Amelioration of persistent left ventricular function impairment through increased plasma ascorbate levels following myocardial infarction

Nicolás Valls, Juan G. Gormaz, Rubén Aguayo, Jaime González, Roberto Brito, Daniel Hasson, Matías Libuy, Cristóbal Ramos, Rodrigo Carrasco, Juan C. Prieto, Gastón Dussaillant, Ángel Puentes, Viviana Noriega, Ramón Rodrigo

Resultado de la investigación: Article

6 Citas (Scopus)

Resumen

Purpose: Percutaneous coronary angioplasty (PCA) has been demonstrated to reduce mortality and morbidity and thereby improve the prognosis of patients undergoing acute myocardial infarctions (AMIs). However, this procedure paradoxically increases the initial damage as the result of a condition known as ‘myocardial reperfusion injury’. Oxidative stress may contribute to the mechanism of this injury. The goal of the present study was to ascertain whether high plasma ascorbate levels could ameliorate the reperfusion injuries that occur after the successful restoration of blood flow. Methods: Patients from three clinical centers of the public health system were included in the study. The groups were formed by either-sex patients with a diagnosis of ST-segment elevation myocardial infarction with an indication for primary PCA. Only the patients who presented with their first myocardial infarction were enrolled. Ascorbate was administered through an infusion given prior to the restoration of the coronary flow, which was then followed by oral treatment with vitamin C (500 mg/12 hours) plus vitamin E (400 IU/day) for 84 days. The left ventricular ejection fraction (LVEF) was determined by using cardiac magnetic resonance on days 6 and 84 following the onset of the reperfusion. In addition, the microvascular function was assessed by an angiographic evaluation using the Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade (TMPG). The results were grouped according to the plasma ascorbate concentration achieved immediately following the onset of reperfusion into either the HA group (high ascorbate, >1 mmol/l) or the LA group (low ascorbate, <1 mmol/l). The biochemical parameters were analyzed throughout the protocol. Results: The LVEF of the HA group was significantly higher than that of the LA group, values on day 84 in the HA group were 33% higher than those of the LA group. The amelioration of the LVEF was accompanied by an improvement in the microvascular dysfunction, after PCA, 95% of the patients in the HA group achieved a TMPG of 2–3, in the LA group only 79% of patients showed a TMPG of 2–3. Conclusions: These data are consistent with the protective effect of high plasma levels of ascorbate against the oxidative challenge caused by reperfusion injury in patients subjected to PCA following an AMI. Further studies are needed to elucidate the mechanism accounting for this beneficial antioxidant effect.

Idioma originalEnglish
Páginas (desde-hasta)75-83
Número de páginas9
PublicaciónRedox Report
Volumen21
N.º2
DOI
EstadoPublished - 3 mar 2016

Huella dactilar

Left Ventricular Function
Myocardial Infarction
Plasmas
Restoration
Angioplasty
Stroke Volume
Oxidative stress
Public health
Magnetic resonance
Vitamin E
Perfusion
Ascorbic Acid
Reperfusion Injury
Blood
Reperfusion
Antioxidants
Myocardial Reperfusion Injury
Oxidative Stress
Magnetic Resonance Spectroscopy
Public Health

ASJC Scopus subject areas

  • Biochemistry
  • Physiology
  • Clinical Biochemistry
  • Cell Biology
  • Biochemistry, medical

Citar esto

Valls, Nicolás ; Gormaz, Juan G. ; Aguayo, Rubén ; González, Jaime ; Brito, Roberto ; Hasson, Daniel ; Libuy, Matías ; Ramos, Cristóbal ; Carrasco, Rodrigo ; Prieto, Juan C. ; Dussaillant, Gastón ; Puentes, Ángel ; Noriega, Viviana ; Rodrigo, Ramón. / Amelioration of persistent left ventricular function impairment through increased plasma ascorbate levels following myocardial infarction. En: Redox Report. 2016 ; Vol. 21, N.º 2. pp. 75-83.
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abstract = "Purpose: Percutaneous coronary angioplasty (PCA) has been demonstrated to reduce mortality and morbidity and thereby improve the prognosis of patients undergoing acute myocardial infarctions (AMIs). However, this procedure paradoxically increases the initial damage as the result of a condition known as ‘myocardial reperfusion injury’. Oxidative stress may contribute to the mechanism of this injury. The goal of the present study was to ascertain whether high plasma ascorbate levels could ameliorate the reperfusion injuries that occur after the successful restoration of blood flow. Methods: Patients from three clinical centers of the public health system were included in the study. The groups were formed by either-sex patients with a diagnosis of ST-segment elevation myocardial infarction with an indication for primary PCA. Only the patients who presented with their first myocardial infarction were enrolled. Ascorbate was administered through an infusion given prior to the restoration of the coronary flow, which was then followed by oral treatment with vitamin C (500 mg/12 hours) plus vitamin E (400 IU/day) for 84 days. The left ventricular ejection fraction (LVEF) was determined by using cardiac magnetic resonance on days 6 and 84 following the onset of the reperfusion. In addition, the microvascular function was assessed by an angiographic evaluation using the Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade (TMPG). The results were grouped according to the plasma ascorbate concentration achieved immediately following the onset of reperfusion into either the HA group (high ascorbate, >1 mmol/l) or the LA group (low ascorbate, <1 mmol/l). The biochemical parameters were analyzed throughout the protocol. Results: The LVEF of the HA group was significantly higher than that of the LA group, values on day 84 in the HA group were 33{\%} higher than those of the LA group. The amelioration of the LVEF was accompanied by an improvement in the microvascular dysfunction, after PCA, 95{\%} of the patients in the HA group achieved a TMPG of 2–3, in the LA group only 79{\%} of patients showed a TMPG of 2–3. Conclusions: These data are consistent with the protective effect of high plasma levels of ascorbate against the oxidative challenge caused by reperfusion injury in patients subjected to PCA following an AMI. Further studies are needed to elucidate the mechanism accounting for this beneficial antioxidant effect.",
keywords = "Myocardial infarction, Oxidative stress, Ventricular ejection fraction, Vitamin C",
author = "Nicol{\'a}s Valls and Gormaz, {Juan G.} and Rub{\'e}n Aguayo and Jaime Gonz{\'a}lez and Roberto Brito and Daniel Hasson and Mat{\'i}as Libuy and Crist{\'o}bal Ramos and Rodrigo Carrasco and Prieto, {Juan C.} and Gast{\'o}n Dussaillant and {\'A}ngel Puentes and Viviana Noriega and Ram{\'o}n Rodrigo",
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Valls, N, Gormaz, JG, Aguayo, R, González, J, Brito, R, Hasson, D, Libuy, M, Ramos, C, Carrasco, R, Prieto, JC, Dussaillant, G, Puentes, Á, Noriega, V & Rodrigo, R 2016, 'Amelioration of persistent left ventricular function impairment through increased plasma ascorbate levels following myocardial infarction', Redox Report, vol. 21, n.º 2, pp. 75-83. https://doi.org/10.1179/1351000215Y.0000000018

Amelioration of persistent left ventricular function impairment through increased plasma ascorbate levels following myocardial infarction. / Valls, Nicolás; Gormaz, Juan G.; Aguayo, Rubén; González, Jaime; Brito, Roberto; Hasson, Daniel; Libuy, Matías; Ramos, Cristóbal; Carrasco, Rodrigo; Prieto, Juan C.; Dussaillant, Gastón; Puentes, Ángel; Noriega, Viviana; Rodrigo, Ramón.

En: Redox Report, Vol. 21, N.º 2, 03.03.2016, p. 75-83.

Resultado de la investigación: Article

TY - JOUR

T1 - Amelioration of persistent left ventricular function impairment through increased plasma ascorbate levels following myocardial infarction

AU - Valls, Nicolás

AU - Gormaz, Juan G.

AU - Aguayo, Rubén

AU - González, Jaime

AU - Brito, Roberto

AU - Hasson, Daniel

AU - Libuy, Matías

AU - Ramos, Cristóbal

AU - Carrasco, Rodrigo

AU - Prieto, Juan C.

AU - Dussaillant, Gastón

AU - Puentes, Ángel

AU - Noriega, Viviana

AU - Rodrigo, Ramón

PY - 2016/3/3

Y1 - 2016/3/3

N2 - Purpose: Percutaneous coronary angioplasty (PCA) has been demonstrated to reduce mortality and morbidity and thereby improve the prognosis of patients undergoing acute myocardial infarctions (AMIs). However, this procedure paradoxically increases the initial damage as the result of a condition known as ‘myocardial reperfusion injury’. Oxidative stress may contribute to the mechanism of this injury. The goal of the present study was to ascertain whether high plasma ascorbate levels could ameliorate the reperfusion injuries that occur after the successful restoration of blood flow. Methods: Patients from three clinical centers of the public health system were included in the study. The groups were formed by either-sex patients with a diagnosis of ST-segment elevation myocardial infarction with an indication for primary PCA. Only the patients who presented with their first myocardial infarction were enrolled. Ascorbate was administered through an infusion given prior to the restoration of the coronary flow, which was then followed by oral treatment with vitamin C (500 mg/12 hours) plus vitamin E (400 IU/day) for 84 days. The left ventricular ejection fraction (LVEF) was determined by using cardiac magnetic resonance on days 6 and 84 following the onset of the reperfusion. In addition, the microvascular function was assessed by an angiographic evaluation using the Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade (TMPG). The results were grouped according to the plasma ascorbate concentration achieved immediately following the onset of reperfusion into either the HA group (high ascorbate, >1 mmol/l) or the LA group (low ascorbate, <1 mmol/l). The biochemical parameters were analyzed throughout the protocol. Results: The LVEF of the HA group was significantly higher than that of the LA group, values on day 84 in the HA group were 33% higher than those of the LA group. The amelioration of the LVEF was accompanied by an improvement in the microvascular dysfunction, after PCA, 95% of the patients in the HA group achieved a TMPG of 2–3, in the LA group only 79% of patients showed a TMPG of 2–3. Conclusions: These data are consistent with the protective effect of high plasma levels of ascorbate against the oxidative challenge caused by reperfusion injury in patients subjected to PCA following an AMI. Further studies are needed to elucidate the mechanism accounting for this beneficial antioxidant effect.

AB - Purpose: Percutaneous coronary angioplasty (PCA) has been demonstrated to reduce mortality and morbidity and thereby improve the prognosis of patients undergoing acute myocardial infarctions (AMIs). However, this procedure paradoxically increases the initial damage as the result of a condition known as ‘myocardial reperfusion injury’. Oxidative stress may contribute to the mechanism of this injury. The goal of the present study was to ascertain whether high plasma ascorbate levels could ameliorate the reperfusion injuries that occur after the successful restoration of blood flow. Methods: Patients from three clinical centers of the public health system were included in the study. The groups were formed by either-sex patients with a diagnosis of ST-segment elevation myocardial infarction with an indication for primary PCA. Only the patients who presented with their first myocardial infarction were enrolled. Ascorbate was administered through an infusion given prior to the restoration of the coronary flow, which was then followed by oral treatment with vitamin C (500 mg/12 hours) plus vitamin E (400 IU/day) for 84 days. The left ventricular ejection fraction (LVEF) was determined by using cardiac magnetic resonance on days 6 and 84 following the onset of the reperfusion. In addition, the microvascular function was assessed by an angiographic evaluation using the Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade (TMPG). The results were grouped according to the plasma ascorbate concentration achieved immediately following the onset of reperfusion into either the HA group (high ascorbate, >1 mmol/l) or the LA group (low ascorbate, <1 mmol/l). The biochemical parameters were analyzed throughout the protocol. Results: The LVEF of the HA group was significantly higher than that of the LA group, values on day 84 in the HA group were 33% higher than those of the LA group. The amelioration of the LVEF was accompanied by an improvement in the microvascular dysfunction, after PCA, 95% of the patients in the HA group achieved a TMPG of 2–3, in the LA group only 79% of patients showed a TMPG of 2–3. Conclusions: These data are consistent with the protective effect of high plasma levels of ascorbate against the oxidative challenge caused by reperfusion injury in patients subjected to PCA following an AMI. Further studies are needed to elucidate the mechanism accounting for this beneficial antioxidant effect.

KW - Myocardial infarction

KW - Oxidative stress

KW - Ventricular ejection fraction

KW - Vitamin C

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U2 - 10.1179/1351000215Y.0000000018

DO - 10.1179/1351000215Y.0000000018

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JO - Redox Report

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