He heart attack Myocardial infarction is one of the most severe cardiac pathologies and constitutes a medical emergency in which the blood supply to the heart is interrupted by a clot that completely obstructs one of the coronary arteries. What this achieves as a consequence is the necrosis of the affected tissues.
Unfortunately, this condition is the main cause of death in people over 35 years of age worldwide.
That was the reason why a group of researchers from Conicet They began a study in search of the reasons and factors to contribute to its prevention and treatments that allow the reduction of the damage that a heart attack can cause in the human body.
And what was discovered was revealing, because what these Argentine scientists managed to demonstrate is that the administration of hydrocortisone, a medication from the group of corticosteroids, to a heart that has suffered a heart attack helps reduce damage by 30 percent.
The research was led by the team from the Cardiovascular Research Center (CIC) of the University of La Plata and was recently published in the scientific journal European Journal of Clinical Investigation.
“In our laboratory we work with different models of cardiac pathologies, and we focus on the heart attackfor which we use an isolated heart to which we perform an injury due to ischemia, that is, a reduction in blood flow due to ligation of one of the arteries that irrigates it,” explained Romina Gisel Díaz, Conicet researcher at the CIC and member of the scientific team.
“We tested the administration of hydrocortisone directly in the solution in which the heart is suspended to simulate the interior of the organism, and we saw that it crosses the cellular barrier, enters the muscle, and begins to act,” he added.
Although the drug is administered for only ten minutes, its action develops little by little and the maximum effect is observed after two hours, with a very significant recovery of cardiac function, the researcher said.
“The size of the heart attack It is reduced to 10 percent of the heart while, without this medication, that portion reaches 40 percent of the tissue. That is why we conclude that the improvement is around 30 percent,” said the expert.
What is hydrocortisone?
Hydrocortisone is the name of the hormone cortisol produced by the body in stressful situations. It is usually supplied as a medication for its anti-inflammatory and anti-allergic action, mainly in the form of a nasal spray for respiratory conditions, or in a cream for skin reactions, such as diaper rash.
“It is a very low-potency corticosteroid with an effect similar to that of the naturally produced hormone, and that is why it is used in pediatrics,” the expert clarified.
“The most powerful corticosteroids such as betamethasone or dexamethasone, which are injected to treat severe joint or muscle pain, usually generate many adverse effects at the cardiovascular level, which is why they would not be useful for cardiac treatment,” Díaz stressed. In addition, he explained that Those mentioned are systemic drugs that would have “unavoidable consequences for the entire organism.”
In addition to the result itself, the research also reported as novel the mechanism by which it occurs, which is through an improvement in mitochondrial function. “In a heart attack, the first thing that happens is a reduction to zero in the oxygen supply that triggers different processes to try for the cells to survive. But these processes work with failures, and then reactive oxygen species begin to be generated, unstable molecules that react easily with others,” Díaz described.
The buildup of these molecules can damage DNA, RNA, and proteins, causing cell death. “The cells that did not die from ischemia do so from oxidative stress. Therefore, the prevention of this phenomenon directly affects the size of the infarcted area. What we observed is that hydrocortisone reduces oxidative stress by half, and this reduction translates into the total damage that the heart muscle will suffer,” the researcher emphasized.
Until now, the medical protocol indicates that the most urgent thing in the face of a heart attack is to achieve revascularization, that is, giving the patient some drug that allows blood flow to be quickly restored through different capillaries. For this, fibrinolytics or anticoagulants are used, medications capable of dissolving clots or thrombi that are blocking the artery. “This intervention is the first rescue. But what this immediately produces is oxidative damage that requires action to stop it, and our research is anchored in this need,” the specialist concluded.
What follows in the future is to begin testing the in vivo administration of intravenous hydrocortisone as soon as the ischemia ceases. In this way, we will seek to restore blood flow to analyze how and how quickly the beneficial effects observed on the infarcted heart occur.
