Grant: Collaborative Health Research Projects (NSERC partnered)

"Myocardial infarction is one of major killers in industrialized countries. The restoration of the circulation, or reperfusion, in jeopardized areas is essential to minimize damages caused by ischemia. Despite the undeniable benefit of reperfusion, it remains that the effectiveness of reperfusion is reduced by phenomena that occur during this period. In recent years it has been demonstrated experimentally that a pharmacological or mechanical intervention in early reperfusion is effective to reduce reperfusion injury and ultimately infarct size. Unfortunately, these interventions are hardly feasible in humans, particularly because of the narrow window for intervention. This project offers an innovation in reperfusion ie the development and use of a new angioplasty catheter that will begin the infusion of a pharmacological product downstream of the occlusion before restoration of circulation in ischemic areas and reduce microembolisation particles. Hypothesis: The use of this catheter combined with pharmacological treatment will significantly reduce myocardial damages, limit its consequences and allow patients to have a better quality of life after myocardial infarction. This project targets 5 different aims: 1 - Develop a catheter for the infusion of a drug downstream of the occlusion and the reduction microembolisation particle; 2 - Demonstrate the effectiveness of the catheter to allow the infusion of material downstream of the occlusion in a porcine model of myocardial infarction and reduce particulate microembolisation; 3 - Demonstrate the effectiveness of adenosine and nicorandil as an adjunct therapy to the use of the catheter to reduce reperfusion injury; 4 - Demonstrate the effectiveness of this new intervention to reduce reperfusion injury in humans; 5 - To train highly qualified personnel for the development and use of this catheter. After obtaining the prototype of the catheter, we will use porcine model of myocardial infarction to determine its effectiveness to reduce infarct size and no-reflow. Finally we will use this catheter in humans in a pilot study. During this project, in addition to developing a close collaboration between engineers, researchers and physicians, we will train graduate students. "