Virginia Commonwealth University

Cytos Pharmaceuticals LLC

Rakesh C Kukreja

Michael L Hess

A method is provided for the prevention of ischemia/reperfusion injury, for example, in patients undergoing heart surgery, and involves the administration of a phosphodiesterase-5 (PDE-5) inhibitor such as sildenafil. The method may also be used during or after a heart attack to prevent or lessen ischemic heart damage.

Method of treating myocardial infarction with PDE-5 inhibitors

Histidine has been found to be efficacious in preventing ischemic/reperfusion induced myocardial injury both functionally and ultrastructurally. Isolated perfused rat hearts (n=8/group) were subjected to 30 minutes of global ischemia and 20 minutes of reperfusion. Histidine concentrations ranging from 10 to 50 mM were given throughout the experiment. During ischemia and reperfusion without histidine the contractile function and coronary flow were 59.+-.10% and 78.+-.6% of control, respectively. Perfusion with histidine (25 mM and above) resulted in significant increases in contractility (94.+-.4%) and coronary flow (92.+-.4) levels. The incidence of arrhythmias (ventricular tachycardia and ventricular fibrillation) during reperfusion was 100 percent (8/8) in the ischemic/reperfused group with an average duration of 13.23.+-.4.48 min. The addition of 25 mM histidine to the perfusion medium reduced the incidence and duration of arrhythmias significantly (mean.+-.SEM 2.25.+-.0.98 min) (P&lt;0.01). The protective effects of histidine (25 mM and 50 mM) were significantly better than SOD/catalase/mannitol. Histidine has also been found to significantly reduce the infarct size and the occurrence of arrhythmias in vivo.

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Richmond, VA, United States of America

Rakesh C Kukreja