Preconditioning during simulated MIDCABG attenuates blood flow defects and neutrophil accumulation

Bufkin, Bradley L.; Shearer, Steven T; Vinten‐Johansen, Jakob; Duarte, Ignacio; Thourani, Vinod H.; Nakamura, Masanori; Zhao, Zhi‐Qing; Guyton, Robert A.

doi:10.1016/s0003-4975(98)00529-3

Cited by 23 publications

(19 citation statements)

References 17 publications

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“…Ischemic injury is manifested as contractile dysfunction and vascular endothelial injury. 10 Because of the limited tolerance of the working heart to ischemia under normothermia, the risk of irreversible myocardial damage becomes consid- erable in the absence of cardioplegia. IP has become a potential alternative method of myocardial protection since Przyklenk et al 20 showed that brief episodes of ischemia in one vascular bed can protect even remote areas of the myocardium from subsequent sustained coronary artery occlusion.…”

Section: Discussionmentioning

confidence: 99%

“…9 The ischemic period during grafting may cause contractile dysfunction and vascular endothelial injury, and involves a risk of myocardial necrosis. 10 Ischemic preconditioning (IP) is created by a brief period of myocardial ischemia followed by reperfusion, and it increases myocardial tolerance to subsequent long-term ischemic insult. 11 IP has been widely studied and has proved to be one of the most potent endogenous myocardial mechanisms protecting against ischemia/reperfusion injury in experimental models as well as in humans.…”

mentioning

confidence: 99%

“…13 IP has been considered to be a promising method for achieving myocardial protection, although controversial results concerning the effectiveness of IP also have been shown. 10,11,14,15 Reports on IP in patients undergoing off-pump CBP surgery are still few in number, and not all of those studies are even randomized. 16 -19 Therefore, we aimed at investigating the IP effects in patients undergoing off-pump coronary artery bypass grafting (CABG) in a randomized controlled study.…”

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confidence: 99%

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Regional Ischemic Preconditioning Enhances Myocardial Performance in Off-Pump Coronary Artery Bypass Grafting

Laurikka

Iisalo

et al. 2002

Chest

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Regional Ischemic Preconditioning Enhances Myocardial Performance in Off-Pump Coronary Artery Bypass Grafting

Laurikka

Iisalo

et al. 2002

Chest

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“…With the current increasing interest in minimally invasive direct coronary artery bypass grafting and OPCAB [29,30], preconditioning may be helpful in protecting an area of the heart which is undergoing revascularization without cardiopulmonary bypass and cardioplegia. In a certain clinical setting, however, even a brief period of ischemia may be inadvisable.…”

Section: Discussionmentioning

confidence: 99%

Mitochondrial ATP-Sensitive Potassium Channel Plays a Dominant Role in Ischemic Preconditioning of Rabbit Heart

Nakai

Horimoto²,

Mieno³

et al. 2001

Eur Surg Res

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Background: The ATP-sensitive potassium (K_ATP) channel has been shown to be important in the ischemic preconditioning (IPC) response. Recently, the mitochondrial rather than the sarcolemmal K_ATP channel has been focused on due to its energy-modulating property. Hence, this study was undertaken to elucidate the role of the mitochondrial K_ATP channel in IPC by modulating the mitochondrial K_ATP channel in isolated perfused rabbit hearts. Methods: Seven hearts served as a control with no interventions. Seven hearts underwent IPC consisting of two 5-min cycles of global ischemia followed by 5 min of reperfusion. Seven hearts received the selective mitochondrial K_ATP channel blocker 5-dehydroxydecanoate (5-HD, 100 µM) for 5 min before IPC, and 7 hearts received the selective mitochondrial K_ATP channel opener diazoxide (50 µM) for 5 min. Then, all hearts were subjected to 1 h of left anterior descending coronary artery ischemia and 1 h of reperfusion. Left ventricular pressures, monophasic action potentials and coronary flow were measured throughout the experiment and infarct size was detected at the end of experiment. Results: (1) The mitochondria-selective K_ATP channel opener diazoxide reduced infarct size as compared to control (p < 0.05); (2) IPC reduced infarct size and preserved postischemic diastolic function as compared to control (p < 0.05), and (3) the mitochondria-selective K_ATP channel blocker 5-HD reversed these effects. Conclusion: The mitochondrial ATP-sensitive potassium channel may be a potential site of cardioprotection.

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“…Therefore, IP might be an ideal and effective method in achieving additional myocardial protection. There are nevertheless controversial data in various studies [1,[98][99][100]. During minimal invasive CABG operation, Jacobsohn described the protective effect of IP, even no change in ST-T segment and T-wave during IP has an IP effect of improved contractility [40].…”

Section: Off-pump Cabg Patientsmentioning

confidence: 99%

Ischemic Preconditioning in Cardiac Surgery

Tarkka

2011

Int J Angiol

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Murry and colleagues in 1986 described a paradoxical phenomenon that exposure of the heart to repeated brief ischemic episodes delayed the severity of myocardial infarction of a following prolonged myocardial ischemia and termed it myocardial ischemic preconditioning (IP). From then on, IP had been extensively studied in various kinds of experimental models as well as in humans. Besides delaying myocardial infarction, IP has been proved to be a potent endogenous factor in preserving high energy phosphates, suppressing arrhythmias and improving postischemic functional recovery. Delaying myocardial ultrastructure damage, reducing lactate, reducing the utilization of myocardial glycogen and protecting coronary endothelium after IP has also been found. Different experimental models and conditions resembling cardiac surgery have also been investigated. The mechanism of IP is not yet clear, however. The conclusions derived from animal studies could not totally stand for the situation in open heart surgery. IP was found effective in preserving high energy phosphate, improving heart performance and decreasing cardiac troponin T release during open heart surgery. Controversial exists because in same reports there were no effects of IP. The difference in IP protocol, myocardial protective method and study object might be the reason of the controversial results. Several clinical factors may affect IP effects during clinical practice. The purpose of the present study was to review the recent literature on IP, especially the IP mechanism, IP phenomenon in cardiac surgery and the possible influential factors, to summarize whether IP might prefer additional protection of current protective strategy in cardiac surgery.

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Preconditioning during simulated MIDCABG attenuates blood flow defects and neutrophil accumulation

Cited by 23 publications

References 17 publications

Regional Ischemic Preconditioning Enhances Myocardial Performance in Off-Pump Coronary Artery Bypass Grafting

Regional Ischemic Preconditioning Enhances Myocardial Performance in Off-Pump Coronary Artery Bypass Grafting

Mitochondrial ATP-Sensitive Potassium Channel Plays a Dominant Role in Ischemic Preconditioning of Rabbit Heart

Ischemic Preconditioning in Cardiac Surgery

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