The role of arginine vasopressin in myocardial infarction and reperfusion.

The role of arginine vasopressin in myocardial infarction and reperfusion. Kardiol Pol. 2019 Sep 25;: Authors: Nobian A, Ashfaq M, Spyridopoulos I Abstract Little attention is paid to the coronary microvasculature when treating acute myocardial infarction (MI). Microvascular obstruction (MVO) contributes to ischaemia-reperfusion (I-R) injury which hampers distal blood flow to the myocardium despite recanalisation of the culprit epicardial vessel. One of the mechanisms behind reperfusion injury is MVO due to persistent vasoconstrictor tone during reperfusion.  Arginine vasopressin (AVP) is a hormone with prominent vasoactive effect on the coronary microvessels. AVP levels are elevated as part of a stress response triggered by MI which can exert vasoconstrictive effects on coronary arteries in pre-clinical models, mainly in non-epicardial vessels of the microcirculation. Circulating AVP levels are up to 100-fold increased in MI and do not immediately decrease to baseline levels upon reperfusion. This would allow slow flow phenomenon and mediate I-R injury. Recently, the C-terminal fragment of pre-provasopressin, copeptin, has emerged to be a surrogate biomarker for AVP as it is more stable in the circulation. Multiple studies have shown the predictive value of both AVP and copeptin in regards to long-term prognoses of MI patients. We propose that both AVP and copeptin have more than just a predictive value but also play a role in the ...
Source: Kardiologia Polska - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research