Grant: Operating Grant -PA: Inst of Circulatory and Respiratory Health - Bridge Funding

It is well known that treatment of an acute heart attack with balloon angioplasty saves lives and decreases the size of the heart attack. Balloon angioplasty restores blood flow in the artery that has caused the heart attack due to an acute complete blockage with blood clot. Unfortunately even when balloon angioplasty succeeds in opening the artery, the very small artery branches deep within the heart muscle may become damaged, which may prevent the heart from healing properly. Currently it is not understood why this occurs and there is no good therapy to prevent this injury. A potential cause of this small vessel injury is the embolization of clot as a result of the angioplasty. The objectives of this project are to study how and why this damage occurs in the small arteries of the heart following heart attack treated by angioplasty. We intend to show that new types of imaging, such as myocardial contrast echocardiography and magnetic resonance imaging, can provide very important information about the health of these small arteries during the heart attack and at 3 days after the heart attack. The final objective is to determine the molecular pathways that are involved in the heart muscle damage as a result of the heart attack, and to assess whether there are differences in the pattern of injury when there is additional embolization of clot during angioplasty. As a result of these studies, we expect to better understand how the heart is injured during a heart attack, and the possible contributing role of clot embolization by coronary angioplasty. We expect that these insights will assist us in developing new therapies to decrease heart damage and improve patient outcomes.