ArticleJournal of the American College of Cardiology2020
Transvalvular Ventricular Unloading Before Reperfusion in Acute Myocardial Infarction.
Article in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.
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Who cites it
46 citing papers in PubMed, 106 citations in OpenAlex.
- Historical account of reperfusion therapy and the development of cardioprotection beyond reperfusion.Basic research in cardiology · 2026Review
- Circulating Extracellular Vesicles in the Pathogenesis of Heart Failure in Patients With Chronic Kidney Disease.Circulation · 2026Article
- Cardiogenic Shock Systems of Care Best Practices. Part 2: The Shock Team and Inpatient Management.US cardiology · 2026Review
- Mechano-Ino-Chronotropic Unloading in Cardiogenic Shock Due to Acute Myocardial Infarction-Hemodynamic Insights From Simulation Modeling.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Percutaneous Mechanical Circulatory Support Devices in Cardiogenic Shock: A Narrative Review in Light of Recent Evidence.Journal of clinical medicine · 2025Review
- Normoxemic Extracorporeal Membrane Oxygenation Reduces Infarct Size and Preserves Mitochondrial Integrity in Preclinical Models of Acute Myocardial Infarction.Journal of cardiovascular translational research · 2025Article
- Expert consensus statement on the evaluation, treatment, and transfer of cardiogenic shock using a Delphi method approach: a report of the Japan Critical Care Cardiology Committee (J4 CS).Journal of intensive care · 2025Article
- Association Between Extracorporeal Cardiopulmonary Resuscitation and Prognosis in the Short and Long Term in Patients With Acute Myocardial Infarction Complicated by Refractory Cardiac Arrest.Circulation reports · 2025Article
- Article
- Reverse Remodeling in Infarct Cardiomyopathy: A Role for Temporary Mechanical Circulatory Support?JACC. Basic to translational science · 2025Article
- Emergent coronary revascularization with percutaneous coronary intervention and coronary artery bypass grafting in patients receiving extracorporeal cardiopulmonary resuscitation.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2024Article
- Utilizing left atrial venoarterial extracorporeal membrane oxygenation to unload the left ventricle prior to angioplasty in acute myocardial infarction: a case series.European heart journal. Case reports · 2024Article
- Restoration of Epicardial Blood Flow After Left Ventricular Unloading With the Impella CP Heart Pump in a Patient With STEMI Treated With Surgical Revascularization.Texas Heart Institute journal · 2024Article
- Novel Role for Cardiolipin as a Target of Therapy to Mitigate Myocardial Injury Caused by Venoarterial Extracorporeal Membrane Oxygenation.Circulation · 2024Article
- Negative Impact of Acute Reloading after Mechanical Left Ventricular Unloading.Journal of cardiovascular translational research · 2024Article
- Mechanically Regulating Cardiac Preload to Maximize Left Ventricular Unloading With a Transvalvular Microaxial Flow Pump.Circulation. Heart failure · 2024Article
- The impact of ECPELLA on haemodynamics and global oxygen delivery: a comprehensive simulation of biventricular failure.Intensive care medicine experimental · 2024Article
- Left ventricular hemodynamics with veno-arterial extracorporeal membrane oxygenation.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2024Article
- Foreword.Interventional cardiology (London, England) · 2024Article
- Myocardial Recovery in Cardiogenic Shock.Methodist DeBakey cardiovascular journal · 2024Review
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMyocardial damage due to acute ST-segment elevation myocardial infarction (STEMI) remains a significant global health problem. New approaches to limit myocardial infarct size and reduce progression to heart failure after STEMI are needed. Mechanically reducing left ventricular (LV) workload (LV unloading) before coronary reperfusion is emerging as a potential approach to reduce infarct size.
objectivesGiven the central importance of mitochondria in reperfusion injury, we hypothesized that compared with immediate reperfusion (IR), LV unloading before reperfusion improves myocardial energy substrate use and preserves mitochondrial structure and function.
methodsTo explore the effect of LV unloading duration on infarct size, we analyzed data from the STEMI-Door to Unload (STEMI-DTU) trial and then tested the effect of LV unloading on ischemia and reperfusion injury, cardiac metabolism, and mitochondrial function in swine models of acute myocardial infarction.
resultsThe duration of LV unloading before reperfusion was inversely associated with infarct size in patients with large anterior STEMI. In preclinical models, LV unloading reduced the expression of hypoxia-sensitive proteins and myocardial damage due to ischemia alone. LV unloading with a transvalvular pump (TV-P) but not with venoarterial extracorporeal membrane oxygenation (ECMO) reduced infarct size. Using unbiased and blinded metabolic profiling, TV-P improved myocardial energy substrate use and preserved mitochondrial structure including cardiolipin content after reperfusion compared with IR or ECMO. Functional testing in mitochondria isolated from the infarct zone showed an intact mitochondrial structure including cardiolipin content, preserved activity of the electron transport chain including mitochondrial complex I, and reduced oxidative stress with TV-P-supported reperfusion but not with IR or ECMO.
conclusionsThese novel findings identify that transvalvular unloading limits ischemic injury before reperfusion, improves myocardial energy substrate use, and preserves mitochondrial structure and function after reperfusion.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.