Abstract:

BACKGROUND: Post-cardiac arrest syndrome (PCAS) significantly contributes to mortality after initially successful cardiopulmonary resuscitation (CPR) in cardiac arrest (CA) patients. Effective cardiocerebral protection is essential for improving post-resuscitation survival. This study investigated the mechanisms and common targets of myocardial dysfunction and brain injury after resuscitation.

METHODS: The male Sprague-Dawley rats (10–12 weeks old, 400–500 g) were divided into two groups: the control group (n=6), which received sham surgery, and the CA/CPR group (n=10), which received ventricular fibrillation (VF) followed by CPR. After 24 h, brain and heart tissues were collected for analysis. The sequencing was used to identify differentially expressed genes (DEGs) between control and CA/CPR rats.

RESULTS: At 24 h after resuscitation, CA/CPR rats presented 217 DEGs in the hippocampus and 80 DEGs in the left ventricle (LV) compared to the control group. In the hippocampus, the most notable biological process was the positive regulation of tumor necrosis factor production, with key pathways related to inflammation and the immune response. In the LV, the Gene Ontology (GO) enrichment analysis revealed that gene alterations were primarily associated with amyloid-beta clearance, a pathway that was also relevant in the brain. Eleven common targets were identified in the DEGs of both heart and brain tissues. The reverse transcription-polymerase chain reaction (RT-PCR) validation revealed significant differences in the mRNA expression of Timp1, Apln, Ccl7, and Lgals3 in both LV and hippocampus.

CONCLUSION: This study identified possible key genes and underlying mechanisms involved in PCAS. The differential genes Timp1, Apln, Ccl7, and Lgals3 might serve as common biomarkers for myocardial and neurological injury following resuscitation.

Key words: Cardiac arrest, Myocardial dysfunction, Brain injury, Post-cardiac arrest syndrome, Resuscitation