva: Report of two cases and review of the literature |
p. 18 |
Saad Alkhafaji, Cornelia S Carr, Abdul-Aziz M Alkhulaifi, Abdulwahed Almulla, Akhlaque Bhat, Amer Chaikhouni |
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CASE REPORT |
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Meandering vessels: A sign of arterial tortuosity on plain chest radiography  |
p. 24 |
Venkatraman Bhat, Ahmed Al Muzrakchi |
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A PICTURE IS WORTH A THOUSAND WORDS |
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A nail through the heart |
p. 27 |
Cornelia Carr |
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GULF RACE REGISTRY |
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Commentary GHA acute coronary syndrome registry: Historical perspective |
p. 28 |
HA Hajar Albinali |
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ART AND MEDICINE |
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Healing Eye |
p. 47 |
Rachel Hajar |
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HISTORY OF MEDICINE |
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The Magnificent Century of Cardiothoracic Surgery |
p. 48 |
Amer Chaikhouni |
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