Studies on prolonged acute regional ischemia III. Early natural history of simulated single and multivessel disease with emphasis on remote myocardium

Strain-related regional alterations of calcium-handling proteins in myocardial remodeling

“…During weaning from cardiopulmonary support, an increase in force and volume leads to a decrease in intracellular calcium and consequently decreased action potential dura- tion, illustrating how stretch (strain) can affect excitationcontraction coupling via its effects on calcium. 18 Both contractile strain 16,[19][20][21][22] and expression of calciumhandling proteins 3,12,[14][15][16][17][23][24][25] in LV myocardium have been studied extensively. In our present study, we investigate the relationship of both the systolic strain (contractile function) and remodeling strain (myocardial structure deformation) to alterations in protein expression during cardiac remodeling.…”

The use of controlled reperfusion strategies in cardiac surgery to minimize ischaemia/reperfusion damage

“…7 The necessity, concentration, and interaction among the different components of each modification of the composition of the reperfusate and the conditions of reperfusion have been investigated experimentally before its clinical application, and details have been published previously. 7,[18][19][20][21][22][23][24][25][26][27]…”

“…41 Over the last decade, knowledge has been gained in the pathophysiology of acute coronary occlusion on ischaemic and non-ischaemic (remote) myocardium that has evolved in a new surgical strategy for revascularization of patients with evolving myocardial infarctions, including the non-ischaemic as well as the ischaemic myocardium. [25][26][27]38,[41][42][43] 3.2.1 Non-ischaemic myocardium Studies of the natural history of acute regional ischaemia after coronary occlusion have shown that acute occlusion of a coronary artery not only affects the ischaemic myocardium, but also causes structural, functional, and metabolic alterations in the remote and adjacent myocardium. [25][26][27] The function of the remote myocardium is the principal determinant of early survival after an otherwise non-lethal coronary occlusion (i.e.…”

“…[25][26][27]38,[41][42][43] 3.2.1 Non-ischaemic myocardium Studies of the natural history of acute regional ischaemia after coronary occlusion have shown that acute occlusion of a coronary artery not only affects the ischaemic myocardium, but also causes structural, functional, and metabolic alterations in the remote and adjacent myocardium. [25][26][27] The function of the remote myocardium is the principal determinant of early survival after an otherwise non-lethal coronary occlusion (i.e. 30% of the left ventricle at risk).…”

“…30% of the left ventricle at risk). 25 Survival after acute coronary occlusion is determined by the infarct size and the capacity of the remote, non-ischaemic myocardium to support the systemic circulation. Cardiogenic shock or left ventricular power failure develops if .40% of the left ventricular muscle mass acutely loses its contractile properties or if there is insufficient remote myocardium to compensate for the acute loss of ,40% of contractile mass.…”