Journal of Cardiovascular Translational Research ( IF 3.4 ) Pub Date : 2021-03-29 , DOI: 10.1007/s12265-021-10114-y Xiaoying Qiao 1 , Shreyas Bhave 1 , Lija Swain 1 , Elric Zweck 1 , Lara Reyelt 1 , Paige Crowley 1 , Shiva K Annamalai 1 , Aditya Chennjorwala 1 , Michele Esposito 1 , Allen Razavi 1 , Sina Foroutanjazi 1 , Cody Machen 1 , Katherine Thayer 1 , Lena Jorde 1 , Richard H Karas 1 , Navin K Kapur 1
New mechanistic insight into how the kidney responds to cardiac injury during acute myocardial infarction (AMI) is required. We hypothesized that AMI promotes inflammation and matrix metalloproteinase-9 (MMP9) activity in the kidney and studied the effect of initiating an Impella CP or veno-arterial extracorporeal membrane oxygenation (VA-ECMO) before coronary reperfusion during AMI. Adult male swine were subjected to coronary occlusion and either reperfusion (ischemia-reperfusion; IR) or support with either Impella or VA-ECMO before reperfusion. IR and ECMO increased while Impella reduced levels of MMP-9 in the myocardial infarct zone, circulation, and renal cortex. Compared to IR, Impella reduced myocardial infarct size and urinary KIM-1 levels, but VA-ECMO did not. IR and VA-ECMO increased pro-fibrogenic signaling via transforming growth factor-beta and endoglin in the renal cortex, but Impella did not. These findings identify that AMI increases inflammatory activity in the kidney, which may be attenuated by Impella support.
中文翻译:
心肌损伤促进急性心肌梗死临床前模型中肾皮质基质金属蛋白酶 9 的活性
需要对急性心肌梗死 (AMI) 期间肾脏如何对心脏损伤作出反应的新机制洞察。我们假设 AMI 促进肾脏炎症和基质金属蛋白酶 9 (MMP9) 活性,并研究了在 AMI 期间冠状动脉再灌注前启动 Impella CP 或静脉-动脉体外膜氧合 (VA-ECMO) 的效果。对成年雄性猪进行冠状动脉闭塞和再灌注(缺血再灌注;IR)或再灌注前使用 Impella 或 VA-ECMO 进行支持。IR 和 ECMO 增加,而 Impella 降低了心肌梗死区、循环和肾皮质中 MMP-9 的水平。与 IR 相比,Impella 减少了心肌梗死面积和尿 KIM-1 水平,但 VA-ECMO 没有。IR 和 VA-ECMO 通过肾皮质中的转化生长因子-β 和内皮糖蛋白增加促纤维化信号,但 Impella 没有。这些发现表明 AMI 增加了肾脏的炎症活动,这可能会因 Impella 支持而减弱。