Rodrigo Fernández-Jiménez1, Jaime García-Prieto2, Javier Sánchez-González3, Jaume Agüero2, Gonzalo J López-Martín2, Carlos Galán-Arriola2, Antonio Molina-Iracheta2, Roisin Doohan2, Valentin Fuster4, Borja Ibáñez5. 1. Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain. 2. Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain. 3. Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Philips Healthcare, Madrid, Spain. 4. Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York. 5. Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain. Electronic address: bibanez@cnic.es.
Abstract
BACKGROUND: Post-ischemia/reperfusion (I/R) myocardial edema was recently shown to follow a consistent bimodal pattern: an initial wave of edema appears on reperfusion and dissipates at 24 h, followed by a deferred wave that initiates days after infarction, peaking at 1 week. OBJECTIVES: This study examined the pathophysiology underlying this post-I/R bimodal edematous reaction. METHODS: Forty instrumented pigs were assigned to different myocardial infarction protocols. Edematous reaction was evaluated by water content quantification, serial cardiac magnetic resonance T2-mapping, and histology/immunohistochemistry. The association of reperfusion with the initial wave of edema was evaluated in pigs undergoing 40-min/80-min I/R and compared with pigs undergoing 120-min ischemia with no reperfusion. The role of tissue healing in the deferred wave of edema was evaluated by comparing pigs undergoing standard 40-min/7-day I/R with animals subjected to infarction without reperfusion (chronic 7-day coronary occlusion) or receiving post-I/R high-dose steroid therapy. RESULTS: Characterization of post-I/R tissue changes revealed maximal interstitial edema early on reperfusion in the ischemic myocardium, with maximal content of neutrophils, macrophages, and collagen at 24 h, day 4, and day 7 post-I/R, respectively. Reperfused pigs had significantly higher myocardial water content at 120 min and T2 relaxation times on 120 min cardiac magnetic resonance than nonreperfused animals. Permanent coronary occlusion or high-dose steroid therapy significantly reduced myocardial water content on day 7 post-infarction. The dynamics of T2 relaxation times during the first post-infarction week were altered significantly in nonreperfused pigs compared with pigs undergoing regular I/R. CONCLUSIONS: The 2 waves of the post-I/R edematous reaction are related to different pathophysiological phenomena. Although the first wave is secondary to reperfusion, the second wave occurs mainly because of tissue healing processes.
BACKGROUND: Post-ischemia/reperfusion (I/R) myocardial edema was recently shown to follow a consistent bimodal pattern: an initial wave of edema appears on reperfusion and dissipates at 24 h, followed by a deferred wave that initiates days after infarction, peaking at 1 week. OBJECTIVES: This study examined the pathophysiology underlying this post-I/R bimodal edematous reaction. METHODS: Forty instrumented pigs were assigned to different myocardial infarction protocols. Edematous reaction was evaluated by water content quantification, serial cardiac magnetic resonance T2-mapping, and histology/immunohistochemistry. The association of reperfusion with the initial wave of edema was evaluated in pigs undergoing 40-min/80-min I/R and compared with pigs undergoing 120-min ischemia with no reperfusion. The role of tissue healing in the deferred wave of edema was evaluated by comparing pigs undergoing standard 40-min/7-day I/R with animals subjected to infarction without reperfusion (chronic 7-day coronary occlusion) or receiving post-I/R high-dose steroid therapy. RESULTS: Characterization of post-I/R tissue changes revealed maximal interstitial edema early on reperfusion in the ischemic myocardium, with maximal content of neutrophils, macrophages, and collagen at 24 h, day 4, and day 7 post-I/R, respectively. Reperfused pigs had significantly higher myocardial water content at 120 min and T2 relaxation times on 120 min cardiac magnetic resonance than nonreperfused animals. Permanent coronary occlusion or high-dose steroid therapy significantly reduced myocardial water content on day 7 post-infarction. The dynamics of T2 relaxation times during the first post-infarction week were altered significantly in nonreperfused pigs compared with pigs undergoing regular I/R. CONCLUSIONS: The 2 waves of the post-I/R edematous reaction are related to different pathophysiological phenomena. Although the first wave is secondary to reperfusion, the second wave occurs mainly because of tissue healing processes.
Authors: David Lopez; Jonathan A Pan; Peter M Pollak; Samantha Clarke; Christopher M Kramer; Mark Yeager; Michael Salerno Journal: NMR Biomed Date: 2017-02-06 Impact factor: 4.044
Authors: Xavier Rossello; Antonio Piñero; Rodrigo Fernández-Jiménez; Javier Sánchez-González; Gonzalo Pizarro; Carlos Galán-Arriola; Manuel Lobo-Gonzalez; Jean Paul Vilchez; Jaime García-Prieto; Jose Manuel García-Ruiz; Ana García-Álvarez; David Sanz-Rosa; Borja Ibanez Journal: J Cardiovasc Transl Res Date: 2018-08-02 Impact factor: 4.132
Authors: Bruno García Del Blanco; Imanol Otaegui; José F Rodríguez-Palomares; Antoni Bayés-Genis; Eduard Fernández-Nofrerías; Victoria Vilalta Del Olmo; Xavier Carrillo; Borja Ibáñez; Fernando Worner; Juan Casanova; Eva Pueo; Jose R González-Juanatey; Javier López-Pais; Alfredo Bardají; Gil Bonet; Mónica Fuertes; Antonio Rodríguez-Sinovas; Marisol Ruiz-Meana; Javier Inserte; Ignasi Barba; Sandra Gómez-Talavera; Gerard Martí; Bernat Serra; Neus Bellera; Manuel Ojeda-Ramos; Hug Cuellar; Filipa Valente; Maria Ángeles Carmona; Elisabet Miró-Casas; Josep R Marsal; Antonia Sambola; Rosa M Lidón; Jordi Bañeras; Jaime Elízaga; Ferran Padilla; José A Barrabés; Derek J Hausenloy; Ignacio Ferreira-González; David García-Dorado Journal: Basic Res Cardiol Date: 2021-01-25 Impact factor: 17.165