Acute Mechanical Unloading Prior to Reperfusion is Cardioprotective and Limits the Development of Heart Failure After Myocardial Infarction

Ischemic heart failure after acute myocardial infarction (AMI) is a major cause of morbidity and mortality worldwide. We recently reported that activation of a trans-valvular axial-flow pump in the LV and delaying myocardial reperfusion, known as Primary Unloading, limits infarct size by reducing LV wall stress and increasing expression of the cardioprotective cytokine, stromal derived factor 1 alpha (SDF1a). The mechanisms underlying the cardioprotective benefit and sustained effect of Primary Unloading remain poorly understood. We now tested the importance of delayed reperfusion, the functional significance of SDF1a, and the late-term impact on myocardial function and scar size associated with Primary Unloading.

9

Esposito ML, Zhang Y, Qiao X, Reyelt L, Paruchuri V, Schnitzler GR, Morine KJ, Annamalai SK, Bogins C, Natov PS, Pedicini R, Breton C, Mullin A, Mackey EE, Patel A, Rowin E, Jaffe IZ, Karas RH, Kapur NK