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Circulation, Vol 84, 341-349, Copyright © 1991 by American Heart Association
MV Cohen, GS Liu and JM Downey
BACKGROUND. A brief coronary occlusion before a more prolonged occlusion
results in less myocardial infarction than the longer occlusion alone.
However, the effects of this preconditioning on recovery of systolic
function after coronary occlusion have not been determined. METHODS AND
RESULTS. Ultrasonic crystals implanted in rabbit myocardium measured
segment length in the distribution of a branch of the left coronary artery
that was fitted with a snare occluder. Rabbits were randomly allocated to
either nonpreconditioned or preconditioned groups. Rabbits in the latter
group underwent preconditioning with a 5-minute coronary occlusion followed
by 10 minutes of reperfusion. Then the coronary artery was occluded for 20
minutes in all rabbits, after which it was allowed to reperfuse for 90
minutes. The hearts were then excised, and infarct size was measured by
staining with triphenyltetrazolium chloride. During coronary occlusion, all
hearts except one demonstrated either akinesis or paradoxical bulging. Five
minutes after release of the 20-minute occlusion, active shortening had
returned in the preconditioned rabbits and averaged 27.9 +/- 16.6% of
baseline shortening. At the same time, paradoxical lengthening persisted in
nonpreconditioned rabbits (-15.5 +/- 19.8% of baseline). By the end of the
90-minute reperfusion period, segment shortening averaged 40.1 +/- 8.4% of
baseline in preconditioned rabbits and only 6.2 +/- 12.0% in
nonpreconditioned rabbits (p less than 0.05). Infarct size as a percentage
of risk area was significantly smaller in preconditioned rabbits as well
(3.0 +/- 1.6% versus 28.8 +/- 7.0%, p less than 0.002) and likely accounted
for the improved shortening. CONCLUSIONS. We conclude that a brief coronary
occlusion before a more prolonged occlusion results in not only reduced
infarct size but also significantly better recovery of systolic function.
ARTICLES
Preconditioning causes improved wall motion as well as smaller infarcts after transient coronary occlusion in rabbits
Department of Physiology, University of South Alabama College of Medicine, Mobile.
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A. Satani, S. Kawashima, and T. Iwasaki Effects of Intracoronary Infusion of Adenosine on Cumulative Deterioration of Regional Myocardial Wall Motion Induced by Repeated Brief Periods of Coronary occlusion in Anesthetized Dogs Angiology, August 1, 1994; 45(8): 695 - 701. [Abstract] [PDF]
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 D. R. Meldrum, M. B. Mitchell, A. Banerjee, and A. H. Harken Cardiac Preconditioning: Induction of Endogenous Tolerance to Ischemia-Reperfusion Injury Arch Surg, November 1, 1993; 128(11): 1208 - 1211. [Abstract] [PDF]
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