Pretreatment with the Na+/H+-exchange inhibitor HOE642 significantly decreased histochemical infarct size from 51.2% to 13.2% (p < 0.005) in porcine hearts subjected to 45 minutes of ischemia.
Does cariporide reduce infarct size and improve myocardial function in regionally ischemic, reperfused porcine hearts?
Pretreatment with the Na+/H+-exchange inhibitor cariporide significantly reduces infarct size and improves functional recovery in a porcine model of myocardial ischemia and reperfusion, effectively delaying cell death.
Absolute Event Rate: 13.2% vs 51.2%
p-value: p=< 0.005
Studies in different preparations have suggested that Na+/H+ exchange is one mechanism causally involved in cell death in myocardial ischemia and reperfusion. The time delay of cell death by pretreatment with the Na+/H+-exchange inhibitor HOE642, cariporide (4-isopropyl-3-methylsulphonylbenzoyl-guanidine methanesulphonate), was investigated in regionally ischemic, reperfused porcine hearts. HOE642 (1 mg/kg) was injected intravenously in 14 thoracotomized pigs 10 min before occlusion of the left anterior descending coronary artery (45 min of ischemia, six pigs; 70 min of ischemia, six pigs; 90 min of ischemia, two pigs). Ischemia was followed by 24 h of reperfusion. Six animals (45 min of ischemia) served as controls. Infarct size was determined as a ratio of infarcted (tetrazolium stain, histology) to ischemic myocardium (dye technique), and regional myocardial function was assessed by sonomicrometry. HOE642 did not affect global hemodynamic parameters. In the pretreated group with 45 min of ischemia, HOE642 significantly decreased histochemical infarct size from 51.2 +/- 12.6% (control group) to 13.2 +/- 12% (p < 0.005) and histologic infarct size from 44.5 +/- 9% to 17.1 +/- 7% (p < 0.005). Recovery of regional systolic shortening after 24 h of reperfusion was improved from 2 +/- 6% (control group) to 12 +/- 7% (p = 0.02). In addition, myocardial contracture and increase in heart rate during early reperfusion were attenuated. When ischemia was prolonged to 70 min after pretreatment with HOE642, infarct size, recovery of systolic shortening, myocardial contracture, and increase in heart rate did not differ from those of the control group. Pretreatment with HOE642 increased the tolerance to ischemia/reperfusion by approximately 20-25 min. Inhibition of Na+/H+ exchange appears to be very promising in the clinical treatment of acute myocardial ischemia and reperfusion.
Klein et al. (Fri,) conducted a other in Myocardial ischemia and reperfusion (n=20). HOE642 (cariporide) vs. Control (no pretreatment) was evaluated on Histochemical infarct size (ratio of infarcted to ischemic myocardium) (p=< 0.005). Pretreatment with the Na+/H+-exchange inhibitor HOE642 significantly decreased histochemical infarct size from 51.2% to 13.2% (p < 0.005) in porcine hearts subjected to 45 minutes of ischemia.
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