News Release: Emory Healthcare , Research , School of Medicine

Feb. 3,  2009

Heart-Cushioning Innovation in Angioplasty Could Reduce Damage

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Emory University cardiologists are testing a "stuttering" modification of angioplasty that could reduce permanent damage to the heart muscle after a heart attack.

During angioplasty, doctors use a balloon at the end of a catheter to break up a fatty plaque that is obstructing a coronary artery. The rush of blood back into the heart after a blood vessel is reopened can produce “reperfusion injury,” caused by biochemical changes in the heart muscle.

The modified procedure inflates and deflates the balloon several times in a precisely controlled way, with the aim of allowing blood back into the heart gradually and thereby reducing reperfusion injury.

"This study could help refine a common, well-established procedure performed on thousands of patients every year," says principal investigator Habib Samady, MD, associate professor of medicine (cardiology) at Emory University School of Medicine. "Without involving any additional drugs or devices, it may be possible to reduce damage to the heart muscle in a very straightforward way."

Researchers led by Jakob Vinten-Johansen, PhD, professor of surgery at Emory University School of Medicine, were the first to demonstrate in 2003 that the modified angioplasty procedure, known as “postconditioning,” could reduce damage to the heart muscle in laboratory animals.

The Emory study is one of the first to test postconditioning in the United States. Its aim is to determine whether postconditioning can benefit patients undergoing angioplasty and if so, to define how.

Post-conditioning has been tested in France, Israel, Denmark and Canada. In addition, a 2007 retrospective study of heart attack patients in Massachusetts who, without prior planning by doctors, required several balloon inflations showed that these patients had less damage to their hearts.

The Emory investigators will assess the degree of heart muscle damage in groups of patients treated with standard angioplasty versus those treated with a modified procedure using MRI (magnetic resonance imaging) and echocardiography.

The Emory study started in September 2008. Doctors have already treated several patients with the modified angioplasty procedure, with a total of 40 participants planned.

References:

First laboratory demonstration:
Z.Q. Zhao et al. Inhibition of myocardial injury by ischemic postconditioning during reperfusion: comparison with ischemic preconditioning. Am J Physiol Heart Circ Physiol. 285: 579-88 (2003).

Key French clinical study:
P. Staat et al. Postconditioning the human heart. Circulation 112: 2143-8 (2005).

Massachusetts retrospective study:
C.E. Darling et al. 'Postconditioning' the human heart: multiple balloon inflations during primary angioplasty may confer cardioprotection. Basic Res Cardiol 102:274-278 (2007).

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