Moderate hypothermia (30°C) maintains myocardial integrity and modifies response of cell survival proteins after reperfusion

Xue, Ning; Emil, Y.; Buroker, Norman E.; Chen, Shi Han; Xu, Chuanzhi; Tien, Ying Tzang; Hyyti, Outi M.; Ge, Ming; Portman, Michael A.

doi:10.1152/ajpheart.00123.2007

Cited by 40 publications

(50 citation statements)

References 40 publications

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“…There was less injury with arrest effect than in the 34-35°C, and the recovery was lower than in the 29-30.5°C arrest ( p < 0.05). The current results are in accordance with previous observations in the isolated rabbit hearts (Ning et al, 1998a(Ning et al, , 2007b.…”

Section: Resultssupporting

confidence: 94%

“…The point around 30.5-31°C is similar to the protective temperature threshold in the isolated rabbit hearts (Ning et al, 1998b(Ning et al, , 1998c(Ning et al, , 2002. Accompanied with marked functional improvement, histological evidence showed that the hypothermia-treated hearts had less swelling and damage to the myocardium, as well as less collagen in the connective tissue (Ning et al, 2007b).…”

Section: Fig 5 Hr After Optimal Hypothermic Arrest (Mean -Se)mentioning

confidence: 58%

“…When significant F values were obtained, individual group means were tested for differences. The criterion for significance was p < 0.05 for all comparisons (Ning et al, 1998c(Ning et al, , 2007a(Ning et al, , 2007b(Ning et al, , 2008.…”

Section: Discussionmentioning

confidence: 99%

“…Previous data showed that preischemic hypothermia could provide cardiac protection (Ning et al, 1998b). Adding 20 minutes of hypothermia before the hypothermic arrest showed very good recovery during reperfusion in the isolated hearts (Ning et al, 2007b). In the cardiac surgery, hypothermia could be started before heart arrest.…”

Section: Pig Hypothermia Protocolmentioning

confidence: 99%

“…It is necessary to explore OPH with well-controlled experiments. A series of studies on mammalian isolated hearts have observed that treatment with 29-30.5°C showed obvious protection after arrest, but 34°C and higher has less protection (Xu et al, 1996;Ning et al, 1998aNing et al, , 1998bNing et al, , 1998cNing et al, , 2007b, suggesting that an OPH for myocardial protection should be < 34°C. The aim of this study was to clarify an OPH in the pig hearts in vivo with a clinical surgery used method-cardiopulmonary bypass (CPB) treated by cardiac arrest for 60 minutes.…”

Section: Introductionmentioning

confidence: 99%

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Optimal Protective Hypothermia in Arrested Mammalian Hearts

Xue

Villet

et al. 2015

Therapeutic Hypothermia and Temperature Management

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Many therapeutic hypothermia recommendations have been reported, but the information supporting them is sparse, and reveals a need for the data of target therapeutic hypothermia (TTH) from well-controlled experiments. The core temperature p35°C is considered as hypothermia, and 29°C is a cooling injury threshold in pig heart in vivo. Thus, an optimal protective hypothermia (OPH) should be in the range 29-35°C. This study was conducted with a pig cardiopulmonary bypass preparation to decrease the core temperature to 29-35°C range at 20 minutes before and 60 minutes during heart arrest. The left ventricular (LV) developed pressure, maximum of the first derivative of LV (dP/dt max ), cardiac power, heart rate, cardiac output, and myocardial velocity (V max ) were recorded continuously via an LV pressure catheter and an aortic flow probe. At 20 minutes of offpump during reperfusion after 60 minutes arrest, 17 hypothermic hearts showed that the recovery of V max and dP/dt max established sigmoid curves that consisted of two plateaus: a good recovery plateau at 29-30.5°C, the function recovered to baseline level (BL) (V max = 118.4% -3.9% of BL, LV dP/dt max = 120.7% -3.1% of BL, n = 6); another poor recovery plateau at 34-35°C ( V max = 60.2% -2.8% of BL, LV dP/dt max = 28.0% -5.9% of BL, p < 0.05, n = 6; ), which are similar to the four normothermia arrest (37°C) hearts (V max = 55.9% -4.8% of BL, LV dP/dt max = 24.5% -2.1% of BL, n = 4). The 32-32.5°C arrest hearts showed moderate recovery (n = 5). A point of inflection (around 30.5-31°C) existed at the edge of a good recovery plateau followed by a steep slope. The point presented an OPH that should be the TTH. The results are concordant with data in the mammalian hearts, suggesting that the TTH should be initiated to cool core temperature at 31°C.

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Section: Resultssupporting

confidence: 94%

Section: Fig 5 Hr After Optimal Hypothermic Arrest (Mean -Se)mentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Pig Hypothermia Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Optimal Protective Hypothermia in Arrested Mammalian Hearts

Xue

Villet

et al. 2015

Therapeutic Hypothermia and Temperature Management

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Stress‐specific responses of p21 expression: Implication of transcript variant p21 alt‐a in long‐term hypoxia

Kaija

Särkioja

Kortelainen

et al. 2012

J of Cellular Biochemistry

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p21 (CDKN1A, Cip1, Waf1) is a cyclin-dependent kinase inhibitor capable of causing cell cycle arrest or promoting cell cycle transit as well as acting as a regulator of apoptosis. In this study, we analyzed the effects of various antemortem conditions on p21 protein level and expression profiles of known p21 transcript variants in human heart tissue. The selected death cause groups were: non-cardiac, hypothermia, acute ischemia, and chronic hypoxia. Immunohistochemical staining of p21 in cardiac myocytes could be observed only in hypothermia death cases, in which the mRNA expression of the most abundant variant, p21V1, also exceeded that in other death cause groups. Cytoplasmic localization of p21 protein in vascular smooth muscle cells together with substantially increased expression of cardioprotective Pim-1 especially in chronic hypoxia, but in acute ischemia and hypothermia as well, indicate change of p21 function from cell cycle arrest to promotion of proliferation and cell survival in these cases. In chronic hypoxia deaths the expression of variant p21 alt-a was highly pronounced whereas the expression of variant p21B was low. In chronic hypoxia deaths the expression of p53 was substantially higher compared to the other groups, being a potential regulator of p21 alt-a expression. In acute ischemia deaths increased expression of variant p21B, suggested to be proapoptotic in several cell lines, was observed. Our results suggest a role for variant p21 alt-a in hypoxia and for variant p21B in acute myocardial ischemia. The known cardioprotective aspect of hypothermia might come from an increased p21 protein level.

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Therapeutic Hypothermia after Cardiac Arrest

Ristagno

Tang²

2009

Intensive Care Medicine

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Moderate hypothermia (30°C) maintains myocardial integrity and modifies response of cell survival proteins after reperfusion

Cited by 40 publications

References 40 publications

Optimal Protective Hypothermia in Arrested Mammalian Hearts

Optimal Protective Hypothermia in Arrested Mammalian Hearts

Stress‐specific responses of p21 expression: Implication of transcript variant p21 alt‐a in long‐term hypoxia

Therapeutic Hypothermia after Cardiac Arrest

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