Advertisement

Preconditioning and the Coronary Vasculature

  • Barbara Bauer
  • Robert A. Kloner
  • Karin Przyklenk
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 148)

Abstract

In 1986, Murry et al. showed that repeated short episodes of coronary occlusion protect the myocytes against subsequent sustained ischemia: This phenomenon was termed ischemic preconditioning [1]. While there is no doubt that preconditioning limits infarct size, myocardial necrosis is not the only consequence of sustained/ischemia reperfusion: One or more hours of occlusion followed by reflow also results in ventricular arrhythmias, postischemic contractile dysfunction or “stunning,” and abnormalities in myocardial perfusion. The obvious question therefore arises: Do the benefits of ischemic preconditioning extend beyond the concept of myocyte viability and attenuate other deleterious sequelae associated with sustained ischemia/reperfusion?

Keywords

Leave Anterior Descend Ischemic Precondition Coronary Blood Flow Coronary Occlusion Regional Myocardial Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Murry CE, Jennings RB, Reimer KA. 1986. Preconditioning with ischemia: A delay of lethal cell injury in ischemic myocardium. Circulation 74:1124–1136.PubMedCrossRefGoogle Scholar
  2. 2.
    Ku DD. 1982. Coronary vascular reactivity after acute myocardial ischmia. Science 218:576–578.PubMedCrossRefGoogle Scholar
  3. 3.
    Van Benthuysen KM, McMurry IF, Horowitz LD. 1987. Reperfusion after acute coronary occlusion in dogs impairs endothelium-dependent relaxation to acetylcholine and augments contractile reactivity in vivo. J Clin Invest 79:265–274.CrossRefGoogle Scholar
  4. 4.
    Mehta JL, Nichols WW, Donnelly WH, Lawson DL, Saldeen TGP. 1989. Impaired coronary vasodilator response to acetylcholine and bradykinin after occlusion-reperfusion. Circ Res 64:43–54.PubMedCrossRefGoogle Scholar
  5. 5.
    Furchtgott RF, Zawadski J. 1980. The obligatory role of endothelial cells on the relaxation of arterial smooth muscle by acetylcholine. Nature (Lond) 288:373–376.CrossRefGoogle Scholar
  6. 6.
    Furchtgott RF, Vanhoutte PM. 1989. Endothelium-derived relaxing and contracting factors. FASEB J 3:2007–2018.Google Scholar
  7. 7.
    Mehta JL, Lawson DL, Nichols WW. 1989. Attenuated coronary relaxation after reperfusion: Effects of Superoxide dismutase and TxA2 inhibitor U-63557. Am J Physiol 257: H1240–H1246.PubMedGoogle Scholar
  8. 8.
    Kloner RA, Ganote CE, Jennings RB. 1974. The “no-reflow” phenomenon after temporary coronary occlusion in the dog. J Clin Invest 54:1496–1508.PubMedCrossRefGoogle Scholar
  9. 9.
    Ambrosio G, Weisman HF, Mannisi IA, Becker LC. 1989. Progressive impairment of regional myocardial perfusion after initial restoration of postischemic blood flow. Circulation 80:1846–1861.PubMedCrossRefGoogle Scholar
  10. 10.
    Przyklenk K, Kloner RA. 1989. “Reperfusion injury” by oxygen-derived free radicals? Effect of superoxidase dismutase + catalase, given at the time of reperfusion on myocardial infarct size, contractile function, coronary microvasculature and regional myocardial blood flow. Circ Res 64:86–96.PubMedCrossRefGoogle Scholar
  11. 11.
    Engler RL, Schmid-Schonbein GW, Pavlec RS. 1983. Leukocyte capillary plugging in myocardial ischemia and reperfusion in the dog. Am J Pathol 111:98–111.PubMedGoogle Scholar
  12. 12.
    Kloner RA, Alker KJ. 1984. The effect of streptokinase on the intramyocardial hemorrhage, infarct size and the no-reflow phenomenon during reperfusion. Circulation 70:513–521.PubMedCrossRefGoogle Scholar
  13. 13.
    Kloner RA, Rude RE, Carlson N, Maroko PR, DeBoer LWV, Braunwald E. 1980. Ultrastructural evidence of microvascular damage and myocardial cell injury after coronary artery occlusion. Which comes first? Circulation 62:945–952.Google Scholar
  14. 14.
    Heyndrickx GR, Baig H, Nellens P, Lensen I, Fishbein MC, Vatner SF. 1978. Depression of regional blood flow and wall thickening after brief coronary occlusions. Am J Physiol 234:H653–H659.PubMedGoogle Scholar
  15. 15.
    Vanhaecke J, Flameng W, Borgers M, Jang IK, Van de Wert F, DeGeest H. 1990. Evidence for decreased coronary flow reserve in viable postischemic myocardium. Circ Res 67:1201–1210.PubMedCrossRefGoogle Scholar
  16. 16.
    Liu GS, Thornton J, Van Winkle DM, Stanley AWH, Olsson RA, Downey JM. 1991. Protection against infarction afforded by preconditioning is mediated by A1 adenosine receptors in rabbit heart. Circulation 84:350–356.PubMedCrossRefGoogle Scholar
  17. 17.
    Thornton JD, Liu GS, Olsson RA, Downey JM. 1992. Intravenous pretreatment with A1-selective adenosine analogues protects the heart against infarction. Circulation 85:659–665.PubMedCrossRefGoogle Scholar
  18. 18.
    Berne RM. 1980. The role of adenosine in the regulation of coronary flow. Circ Res 47:807–813.PubMedCrossRefGoogle Scholar
  19. 19.
    Olafsson B, Forman MB, Puett DW, Pon A, Cates CHU, Friesinger GC, Virmani R. 1987. Reduction of reperfusion injury in the canine preparation by intraoronary adenosine: Importance of the endothelium and the no-reflow phenomenon. Circulation 5:1135–1145.CrossRefGoogle Scholar
  20. 20.
    Bauer B, Simkhovich B, Kloner RA, Przyklenk K. 1993. Does preconditioning protect the coronary vasculature from subsequent ischemia/reperfusion injury? Circulation 88:659–672.PubMedCrossRefGoogle Scholar
  21. 21.
    Nichols WW, Mehta JL, Donnelly TO, Lawson D, Thompson L, ter Riet M. 1989. Reduction in coronary vasodilator reserve following coronary occlusion and reperfusion in anesthetized dogs: Role of endothelium-derived relaxing factor, myocardial neutrophil infiltration and prostaglandins. J Mol Cell Cardiol 20:943–954.CrossRefGoogle Scholar
  22. 22.
    DeFily DV, Chilian WM. 1991. Preconditioning protects coronary microvascular endothelial function. Circulation 84(Suppl II):II434 (abstr).Google Scholar
  23. 23.
    DeFily DV, Chilian WM. 1993. Preconditioning protects coronary arteriolar endothelium from ischemia-reperfusion injury. Am J Physiol 265:H700–H706.PubMedGoogle Scholar
  24. 24.
    Stahl LD, Aversano TR, Becker LC. 1986. Selective enhancement of function of stunned myocardium by increased flow. Circulation 74:843–851.PubMedCrossRefGoogle Scholar
  25. 25.
    Laxson DD, Homans DC, Dai XZ, Sublett E, Bache RJ. 1989. Oxygen consumption and coronary reactivity in postischemic myocardium. Circ Res 64:9–20.PubMedCrossRefGoogle Scholar
  26. 26.
    Schott RJ, Rohmann S, Braun ER, Shaper W. 1990. Ischemic preconditioning reduces infarct size in swine myocardium. Circ Res 66:1133–1142.PubMedCrossRefGoogle Scholar
  27. 27.
    Ovize M, Kloner RA, Hale SL, Przyklenk K. 1992. Coronary cyclic flow variations “precondition” ischemic myocardium. Circulation 85:779–789.PubMedCrossRefGoogle Scholar
  28. 28.
    Gross GJ, Auchampach JA. 1992. Blockade of ATP-sensitive potassium channels prevents myocardial preconditioning in dogs. Circ Res 70:223–233.PubMedCrossRefGoogle Scholar
  29. 29.
    Hale SL, Kloner RA. 1992. Effect of ischemic preconditioning on regional myocardial flow in the rabbit heart. Coronary Artery Dis 3:133–140.CrossRefGoogle Scholar
  30. 30.
    Downey J, Liu Guang. 1992. Acetylcholine preconditions rabbit heart: Further evidence for G, protein coupling in preconditioning. Circulation 86(Suppl I):I174 (abstr).Google Scholar
  31. 31.
    Kitakaze M, Hori M, Takashima S, Sato H, Inoue M, Kamada T. 1993. Ischemic preconditioning increases adenosine release and 5′-nucleotidase activity during myocardial ischemia and reperfusion in dogs: Implications for myocardial salvage. Circulation 87:208–215.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1994

Authors and Affiliations

  • Barbara Bauer
  • Robert A. Kloner
  • Karin Przyklenk

There are no affiliations available

Personalised recommendations