A Metabolomics Study Of Myocardial No-reflow Phenomenon And Limb Ischemia Per-conditioning

The high incidence of ischemic heart disease is an important component of cardiovascular disease and increased year by year.Percutaneous coronary intervention in coronary recanalization, while often associated with myocardial ischemia-reperfusion injury of myocardial no-reflow Phenomenon is one of the major complications.Myocardial no-reflow Phenomenon persistence can lead to arrhythmia,Restenosis, infarct expansion and serious complications. Researches suggest that ischemia conditioning is the simple and effective ways to reduce myocardial no-reflow after coronary reperfusion, and limb ischemia per-conditioning with more conducive to clinical practice.Metabolomics research can be qualitative and quantitative analysis of the changes of small molecular substances in biological fluids, combined with effective methods of pattern recognition, described disease pathophysiology, assessment of treatment efficacy and search for potential bio-markers.Our purpose of this study is use metabolomics methods to look for discrepant metabolites and potential bio-markers of serum in myocardialno-reflow and limb ischemia per-conditioning for studying the pathogenesis and Clinical Diagnostics provide clues.METHODS: 30 male SD rats with or without 45 min left anterior descending(LAD) coronary occlusion, and 120 min reperfusion. Sham group underwent thoracic surgery and without ligate LAD; No-reflow(NR) group ischemia 45 min and reperfusion 120 min; Per-conditioning(Per C) group with 5 30 s ischemia-30 s reperfusion cycles in right hind leg before reperfusion. Use electrocardiogram(ECG) observes cardiac function during operation, and Even's blue, Thioflavin S,Tyiphenyltetrazolium chloride(TTC) dyed heart tissue analysis NR and myocardial infraction area. Gas Chromatography-Mass Spectrometry(GC-MS) was used to detect serum samples, and Multivariate Analysis data(MVDA) analyzed the data.RESULTS: There was no statistically significant difference between NR group and Per C group in risk area, and no-reflow area and infract area was significantly higher than Per C group in NR group(38.18±3.69% vs26.67±9.23%, p=0.002559, no-reflow area)(35.11 ±6.97% vs 24.63±4.91%, p=0.001812, Infract area). Relative concentration of serum metabolites of lactic acid, uric acid, azelaic acid, fructose, melibiose,glucoside, D-galactose, Palmitic acid and oleic acid are lower than Sham group in NR group, and lactic acid, uric acid, fructose, glucosamine glucoside, D-galactose, acetoacetic acid and valine are higher than NR group in Per C group apart from oleic acid. Compared with Sham group,lactic acid, uric acid, fructose, glucoside and D-galactose are lower in NR group, and rebound in Per C group.CONCLUSION: Limb ischemia per-conditioning can effectively reduce myocardial no-reflow phenomenon; Limb ischemia per-conditioning mitigate myocardial no-reflow phenomenon thought the regulation of glucose metabolism, fatty acid metabolism, amino acid metabolism and purine nucleotide metabolism; Lactic acid, uric acid, fructose and D-galactose are potential biomarkers of myocardial no-reflow phenomenon and limb ischemia per-conditioning.