The small chill: mild hypothermia for cardioprotection?

Cardiovascular Research
Renaud TissierAlain Berdeaux

Abstract

Reducing the heart's temperature by 2-5°C is a potent cardioprotective treatment in animal models of coronary artery occlusion. The anti-infarct benefit depends upon the target temperature and the time at which cooling is instituted. Protection primarily results from cooling during the ischaemic period, whereas cooling during reperfusion or beyond offers little protection. In animal studies, protection is proportional to both the depth and duration of cooling. An optimal cooling protocol must appreciably shorten the normothermic ischaemic time to effectively salvage myocardium. Patients presenting with acute myocardial infarction could be candidates for mild hypothermia since the current door-to-balloon time is typically 90 min. But they would have to be cooled quickly shortly after their arrival. Several strategies have been proposed for ultra-fast cooling, but most like liquid ventilation and pericardial perfusion are too invasive. More feasible strategies might include cutaneous cooling, peritoneal lavage with cold solutions, and endovascular cooling with intravenous thermodes. This last option has been investigated clinically, but the results have been disappointing possibly because the devices lacked capacity to cool the p...Continue Reading

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Citations

Jun 17, 2011·Basic Research in Cardiology·Renaud TissierJames M Downey
Jan 1, 2011·Therapeutic Hypothermia and Temperature Management·David Erlinge
Dec 2, 2011·Cardiovascular Research·Renaud TissierAlain Berdeaux
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