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Cialix and the question was does LV unloading start to affect ischemia before reperfusion and in fact are we having an ischemic effect now right in the same time the ichikawa lab from New York was starting to show that with these unloading pumps they were seeing enhanced coronary flow through the myocardium even though the artery was blocked or if the patient had or if the animal had a scar from an infarct we took some of these concepts and started to test this in our laboratory and what we found was that with unloading on the right there was an increase in microsurgical Ettore coronary flow and in fact this started to shrink the area of risk so if you were to open that blocked artery and 50% of the Ariat risk is infarcted no matter what you do another potential mechanism is that by reducing 

Cialix Male Enhancement   getting more cardio protection so we took these preclinical ease clinical data and went back to the bench area at risk you're already going to see a reduction in the infarct size but the real question was do we spell the physiologic effect but does LV unloading actually reduce myocardial ischemia is there something called functional reperfusion by unloading the heart as opposed to just having to do epicardial reperfusion every time and so to answer this question we started to look at hypoxia sensitive proteins so we started to look at things like if one alpha we looked at pH D proteins as well these were obviously highlighted most recently by the Nobel Prize in 2019 and this area of biology is under active 

Cialix BUY investigation in the laboratory but the first question was if you actually are reducing ischemia we should be seeing a change in hip 1 and pH D expression I'm suggesting that the pump is having an effect independent of reperfusion injury and so we've created a preclinical study where we uncoupled ischemic from reperfusion injury in Group A we had 210 minutes of led occlusion and we then had two groups one with no pump and another one with unloading for hunt the remaining under 20 minutes after 90 minutes of occlusion in Group B we replicated the ischemic time but we added under 20 minutes of reperfusion so now we could look at the effect of unloading on ischemic injury versus reperfusion injury an

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