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Moderate Hypothermia Modifies Coronary Hemodynamics and Endothelium‐Dependent Vasodilation in a Porcine Model of Temperature Management

BACKGROUND: Hypothermia has been associated with therapeutic benefits including reduced mortality and better neurologic outcomes in survivors of cardiac arrest. However, undesirable side effects have been reported in patients undergoing coronary interventions. Using a large animal model of temperatu...

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Autores principales: Bobi, Joaquim, Solanes, Núria, Dantas, Ana Paula, Ishida, Kohki, Regueiro, Ander, Castillo, Nadia, Sabaté, Manel, Rigol, Montserrat, Freixa, Xavier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033898/
https://www.ncbi.nlm.nih.gov/pubmed/32009525
http://dx.doi.org/10.1161/JAHA.119.014035
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author Bobi, Joaquim
Solanes, Núria
Dantas, Ana Paula
Ishida, Kohki
Regueiro, Ander
Castillo, Nadia
Sabaté, Manel
Rigol, Montserrat
Freixa, Xavier
author_facet Bobi, Joaquim
Solanes, Núria
Dantas, Ana Paula
Ishida, Kohki
Regueiro, Ander
Castillo, Nadia
Sabaté, Manel
Rigol, Montserrat
Freixa, Xavier
author_sort Bobi, Joaquim
collection PubMed
description BACKGROUND: Hypothermia has been associated with therapeutic benefits including reduced mortality and better neurologic outcomes in survivors of cardiac arrest. However, undesirable side effects have been reported in patients undergoing coronary interventions. Using a large animal model of temperature management, we aimed to describe how temperature interferes with the coronary vasculature. METHODS AND RESULTS: Coronary hemodynamics and endothelial function were studied in 12 pigs at various core temperatures. Left circumflex coronary artery was challenged with intracoronary nitroglycerin, bradykinin, and adenosine at normothermia (38°C) and mild hypothermia (34°C), followed by either rewarming (38°C; n=6) or moderate hypothermia (MoHT; 32°C, n=6). Invasive coronary hemodynamics by Doppler wire revealed a slower coronary blood velocity at 32°C in the MoHT protocol (normothermia 20.2±11.2 cm/s versus mild hypothermia 18.7±4.3 cm/s versus MoHT 11.3±5.3 cm/s, P=0.007). MoHT time point was also associated with high values of hyperemic microvascular resistance (>3 mm Hg/cm per second) (normothermia 2.0±0.6 mm Hg/cm per second versus mild hypothermia 2.0±0.8 mm Hg/cm per second versus MoHT 3.4±1.6 mm Hg/cm per second, P=0.273). Assessment of coronary vasodilation by quantitative coronary analysis showed increased endothelium‐dependent (bradykinin) vasodilation at 32°C when compared with normothermia (normothermia 6.96% change versus mild hypothermia 9.01% change versus MoHT 25.42% change, P=0.044). Results from coronary reactivity in vitro were in agreement with angiography data and established that endothelium‐dependent relaxation in MoHT completely relies on NO production. CONCLUSIONS: In this porcine model of temperature management, 34°C hypothermia and rewarming (38°C) did not affect coronary hemodynamics or endothelial function. However, 32°C hypothermia altered coronary vasculature physiology by slowing coronary blood flow, increasing microvascular resistance, and exacerbating endothelium‐dependent vasodilatory response.
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spelling pubmed-70338982020-02-27 Moderate Hypothermia Modifies Coronary Hemodynamics and Endothelium‐Dependent Vasodilation in a Porcine Model of Temperature Management Bobi, Joaquim Solanes, Núria Dantas, Ana Paula Ishida, Kohki Regueiro, Ander Castillo, Nadia Sabaté, Manel Rigol, Montserrat Freixa, Xavier J Am Heart Assoc Original Research BACKGROUND: Hypothermia has been associated with therapeutic benefits including reduced mortality and better neurologic outcomes in survivors of cardiac arrest. However, undesirable side effects have been reported in patients undergoing coronary interventions. Using a large animal model of temperature management, we aimed to describe how temperature interferes with the coronary vasculature. METHODS AND RESULTS: Coronary hemodynamics and endothelial function were studied in 12 pigs at various core temperatures. Left circumflex coronary artery was challenged with intracoronary nitroglycerin, bradykinin, and adenosine at normothermia (38°C) and mild hypothermia (34°C), followed by either rewarming (38°C; n=6) or moderate hypothermia (MoHT; 32°C, n=6). Invasive coronary hemodynamics by Doppler wire revealed a slower coronary blood velocity at 32°C in the MoHT protocol (normothermia 20.2±11.2 cm/s versus mild hypothermia 18.7±4.3 cm/s versus MoHT 11.3±5.3 cm/s, P=0.007). MoHT time point was also associated with high values of hyperemic microvascular resistance (>3 mm Hg/cm per second) (normothermia 2.0±0.6 mm Hg/cm per second versus mild hypothermia 2.0±0.8 mm Hg/cm per second versus MoHT 3.4±1.6 mm Hg/cm per second, P=0.273). Assessment of coronary vasodilation by quantitative coronary analysis showed increased endothelium‐dependent (bradykinin) vasodilation at 32°C when compared with normothermia (normothermia 6.96% change versus mild hypothermia 9.01% change versus MoHT 25.42% change, P=0.044). Results from coronary reactivity in vitro were in agreement with angiography data and established that endothelium‐dependent relaxation in MoHT completely relies on NO production. CONCLUSIONS: In this porcine model of temperature management, 34°C hypothermia and rewarming (38°C) did not affect coronary hemodynamics or endothelial function. However, 32°C hypothermia altered coronary vasculature physiology by slowing coronary blood flow, increasing microvascular resistance, and exacerbating endothelium‐dependent vasodilatory response. John Wiley and Sons Inc. 2020-02-03 /pmc/articles/PMC7033898/ /pubmed/32009525 http://dx.doi.org/10.1161/JAHA.119.014035 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Bobi, Joaquim
Solanes, Núria
Dantas, Ana Paula
Ishida, Kohki
Regueiro, Ander
Castillo, Nadia
Sabaté, Manel
Rigol, Montserrat
Freixa, Xavier
Moderate Hypothermia Modifies Coronary Hemodynamics and Endothelium‐Dependent Vasodilation in a Porcine Model of Temperature Management
title Moderate Hypothermia Modifies Coronary Hemodynamics and Endothelium‐Dependent Vasodilation in a Porcine Model of Temperature Management
title_full Moderate Hypothermia Modifies Coronary Hemodynamics and Endothelium‐Dependent Vasodilation in a Porcine Model of Temperature Management
title_fullStr Moderate Hypothermia Modifies Coronary Hemodynamics and Endothelium‐Dependent Vasodilation in a Porcine Model of Temperature Management
title_full_unstemmed Moderate Hypothermia Modifies Coronary Hemodynamics and Endothelium‐Dependent Vasodilation in a Porcine Model of Temperature Management
title_short Moderate Hypothermia Modifies Coronary Hemodynamics and Endothelium‐Dependent Vasodilation in a Porcine Model of Temperature Management
title_sort moderate hypothermia modifies coronary hemodynamics and endothelium‐dependent vasodilation in a porcine model of temperature management
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033898/
https://www.ncbi.nlm.nih.gov/pubmed/32009525
http://dx.doi.org/10.1161/JAHA.119.014035
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