Cardiac arrest is the result of the heart suddenly not pumping, which leads to blood not circulating to the brain and throughout the body. Without proper treatment and heart stabilization, this condition can be highly fatal. In 2020, incidences of cardiac arrest that occurred in the emergency department had a fatality percentage of 75.4% (Zabel et al., 2024) which is an approximate 2% increase compared to 2016. In 2019, the United States population was approximately 328,239,523. Of that number, 33,147,251 visited the emergency department and of those visits, 53,739 had incidences of cardiac arrest. Researchers estimated that the incidence rate of emergency department cardiac arrest in the United States was 0.2% (Hsu et al., 2023). Therefore, the incidence rate of cardiac arrest as a percentage of the entire United States population is 0.02%.
Risk factors of cardiac arrest can range from a variety of causes. Abuse of alcohol over long periods or during short durations of time causes a risk of cardiac arrest. Overconsumption of coffee and/or highly caffeinated beverages increase risk of cardiac arrest. The use of cocaine, amphetamines, and/or marijuana are also risks. Bodily stress and overexertion as well as emotional stress over an extended period of time are risk factors. A more severe influenza infection can also be a risk factor (National Heart, Lung, and Blood Institute, 2022). Coronary heart disease, any type of arrhythmia, a congenital heart defect, family history of any heart diseases and/or any other diagnosed issues associated with the heart can exacerbate risk factors.
Cardiac arrest is a condition that is most common in men, adults over 30 years old and African Americans (National Heart, Lung, and Blood Institute, 2022). However, the risk increases for women after menopause and black women are more likely to experience cardiac arrest than men and women of all races in the United States. Cardiopulmonary resuscitation (CPR) is able to treat cardiac arrest to prevent fatality (National Heart, Lung, and Blood Institute, 2022), however there is not a guarantee the patient will survive, especially with higher risk factors along with a history of cardiac abnormalities.
Living a long-term healthy lifestyle, which includes abstaining from drinking and overconsuming alcohol, avoiding drug use, staying active, and maintaining a healthy diet, can avoid cardiac arrest. Being aware of activities, situations, and conditions that can cause arrhythmia can also help avoid cardiac arrest. Conditions that increase the likelihood of arrhythmia include obesity, chronic stress, kidney disease, lung disease, cardiomyopathy, heart inflammation, and sleep apnea (National Heart, Lung, and Blood Institute, 2022). Activities and situations that can cause arrhythmia include excessive physical activity, dehydration, hypoglycemia, and hyperglycemia. Living a health-conscious lifestyle can prevent most, if not all, of these conditions and situations.
Exogenous mitochondria can be successfully transplanted into neural cells and localized to endogenous mitochondria. Additionally, exogenous mitochondria have been shown to be functional in neural cells. A well-defined evidence of their functionality is their success in improving neurological function in mice after they have experienced cardiac arrest. The mice were injected with frozen-thawed mitochondria and fresh mitochondria immediately after cardiac arrest resuscitation. Both frozen-thawed mitochondria and fresh mitochondria improved the mics’ neurological function 72 hours after cardiac arrest (Hayashida et al., 2023).
Transplanted mitochondria have also been shown to be successful in ways beyond neurological function. When transplanted fresh mitochondria is injected into mice following resuscitation after cardiac arrest, it increases the survival rate of mice by 40% 72 hours after cardiac arrest. Transplanted mitochondria also decreases and stabilizes blood lactate levels 2 hours after cardiac arrest. Fresh mitochondria, in particular, is more effective in keeping blood lactate levels low. 15 minutes post-cardiac arrest, fresh mitochondria are able to keep lactate levels at 2 mmol/l when they would normally be approximately 3.75 mmol/l. After 2 hours, fresh mitochondria decrease blood lactate levels to 1 mmol/l, which is slightly higher than normal lactate levels after 2 hours (approximately 0.75 mmol/l). Frozen-thawed mitochondria do not have the same effect. While it does decrease blood lactate levels after 2 hours to 1 mmol/l, after 15 minutes it allows blood lactate levels to increase to approximately 4 mmol/l, which is higher than normal blood lactate levels after 15 minutes (3.75 mmol/l). Fresh mitochondria decreases lung edema (W/D ratio of 4) 2 hours post cardiac arrest while fresh-thawed mitochondria increases the lung edema ratio even greater (W/D ratio of 6) than the baseline ratio which is 5.5. Fresh mitochondria also keep glucose levels lower post cardiac arrest compared to frozen-thawed mitochondria and compared to mice with no transplanted mitochondria, Specifically, 15 minutes post cardiac arrest. Glucose levels for fresh mitochondria are around 250 mg/dL while frozen-thawed mitochondria and the control group of mice had glucose levels around 350 mg/dL 15 minutes post cardiac arrest. Cerebral blood flow is increased by fresh mitochondria 1-2 hours post cardiac arrest. At hour one it’s 100% of baseline and at hour two it’s approximately 110% of baseline. Baseline and frozen-thawed mitochondria have consistent percentages which are 80% at hour one and approximately 80% at hour two, with frozen thawed mitochondria being slightly higher than baseline cerebral blood flow (Hayashida et al., 2023).
Data reveals that fresh mitochondria persist in the brain, kidney, and spleen tissues after 24 hours. Fresh mitochondria is more abundant in renal and splenic tissues than it is in brain tissue. (Hayashida et al., 2023) Frozen mitochondria can be used to improve the survival rate and health characteristics of mice post cardiac arrest, However, fresh mitochondria have been shown to produce better results than frozen mitochondria. Fresh mitochondria have been shown to improve survival rate, improve cerebral blood flow, decrease glucose levels, decrease lung edema, and decrease and stabilize blood lactate levels more successfully than frozen mitochondria, making it more effective than frozen mitochondria (Hayashida et al., 2023).
References
The National Heart, Lung, and Blood Institute. (2022, March 24). Causes and Triggers. NHLBI, NIH, https://www.nhlbi.nih.gov/health/arrhythmias/causes
The National Heart, Lung, and Blood Institute. (2022, May 19). What Is Cardiac Arrest?. NHLBI, NIH, https://www.nhlbi.nih.gov/health/cardiac-arrest
Taiwan D., Wang C., Tsai C., Hsu S., Ko C., Sung C., Huang C., Lu T., Chou E., Taiwan D., Taiwan D., & USA D. (2023, November 24). The incidence, predictors, and causes of cardiac arrest in United States emergency departments – PMC. NIH, https://pmc.ncbi.nlm.nih.gov/articles/PMC10701431/
Quazi M. A., Sagheer S., Madrid W. H., Sheikh A. B., Goyal A., Madi M., Sohail A. H., Leyba K., Zabel K. M., Millhuff A. C., & Bilal M. I. (2024, September 20). Cardiac Arrest Mortality and Disposition Patterns in United States Emergency Departments. MDPI, https://www.mdpi.com/2077-0383/13/18/5585
Nishikimi M., Takegawa R., Kim J., Shoaib M., Aoki T., Murao A., Hayashida K., USA C., Shinozaki K., Wang P., Becker L. B., USA L., Yin T., Nakamura E., Miyara S. J., Endo Y., Kuschner C., & Choudhary R. C. (2023, March 16). Exogenous mitochondrial transplantation improves survival and neurological outcomes after resuscitation from cardiac arrest – BMC Medicine. BioMed Central, https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02759-0