Key result
Isoprostane F2alpha-III concentrations were significantly higher following PCI for AMI than in controls (P<0.001), but murine models suggest it alone does not cause the low/no reflow phenomenon.
Why the study?
Does isoprostane F2alpha-III contribute to the low/no reflow phenomenon following acute myocardial infarction?
Observational (n=13)
Does isoprostane F2alpha-III contribute to the low/no reflow phenomenon following acute myocardial infarction?
p-value: p=<0.001
Isoprostane F2alpha-III released during reperfusion after AMI does not appear to be the primary cause of the low/no reflow phenomenon.
Isoprostane F2alpha-III elevation after AMI PCI does not implicate it as a no-reflow driver; hypothesis-generating for alternative reperfusion mechanisms.
AIMS: To investigate whether the vasoconstrictor isoprostane F2alpha-III (iPF2alpha-III), released during myocardial reperfusion, contributes to the low/no reflow phenomenon observed following acute myocardial infarction (AMI). METHODS AND RESULTS: Thirteen patients undergoing primary percutaneous coronary intervention (PCI) for AMI had iPF2alpha-III measured by high-performance liquid and gas chromatography-mass spectrometry. Isoprostane F2alpha-III concentrations were significantly higher following PCI than in controls (1.5+/-1.3 vs.16+/-0.06 nM, p < 0.001). Mean iPF2alpha-III concentration correlated positively with ST-segment resolution at 90 min (R = 0.62, p < 0.05). In the isolated murine heart: (a) coronary vasoconstriction occurred at, or above, iPF2alpha-III concentrations of 1 microM. From 1 to 10 microM, iPF2alpha-III induced dose-dependent vasoconstriction (p = 0.005) with reduction in coronary flows (f) of 57+/-5% and 31+/-4% (percentage baseline), respectively; (b) SQ29548 1 microM completely reversed the vasoconstrictive effects of iPF2alpha-III 10 microM; (c) SQ29548 1 microM infused during reperfusion following 30 min ischaemia had no effect on CF or infarct volume. CONCLUSION: Concentrations of iPF2alpha-III released into the venous circulation during reperfusion following AMI in humans are significantly lower than those required to diminish coronary flow in the murine heart; increased levels indicate successful reperfusion. Inhibition of iPF2alpha-III has no effect on coronary flow or infarct size in the murine heart, suggesting that iPF2alpha-III alone does not account for the low/no reflow phenomenon observed following AMI.
No takes yet. Share an insight, caveat, or question.
Kim Greaves (2004) conducted an observational in Acute myocardial infarction (AMI) (n=13). Isoprostane F2alpha-III (iPF2alpha-III) vs. Controls was evaluated on Isoprostane F2alpha-III concentrations following PCI (p=<0.001). Isoprostane F2alpha-III concentrations were significantly higher following PCI for AMI than in controls (P<0.001), but murine models suggest it alone does not cause the low/no reflow phenomenon.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: