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A role for pericytes in coronary no-reflow

Nature Reviews Cardiology volume 11, pages 427–432 (2014)Cite this article

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Abstract

Despite efforts to restore tissue perfusion after myocardial infarction, coronary no-reflow—a failure to achieve adequate reperfusion of the cardiac microcirculation—is a common complication, which correlates with an increased incidence of death and disability. The treatment of ischaemic stroke is also plagued by no-reflow and, in the brain, a major cause of this phenomenon has been shown to be contractile microvascular pericytes irreversibly constricting capillaries and dying. We propose that cardiac pericytes, which are the second most-common cell type in the heart, impede reperfusion of coronary capillaries in a similar fashion to those in the brain after a stroke. Pericyte constriction might contribute to morbidity in patients by causing microvascular obstruction, even after successful treatment of coronary artery block. The similarity of the no-reflow phenomenon in the brain and in the heart suggests that cardiac pericytes are a novel therapeutic target for coronary no-reflow after myocardial infarction.

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Figure 1: Cerebral and coronary no-reflow.
Figure 2: Cerebral cortical and myocardial pericytes.
Figure 3: The role of pericytes in health and in no-reflow after ischaemia.

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Acknowledgements

We thank the Fondation Leducq, Wellcome Trust, European Research Council, Medical Research Council (UK), and Rosetrees Trust for funding. We thank P. C. Adams (Newcastle Hospitals NHS Foundation Trust, UK), I. S. Cohen (SUNY Stony Brook University, NY, USA), R. Jolivet (University College London, UK), and A. Mishra (University College London, UK) for comments on the manuscript. We thank A. Nishiyama (University of Connecticut, CT, USA) and D. Dietrich (University Clinic Bonn, Germany) for providing NG2–DsRed mice.

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  1. Department of Neuroscience, Physiology & Pharmacology, University College London, Gower Street, London, WC1E 6BT, UK

    Fergus M. O'Farrell & David Attwell

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Correspondence to David Attwell.

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O'Farrell, F., Attwell, D. A role for pericytes in coronary no-reflow. Nat Rev Cardiol 11, 427–432 (2014). https://doi.org/10.1038/nrcardio.2014.58

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