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Conditioned blood reperfusion during angioplasty (CoBRA) treatment of acute myocardial infarction
Acute myocardial infarct (MI) results in ischemia distal to lesions which puts heart muscle at risk for reperfusion injury (RI). Neutrophils, platelets and complement are putative mediators of RI. Recent advances in filtration technology provide integrated neutrophil and platelet removal together wi...
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Published in: | Perfusion 2001-03, Vol.16 (1_suppl), p.39-49 |
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container_title | Perfusion |
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creator | Patel, Mrugesh B Kilgore, Kenneth S Ortolano, Girolamo A Gryboski, Cyndy L Qureshi, Mansoor A Marcovitz, Pamela Naylor, Keith B Park, James L Wenz, Barry Gikakis, Nicolas Freedman, Robert J Lucchesi, Benedict R O’Neill, William W |
description | Acute myocardial infarct (MI) results in ischemia distal to lesions which puts heart
muscle at risk for reperfusion injury (RI). Neutrophils, platelets and complement
are putative mediators of RI. Recent advances in filtration technology provide
integrated neutrophil and platelet removal together with complement-attenuating
properties in a single blood-conditioning device. The present study characterizes
the properties of a blood-conditioning filter and describes its clinical effect when
used in conjunction with active hemoperfusion for acute MI.The filter reduces leukocytes by 99.9998 ± 0.0002%
(p |
doi_str_mv | 10.1177/026765910101600i106 |
format | article |
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muscle at risk for reperfusion injury (RI). Neutrophils, platelets and complement
are putative mediators of RI. Recent advances in filtration technology provide
integrated neutrophil and platelet removal together with complement-attenuating
properties in a single blood-conditioning device. The present study characterizes
the properties of a blood-conditioning filter and describes its clinical effect when
used in conjunction with active hemoperfusion for acute MI.The filter reduces leukocytes by 99.9998 ± 0.0002%
(p<0.0001) and platelets by 99.9934 ± 0.0069%
(p<0.0001). Human plasma, derived from heparinized blood that was
‘conditioned’ by filtration, was studied using the Langendorff
isolated rabbit heart preparation. The deposition of membrane attack complex and the
resultant functional myocardial impairments [reflected in hemodynamic and
biochemical measurements, including developed pressure, coronary blood flow,
lymph-derived myocardial creatine kinase (CK)] are significantly attenuated by blood
conditioning. Integration of the blood-conditioning filter into an active
hemoperfusion system during primary percutaneous transluminal coronary angioplasty
(PTCA) for acute MI (n=8) did not delay the procedure or cause any
complications. Reperfusion of occluded coronary arteries with 300 cm3 of
conditioned blood led to significant improvement in echocardiographic global wall
motion scores (in standard deviations) following treatment (1.64 ± 0.18
to 1.45 ± 0.15, p=0.02).Initial reperfusion of totally occluded coronary arteries with conditioned blood
leads to acutely improved ventricular function. Collectively, these data provide a
strong indication for continued investigation of conditioned blood reperfusion in
angioplasty following acute MI for the long-term effect upon recovery of salvagable myocardium.</description><identifier>ISSN: 0267-6591</identifier><identifier>EISSN: 1477-111X</identifier><identifier>DOI: 10.1177/026765910101600i106</identifier><identifier>PMID: 11334205</identifier><language>eng</language><publisher>Thousand Oaks, CA: SAGE Publications</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Angioplasty ; Angioplasty, Balloon, Coronary - methods ; Animals ; Arteries ; Blood flow ; Blood plasma ; Blood pressure ; Cardiac muscle ; Complement ; Complement Membrane Attack Complex - metabolism ; Complement Membrane Attack Complex - pharmacology ; Complications ; Conditioning ; Coronary artery ; Coronary vessels ; Creatine ; Creatine kinase ; Electrocardiography ; Female ; Filtration ; Filtration - methods ; Health risks ; Heart ; Hemoperfusion ; Humans ; In Vitro Techniques ; Indication ; Integration ; Ischemia ; Lesions ; Leukapheresis ; Leukocytes ; Leukocytes (neutrophilic) ; Lymph ; Male ; Membrane attack complex ; Middle Aged ; Myocardial infarction ; Myocardial Infarction - blood ; Myocardial Infarction - physiopathology ; Myocardial Infarction - surgery ; Myocardium ; Pilot Projects ; Plateletpheresis ; Platelets ; Prospective Studies ; Rabbits ; Reperfusion ; Reperfusion - methods ; Reperfusion Injury - etiology ; Reperfusion Injury - prevention & control ; Stroke Volume ; Ventricle ; Ventricular Function, Left</subject><ispartof>Perfusion, 2001-03, Vol.16 (1_suppl), p.39-49</ispartof><rights>Copyright Sage Publications Ltd. Jan 2001</rights><rights>2001 SAGE Publications</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c397t-5dbaa4354abdb237f80e07a8b357ea9c3d81822315342aedbb0855ac8d193a5a3</citedby><cites>FETCH-LOGICAL-c397t-5dbaa4354abdb237f80e07a8b357ea9c3d81822315342aedbb0855ac8d193a5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904,79110</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11334205$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patel, Mrugesh B</creatorcontrib><creatorcontrib>Kilgore, Kenneth S</creatorcontrib><creatorcontrib>Ortolano, Girolamo A</creatorcontrib><creatorcontrib>Gryboski, Cyndy L</creatorcontrib><creatorcontrib>Qureshi, Mansoor A</creatorcontrib><creatorcontrib>Marcovitz, Pamela</creatorcontrib><creatorcontrib>Naylor, Keith B</creatorcontrib><creatorcontrib>Park, James L</creatorcontrib><creatorcontrib>Wenz, Barry</creatorcontrib><creatorcontrib>Gikakis, Nicolas</creatorcontrib><creatorcontrib>Freedman, Robert J</creatorcontrib><creatorcontrib>Lucchesi, Benedict R</creatorcontrib><creatorcontrib>O’Neill, William W</creatorcontrib><title>Conditioned blood reperfusion during angioplasty (CoBRA) treatment of acute myocardial infarction</title><title>Perfusion</title><addtitle>Perfusion</addtitle><description>Acute myocardial infarct (MI) results in ischemia distal to lesions which puts heart
muscle at risk for reperfusion injury (RI). Neutrophils, platelets and complement
are putative mediators of RI. Recent advances in filtration technology provide
integrated neutrophil and platelet removal together with complement-attenuating
properties in a single blood-conditioning device. The present study characterizes
the properties of a blood-conditioning filter and describes its clinical effect when
used in conjunction with active hemoperfusion for acute MI.The filter reduces leukocytes by 99.9998 ± 0.0002%
(p<0.0001) and platelets by 99.9934 ± 0.0069%
(p<0.0001). Human plasma, derived from heparinized blood that was
‘conditioned’ by filtration, was studied using the Langendorff
isolated rabbit heart preparation. The deposition of membrane attack complex and the
resultant functional myocardial impairments [reflected in hemodynamic and
biochemical measurements, including developed pressure, coronary blood flow,
lymph-derived myocardial creatine kinase (CK)] are significantly attenuated by blood
conditioning. Integration of the blood-conditioning filter into an active
hemoperfusion system during primary percutaneous transluminal coronary angioplasty
(PTCA) for acute MI (n=8) did not delay the procedure or cause any
complications. Reperfusion of occluded coronary arteries with 300 cm3 of
conditioned blood led to significant improvement in echocardiographic global wall
motion scores (in standard deviations) following treatment (1.64 ± 0.18
to 1.45 ± 0.15, p=0.02).Initial reperfusion of totally occluded coronary arteries with conditioned blood
leads to acutely improved ventricular function. Collectively, these data provide a
strong indication for continued investigation of conditioned blood reperfusion in
angioplasty following acute MI for the long-term effect upon recovery of salvagable myocardium.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Animals</subject><subject>Arteries</subject><subject>Blood flow</subject><subject>Blood plasma</subject><subject>Blood pressure</subject><subject>Cardiac muscle</subject><subject>Complement</subject><subject>Complement Membrane Attack Complex - metabolism</subject><subject>Complement Membrane Attack Complex - pharmacology</subject><subject>Complications</subject><subject>Conditioning</subject><subject>Coronary artery</subject><subject>Coronary vessels</subject><subject>Creatine</subject><subject>Creatine kinase</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Filtration</subject><subject>Filtration - methods</subject><subject>Health risks</subject><subject>Heart</subject><subject>Hemoperfusion</subject><subject>Humans</subject><subject>In Vitro Techniques</subject><subject>Indication</subject><subject>Integration</subject><subject>Ischemia</subject><subject>Lesions</subject><subject>Leukapheresis</subject><subject>Leukocytes</subject><subject>Leukocytes (neutrophilic)</subject><subject>Lymph</subject><subject>Male</subject><subject>Membrane attack complex</subject><subject>Middle Aged</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - surgery</subject><subject>Myocardium</subject><subject>Pilot Projects</subject><subject>Plateletpheresis</subject><subject>Platelets</subject><subject>Prospective Studies</subject><subject>Rabbits</subject><subject>Reperfusion</subject><subject>Reperfusion - methods</subject><subject>Reperfusion Injury - etiology</subject><subject>Reperfusion Injury - prevention & control</subject><subject>Stroke Volume</subject><subject>Ventricle</subject><subject>Ventricular Function, Left</subject><issn>0267-6591</issn><issn>1477-111X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNp90dFqFDEUBuBQlHbb-gSCBAuiF6PnTCaT5LIutQoFQSp4N5yZZJaUmcmazFzs25tlF1pESy4C4Tt_DvyMvUb4iKjUJyhrVUuDkE8N4BHqE7bCSqkCEX-9YKu9KPbkjJ2n9AAAVVWJU3aGKERVglwxWofJ-tmHyVneDiFYHt3WxX5J-Y3bJfppw2na-LAdKM07_n4dPv-4_sDn6Gge3TTz0HPqltnxcRc6itbTwP3UU-z2uZfsZU9Dcq-O9wX7-eXmfv21uPt--219fVd0wqi5kLYlqoSsqLVtKVSvwYEi3QqpHJlOWI26LAXKvDk527agpaROWzSCJIkL9u6Qu43h9-LS3Iw-dW4YaHJhSY0CDaaWIsO3f8GHsMQp79agMdIIaVRGV_9FWstal6AwK3FQXQwpRdc32-hHirsGodmX1PyjpDz15pi9tKOzjzPHVjKAA0i0cU8-fibzDywjmgU</recordid><startdate>20010301</startdate><enddate>20010301</enddate><creator>Patel, Mrugesh B</creator><creator>Kilgore, Kenneth S</creator><creator>Ortolano, Girolamo A</creator><creator>Gryboski, Cyndy L</creator><creator>Qureshi, Mansoor A</creator><creator>Marcovitz, Pamela</creator><creator>Naylor, Keith B</creator><creator>Park, James L</creator><creator>Wenz, Barry</creator><creator>Gikakis, Nicolas</creator><creator>Freedman, Robert J</creator><creator>Lucchesi, Benedict R</creator><creator>O’Neill, William W</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20010301</creationdate><title>Conditioned blood reperfusion during angioplasty (CoBRA) treatment of acute myocardial infarction</title><author>Patel, Mrugesh B ; Kilgore, Kenneth S ; Ortolano, Girolamo A ; Gryboski, Cyndy L ; Qureshi, Mansoor A ; Marcovitz, Pamela ; Naylor, Keith B ; Park, James L ; Wenz, Barry ; Gikakis, Nicolas ; Freedman, Robert J ; Lucchesi, Benedict R ; O’Neill, William W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c397t-5dbaa4354abdb237f80e07a8b357ea9c3d81822315342aedbb0855ac8d193a5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary - methods</topic><topic>Animals</topic><topic>Arteries</topic><topic>Blood flow</topic><topic>Blood plasma</topic><topic>Blood pressure</topic><topic>Cardiac muscle</topic><topic>Complement</topic><topic>Complement Membrane Attack Complex - metabolism</topic><topic>Complement Membrane Attack Complex - pharmacology</topic><topic>Complications</topic><topic>Conditioning</topic><topic>Coronary artery</topic><topic>Coronary vessels</topic><topic>Creatine</topic><topic>Creatine kinase</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Filtration</topic><topic>Filtration - methods</topic><topic>Health risks</topic><topic>Heart</topic><topic>Hemoperfusion</topic><topic>Humans</topic><topic>In Vitro Techniques</topic><topic>Indication</topic><topic>Integration</topic><topic>Ischemia</topic><topic>Lesions</topic><topic>Leukapheresis</topic><topic>Leukocytes</topic><topic>Leukocytes (neutrophilic)</topic><topic>Lymph</topic><topic>Male</topic><topic>Membrane attack complex</topic><topic>Middle Aged</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - surgery</topic><topic>Myocardium</topic><topic>Pilot Projects</topic><topic>Plateletpheresis</topic><topic>Platelets</topic><topic>Prospective Studies</topic><topic>Rabbits</topic><topic>Reperfusion</topic><topic>Reperfusion - methods</topic><topic>Reperfusion Injury - etiology</topic><topic>Reperfusion Injury - prevention & control</topic><topic>Stroke Volume</topic><topic>Ventricle</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patel, Mrugesh B</creatorcontrib><creatorcontrib>Kilgore, Kenneth S</creatorcontrib><creatorcontrib>Ortolano, Girolamo A</creatorcontrib><creatorcontrib>Gryboski, Cyndy L</creatorcontrib><creatorcontrib>Qureshi, Mansoor A</creatorcontrib><creatorcontrib>Marcovitz, Pamela</creatorcontrib><creatorcontrib>Naylor, Keith B</creatorcontrib><creatorcontrib>Park, James L</creatorcontrib><creatorcontrib>Wenz, Barry</creatorcontrib><creatorcontrib>Gikakis, Nicolas</creatorcontrib><creatorcontrib>Freedman, Robert J</creatorcontrib><creatorcontrib>Lucchesi, Benedict R</creatorcontrib><creatorcontrib>O’Neill, William W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Perfusion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patel, Mrugesh B</au><au>Kilgore, Kenneth S</au><au>Ortolano, Girolamo A</au><au>Gryboski, Cyndy L</au><au>Qureshi, Mansoor A</au><au>Marcovitz, Pamela</au><au>Naylor, Keith B</au><au>Park, James L</au><au>Wenz, Barry</au><au>Gikakis, Nicolas</au><au>Freedman, Robert J</au><au>Lucchesi, Benedict R</au><au>O’Neill, William W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Conditioned blood reperfusion during angioplasty (CoBRA) treatment of acute myocardial infarction</atitle><jtitle>Perfusion</jtitle><addtitle>Perfusion</addtitle><date>2001-03-01</date><risdate>2001</risdate><volume>16</volume><issue>1_suppl</issue><spage>39</spage><epage>49</epage><pages>39-49</pages><issn>0267-6591</issn><eissn>1477-111X</eissn><abstract>Acute myocardial infarct (MI) results in ischemia distal to lesions which puts heart
muscle at risk for reperfusion injury (RI). Neutrophils, platelets and complement
are putative mediators of RI. Recent advances in filtration technology provide
integrated neutrophil and platelet removal together with complement-attenuating
properties in a single blood-conditioning device. The present study characterizes
the properties of a blood-conditioning filter and describes its clinical effect when
used in conjunction with active hemoperfusion for acute MI.The filter reduces leukocytes by 99.9998 ± 0.0002%
(p<0.0001) and platelets by 99.9934 ± 0.0069%
(p<0.0001). Human plasma, derived from heparinized blood that was
‘conditioned’ by filtration, was studied using the Langendorff
isolated rabbit heart preparation. The deposition of membrane attack complex and the
resultant functional myocardial impairments [reflected in hemodynamic and
biochemical measurements, including developed pressure, coronary blood flow,
lymph-derived myocardial creatine kinase (CK)] are significantly attenuated by blood
conditioning. Integration of the blood-conditioning filter into an active
hemoperfusion system during primary percutaneous transluminal coronary angioplasty
(PTCA) for acute MI (n=8) did not delay the procedure or cause any
complications. Reperfusion of occluded coronary arteries with 300 cm3 of
conditioned blood led to significant improvement in echocardiographic global wall
motion scores (in standard deviations) following treatment (1.64 ± 0.18
to 1.45 ± 0.15, p=0.02).Initial reperfusion of totally occluded coronary arteries with conditioned blood
leads to acutely improved ventricular function. Collectively, these data provide a
strong indication for continued investigation of conditioned blood reperfusion in
angioplasty following acute MI for the long-term effect upon recovery of salvagable myocardium.</abstract><cop>Thousand Oaks, CA</cop><pub>SAGE Publications</pub><pmid>11334205</pmid><doi>10.1177/026765910101600i106</doi><tpages>11</tpages></addata></record> |
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source | SAGE |
subjects | Adult Aged Aged, 80 and over Angioplasty Angioplasty, Balloon, Coronary - methods Animals Arteries Blood flow Blood plasma Blood pressure Cardiac muscle Complement Complement Membrane Attack Complex - metabolism Complement Membrane Attack Complex - pharmacology Complications Conditioning Coronary artery Coronary vessels Creatine Creatine kinase Electrocardiography Female Filtration Filtration - methods Health risks Heart Hemoperfusion Humans In Vitro Techniques Indication Integration Ischemia Lesions Leukapheresis Leukocytes Leukocytes (neutrophilic) Lymph Male Membrane attack complex Middle Aged Myocardial infarction Myocardial Infarction - blood Myocardial Infarction - physiopathology Myocardial Infarction - surgery Myocardium Pilot Projects Plateletpheresis Platelets Prospective Studies Rabbits Reperfusion Reperfusion - methods Reperfusion Injury - etiology Reperfusion Injury - prevention & control Stroke Volume Ventricle Ventricular Function, Left |
title | Conditioned blood reperfusion during angioplasty (CoBRA) treatment of acute myocardial infarction |
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