Q: Reperfusion injury of the heart can be effectively controlled by performing 'endovascular cooling' before percutaneous coronary intervention (PCI).
A) True
B) False
Answer: B
This question aims to highlight the importance of reperfusion injury and the fact that no effective management was identified for it. Various treatment modalities have been tested, which include but are not limited to the following:
- Ischemic conditioning
- Glycoprotein IIb/IIIa inhibitors
- Adenosine
- Vasodilators such as nitric oxide (NO), and angiotensin converting enzyme (ACE)
- Ion channel modulation
- Glucose-insulin-potassium solution
- Antineutrophil and anticomplement therapy
- Antioxidant therapy
- Magnesium
- Cyclosporine
- Intravenous MTP-131
- Intravenous sodium nitrite
- Losmapimod
- Inhibitors of delta-protein kinase C
Endovascular cooling on the concept of cardioplegia during cardiac bypass surgery is proposed before performing PCI. It was thought myocardial metabolism would decrease at lower temperatures and provide some cardioprotection. Studies fail to show any such benefits.
In summary, effective therapies remain elusive for reperfusion injury.
#cardiology
References:
1. He J, Liu D, Zhao L, Zhou D, Rong J, Zhang L, Xia Z. Myocardial ischemia/reperfusion injury: Mechanisms of injury and implications for management (Review). Exp Ther Med. 2022 Jun;23(6):430. doi: 10.3892/etm.2022.11357. Epub 2022 May 6. PMID: 35607376; PMCID: PMC9121204.
2. He J, Bellenger NG, Ludman AJ, Shore AC, Strain WD. Treatment of myocardial ischaemia-reperfusion injury in patients with ST-segment elevation myocardial infarction: promise, disappointment, and hope. Rev Cardiovasc Med. 2022 Jan 17;23(1):23. doi: 10.31083/j.rcm2301023. PMID: 35092215.
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