[Effects of ischemic preconditioning on the recovery of myocardial function after unprotected ischemia and cardioplegia in the isolated and crystalloid perfused rat hearts]. 1997

H Otani, and H Kawasaki, and H Ninomiya, and M Kido, and H Kawaguchi, and M Osako, and Y Kato, and H Imamura
Department of Thoracic and Cardiovascular Surgery, Kansai Medical University, Osaka Japan.

Preconditioning with repetitive brief periods of ischemic (IPC) is known to induce myocardial protection against a subsequent more prolonged period of ischemia. We investigated whether IPC can offer similar beneficial effects on myocardial function after cardioplegic preservation in isolated and crystalloid-perfused rat hearts. IPC was produced by 5 periods of 1 min ischemia followed by 5 min reperfusion before 25 min of unmodified ischemia or 40 min of cardioplegia. IPC had no significant effect on the time to contractile arrest (control: 211 +/- 27 sec, IPC: 240 +/- 32 sec) after unmodified ischemia, while the time to electrical asystole was significantly (p < 0.05) shortened by IPC (676 +/- 107 sec) compared to control (1021 +/- 197 sec). However, rapid contractile arrest concomitant with electrical asystole was induced by infusion of St. Thomas' Hospital solution in control as well as in IPC-treated hearts without a significant intergroup difference (control: 33 +/- 7 sec, IPC 39 +/- 9 sec). Although myocardial ATP was significantly reduced by IPC, IPC-treated hearts showed a significantly higher ATP level after 25 min of unprotected ischemia. Accumulation of myocardial lactate after 25 min of unprotected ischemia was significantly (p < 0.05) inhibited by IPC. However, the levels of myocardial ATP and lactate after 40 min of cardioplegia were comparable between control and IPC-treated hearts. Left ventricular developed pressure (LVDP) at 30 min reperfusion after unprotected ischemia was significantly improved by IPC, while the recovery of LVDP at 30 min reperfusion after cardioplegia was comparable between control and IPC-treated hearts. The onset of ischemic contracture, i.e., a rise of left ventricular end-diastolic pressure (LVEDP), was significantly accelerated and its magnitude was significantly greater in IPC-treated hearts during unprotected ischemia and also during cardioplegia. However, a significant decrease of LVEDP during reperfusion compared to control hearts was observed only after unprotected ischemia. The amounts of creatine kinase (CK) released during 30 min reperfusion after unprotected ischemia was significantly greater in control than in IPC-treated hearts, but there was no significant difference in CK release between control and IPC-treated hearts during reperfusion after cardioplegia. These results suggest that IPC-induced cardioprotection may be induced via inhibition of anaerobic energy metabolism through a negative chronotropic effect during unprotected ischemia, but such a beneficial effect is dissipated with cardioplegia by which rapid electrical asystole is induced. It is, therefore, concluded that IPC may not provide additional myocardial protection over conventional hyperkalemic cardioplegia.

UI MeSH Term Description Entries
D008274 Magnesium A metallic element that has the atomic symbol Mg, atomic number 12, and atomic weight 24.31. It is important for the activity of many enzymes, especially those involved in OXIDATIVE PHOSPHORYLATION.
D008297 Male Males
D009206 Myocardium The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow. Muscle, Cardiac,Muscle, Heart,Cardiac Muscle,Myocardia,Cardiac Muscles,Heart Muscle,Heart Muscles,Muscles, Cardiac,Muscles, Heart
D011189 Potassium Chloride A white crystal or crystalline powder used in BUFFERS; FERTILIZERS; and EXPLOSIVES. It can be used to replenish ELECTROLYTES and restore WATER-ELECTROLYTE BALANCE in treating HYPOKALEMIA. Slow-K,Chloride, Potassium
D002122 Calcium Chloride A salt used to replenish calcium levels, as an acid-producing diuretic, and as an antidote for magnesium poisoning. Calcium Chloride Dihydrate,Calcium Chloride, Anhydrous
D005947 Glucose A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. Dextrose,Anhydrous Dextrose,D-Glucose,Glucose Monohydrate,Glucose, (DL)-Isomer,Glucose, (alpha-D)-Isomer,Glucose, (beta-D)-Isomer,D Glucose,Dextrose, Anhydrous,Monohydrate, Glucose
D006324 Heart Arrest, Induced A procedure to stop the contraction of MYOCARDIUM during HEART SURGERY. It is usually achieved with the use of chemicals (CARDIOPLEGIC SOLUTIONS) or cold temperature (such as chilled perfusate). Cardiac Arrest, Induced,Cardioplegia,Induced Cardiac Arrest,Induced Heart Arrest,Cardioplegias
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001639 Bicarbonates Inorganic salts that contain the -HCO3 radical. They are an important factor in determining the pH of the blood and the concentration of bicarbonate ions is regulated by the kidney. Levels in the blood are an index of the alkali reserve or buffering capacity. Bicarbonate,Bicarbonate Ions,Hydrogen Carbonates,Bicarbonate Ion,Carbonic Acid Ions,Hydrogen Carbonate,Carbonate, Hydrogen,Carbonates, Hydrogen,Ion, Bicarbonate,Ions, Bicarbonate,Ions, Carbonic Acid

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