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January 1, 2006Circulation JournalOpen Access

Brief Episode of Myocardial Ischemia Before Prolonged Ischemia Attenuates Cardiac Sympathetic Nerve Injury

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Why the study?

Does a brief episode of myocardial ischemia before prolonged ischemia attenuate cardiac sympathetic nerve injury in patients with acute myocardial infarction?

Population

30 patients with a first acute myocardial infarction and male Wistar rats.

Comparison

Brief episode of myocardial ischemia before… vs No brief episode of myocardial ischemia before…

Design

Cohort, Images were visually assessed by 2 experienced nuclear cardiologists…

Follow-up

2-3 weeks after the onset of MI

Authors

TNTeruo NakadateTNTakashi NozawaAMAkira Matsuki

Discussion

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Overview

Pre-infarction angina was associated with less sympathetic denervation post-AMI; hypothesis-generating for preconditioning, needs prospective confirmation.

Structured PICO

Does a brief episode of myocardial ischemia before prolonged ischemia attenuate cardiac sympathetic nerve injury in patients with acute myocardial infarction?

P
Population
30 patients with a first acute myocardial infarction (13 with pre-infarction angina within 3 days prior, 17 without pre-infarction angina) and male Wistar rats.
I
Intervention
Brief episode of myocardial ischemia before prolonged ischemia (pre-infarction angina in humans; 5-min coronary ligation followed by 5-min reperfusion in rats).
C
Comparator
No brief episode of myocardial ischemia before prolonged ischemia (no pre-infarction angina in humans; no 5-min coronary ligation in rats).
O
Outcome
Cardiac sympathetic neural function assessed by the difference in total defect score between 123I-MIBG and Thallium-201 (201Tl) imaging.surrogate

A brief episode of myocardial ischemia prior to prolonged ischemia (pre-infarction angina) attenuates cardiac sympathetic neural injury and reduces norepinephrine release.

Limitations

  • Tracer uptake of human hearts is often lower in the LV inferior region, especially with 123I-MIBG imaging.
  • Trend towards a greater number of patients with TIMI flow grade ≥2 before coronary intervention in the group without pre-infarction angina, which might partially affect the results.

Cite This Study

Nakadate et al. (2006) studied this question.

synapsesocial.com/papers/6a80eebcda9cafc35e337652https://doi.org/10.1253/circj.70.919
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Results of sympathetic denervation in the canine heart: supersensitivity that may be arrhythmogenic.1987 · 264 citations
  2. 2A new, concise dialysis approach to assessment of cardiac sympathetic nerve terminal abnormalities1997 · 59 citations
  3. 3Sympathetic denervation caused by long‐term noradrenaline infusions; prevention by desipramine and superoxide dismutase1989 · 35 citations
  4. 4The Thrombolysis in Myocardial Infarction (TIMI) Trial1985 · 3,192 citations
  5. 5Ischemic Preconditioning Attenuates Cardiac Sympathetic Nerve Injury via ATP-Sensitive Potassium Channels During Myocardial Ischemia2001 · 41 citations