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Advances in Ischemic/Reperfusion Injury in Acute Myocardial Infarction
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Advances in Ischemic/Reperfusion Injury in Acute Myocardial Infarction

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (15 April 2022) | Viewed by 14184

Special Issue Editor

Dr. Gabriele Crimi

E-Mail Website
Guest Editor
Interventional Cardiology Unit, IRCCS Policlinico San Martino di Genova, Genova, Italy
Interests: myocardial ischemic/reperfusion injury; transcatheter heart valve interventions; coronary phisiology

Special Issue Information

Dear Colleagues,

acute myocardial infarction is associated with high rates of morbidity and mortality. Timely reperfusion is a mainstay for myocardial salvage and infarct size limitation, however, the reperfusion itself may trigger a lethal tissue injury which is known as myocardial ischemia/reperfusion injury. Myocardial reperfusion injury may substantially limit the benefit of reperfusion and negatively impact on final infarct size and clinical outcome.

In the past decades, remarkable advances were made in the understanding of the molecular pathways of myocardial reperfusion injury, this led to the development of strategies, drugs and also devices targeting reperfusion injury, aiming to limit the impact of reperfusion injury on infarct size. Altough favourable results in pre-clinical and animal studies, many novel treamens failed in the translational pathway and still a strategy to effectively limit the reperfusion injury during primary coronary interventions is lacking.

In this special issue of the Journal of Clinical Medicine will focus on presenting results of pre-clinical and clinical studies abour myocardial ischemia/reperfusion injury, with a particular emphasis on translational models and strategies that may applied in clinical setting during primary coronary interventions.

Dr. Gabriele Crimi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Myocardial Infarction 
  • Infarct size 
  • Myocardial Reperfusion Injury 
  • Coronary Physiology

Published Papers (5 papers)

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Research

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9 pages, 966 KiB  
Article
Mechanical Unloading of the Left Ventricle before Coronary Reperfusion in Preclinical Models of Myocardial Infarction without Cardiogenic Shock: A Meta-Analysis
by Stefano Benenati, Gabriele Crimi, Andrea Macchione, Corinna Giachero, Fabio Pescetelli, Manrico Balbi, Italo Porto and Matteo Vercellino
J. Clin. Med. 2022, 11(16), 4913; https://doi.org/10.3390/jcm11164913 - 21 Aug 2022
Cited by 2 | Viewed by 1715
Abstract
Aim: to compare a conventional primary reperfusion strategy with a primary unloading approach before reperfusion in preclinical studies. Methods: we performed a meta-analysis of preclinical studies. The primary endpoint was infarct size (IS). Secondary endpoints were left ventricle end-diastolic pressure (LVEDP), mean arterial [...] Read more.
Aim: to compare a conventional primary reperfusion strategy with a primary unloading approach before reperfusion in preclinical studies. Methods: we performed a meta-analysis of preclinical studies. The primary endpoint was infarct size (IS). Secondary endpoints were left ventricle end-diastolic pressure (LVEDP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO). We calculated mean differences (MDs) and associated 95% confidence intervals (CIs). Sensitivity and subgroup analyses on the primary and secondary endpoints, as well as a meta-regression on the primary endpoint using the year of publication as a covariate, were also conducted. Results: 11 studies (n = 142) were selected and entered in the meta-analysis. Primary unloading reduced IS (MD −28.82, 95% CI −35.78 to −21.86, I2 96%, p < 0.01) and LVEDP (MD −3.88, 95% CI −5.33 to −2.44, I2 56%, p = 0.02) and increased MAP (MD 7.26, 95% CI 1.40 to 13.12, I2 43%, p < 0.01) and HR (MD 5.26, 95% CI 1.97 to 8.55, I2 1%, p < 0.01), while being neutral on CO (MD −0.11, 95% CI −0.95 to 0.72, I2 88%, p = 0.79). Sensitivity and subgroup analyses showed, overall, consistent results. The meta-regression on the primary endpoint demonstrated a significant influence of the year of publication on effect estimate. Conclusions: in animal models of myocardial infarction, a primary unloading significantly reduces IS and exerts beneficial hemodynamic effects compared to a primary reperfusion. Full article
(This article belongs to the Special Issue Advances in Ischemic/Reperfusion Injury in Acute Myocardial Infarction)
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13 pages, 2209 KiB  
Article
Parathyroid Hormone-Related Peptide and Its Analog, Abaloparatide, Attenuate Lethal Myocardial Ischemia-Reperfusion Injury
by Joseph Wider, Vishnu V. R. Undyala, Beate Lanske, Nabanita S. Datta and Karin Przyklenk
J. Clin. Med. 2022, 11(9), 2273; https://doi.org/10.3390/jcm11092273 - 19 Apr 2022
Cited by 2 | Viewed by 1733
Abstract
Parathyroid hormone-related peptide (PTHrP) is well-known to play a role in bone formation, and abaloparatide, an analog of PTHrP(1-34), is approved for the treatment of osteoporosis in post-menopausal women. PTHrP has also been reported to have cardiovascular effects, with recent data demonstrating that [...] Read more.
Parathyroid hormone-related peptide (PTHrP) is well-known to play a role in bone formation, and abaloparatide, an analog of PTHrP(1-34), is approved for the treatment of osteoporosis in post-menopausal women. PTHrP has also been reported to have cardiovascular effects, with recent data demonstrating that exogenously administered PTHrP can limit the death of isolated cardiomyocytes subjected to oxidative stress via upregulation of classic ‘survival kinase’ signaling. Our aim in the current study was to extend this concept and, employing both in vitro and in vivo models, establish whether PTHrP(1-36) and abaloparatide are cardioprotective in the setting of lethal myocardial ischemia-reperfusion injury. We report that preischemic administration of PTHrP(1-36) and abaloparatide attenuated cell death in HL-1 cardiomyocytes subjected to simulated ischemia-reperfusion, an effect that was accompanied by the augmented expression of phospho-ERK and improved preservation of phospho-Akt, and blocked by co-administration of the MEK-ERK inhibitor PD98059. Moreover, using the translationally relevant swine model of acute coronary artery occlusion-reperfusion, we make the novel observation that myocardial infarct size was significantly reduced in pigs pretreated with PTHrP(1-36) when compared with placebo-controls (13.1 ± 3.3% versus 42.0 ± 6.6% of the area of at-risk myocardium, respectively; p < 0.01). Taken together, these data provide the first evidence in support of the concept that pretreatment with PTHrP(1-36) and abaloparatide renders cardiomyocytes resistant to lethal myocardial ischemia-reperfusion injury. Full article
(This article belongs to the Special Issue Advances in Ischemic/Reperfusion Injury in Acute Myocardial Infarction)
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Review

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20 pages, 1645 KiB  
Review
PCSK9 and Other Metabolic Targets to Counteract Ischemia/Reperfusion Injury in Acute Myocardial Infarction and Visceral Vascular Surgery
by Silvia Ortona, Chiara Barisione, Pier Francesco Ferrari, Domenico Palombo and Giovanni Pratesi
J. Clin. Med. 2022, 11(13), 3638; https://doi.org/10.3390/jcm11133638 - 23 Jun 2022
Cited by 4 | Viewed by 2877
Abstract
Ischemia/reperfusion (I/R) injury complicates both unpredictable events (myocardial infarction and stroke) as well as surgically-induced ones when transient clampage of major vessels is needed. Although the main cause of damage is attributed to mitochondrial dysfunction and oxidative stress, the use of antioxidant compounds [...] Read more.
Ischemia/reperfusion (I/R) injury complicates both unpredictable events (myocardial infarction and stroke) as well as surgically-induced ones when transient clampage of major vessels is needed. Although the main cause of damage is attributed to mitochondrial dysfunction and oxidative stress, the use of antioxidant compounds for protection gave poor results when challenged in clinics. More recently, there is an assumption that, in humans, profound metabolic changes may prevail in driving I/R injury. In the present work, we narrowed the field of search to I/R injury in the heart/brain/kidney axis in acute myocardial infarction, major vascular surgery, and to the current practice of protection in both settings; then, to help the definition of novel strategies to be translated clinically, the most promising metabolic targets with their modulatory compounds—when available—and new preclinical strategies against I/R injury are described. The consideration arisen from the broad range of studies we have reviewed will help to define novel therapeutic approaches to ensure mitochondrial protection, when I/R events are predictable, and to cope with I/R injury, when it occurs unexpectedly. Full article
(This article belongs to the Special Issue Advances in Ischemic/Reperfusion Injury in Acute Myocardial Infarction)
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15 pages, 1195 KiB  
Review
“No-Reflow” Phenomenon: A Contemporary Review
by Gianmarco Annibali, Innocenzo Scrocca, Tiziana Claudia Aranzulla, Emanuele Meliga, Francesco Maiellaro and Giuseppe Musumeci
J. Clin. Med. 2022, 11(8), 2233; https://doi.org/10.3390/jcm11082233 - 16 Apr 2022
Cited by 25 | Viewed by 5464
Abstract
Primary percutaneous angioplasty (pPCI), represents the reperfusion strategy of choice for patients with STEMI according to current international guidelines of the European Society of Cardiology. Coronary no-reflow is characterized by angiographic evidence of slow or no anterograde epicardial flow, resulting in inadequate myocardial [...] Read more.
Primary percutaneous angioplasty (pPCI), represents the reperfusion strategy of choice for patients with STEMI according to current international guidelines of the European Society of Cardiology. Coronary no-reflow is characterized by angiographic evidence of slow or no anterograde epicardial flow, resulting in inadequate myocardial perfusion in the absence of evidence of mechanical vessel obstruction. No reflow (NR) is related to a functional and structural alteration of the coronary microcirculation and we can list four main pathophysiological mechanisms: distal atherothrombotic embolization, ischemic damage, reperfusion injury, and individual susceptibility to microvascular damage. This review will provide a contemporary overview of the pathogenesis, diagnosis, and treatment of NR. Full article
(This article belongs to the Special Issue Advances in Ischemic/Reperfusion Injury in Acute Myocardial Infarction)
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10 pages, 2200 KiB  
Review
Percutaneous Coronary Revascularization after Out-of-Hospital Cardiac Arrest: A Review of the Literature and a Case Series
by Francesca Scavelli, Iside Cartella, Claudio Montalto, Jacopo Andrea Oreglia, Luca Villanova, Laura Garatti, Claudia Colombo, Alice Sacco and Nuccia Morici
J. Clin. Med. 2022, 11(5), 1395; https://doi.org/10.3390/jcm11051395 - 3 Mar 2022
Cited by 1 | Viewed by 1452
Abstract
Out-of-hospital cardiac arrest (OHCA) is still associated with high mortality and severe complications, despite major treatment advances in this field. Ischemic heart disease is a common cause of OHCA, and current guidelines clearly recommend performing immediate coronary angiography (CAG) in patients whose post-resuscitation [...] Read more.
Out-of-hospital cardiac arrest (OHCA) is still associated with high mortality and severe complications, despite major treatment advances in this field. Ischemic heart disease is a common cause of OHCA, and current guidelines clearly recommend performing immediate coronary angiography (CAG) in patients whose post-resuscitation electrocardiogram shows ST-segment elevation (STE). Contrarily, the optimal approach and the advantage of early revascularization in cases of no STE is less clear, and decisions are often based on the individual experience of the center. Numerous studies have been conducted on this topic and have provided contradictory evidence; however, more recently, results from several randomized clinical trials have suggested that performing early CAG has no impact on overall survival in patients without STE. Full article
(This article belongs to the Special Issue Advances in Ischemic/Reperfusion Injury in Acute Myocardial Infarction)
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