Document Detail

Ischemic preconditioning at a distance: reduction of myocardial infarct size by partial reduction of blood supply combined with rapid stimulation of the gastrocnemius muscle in the rabbit.
MedLine Citation:
PMID:  9315559     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Limitation of myocardial infarct size by an earlier brief complete occlusion of a coronary artery is defined as ischemic preconditioning. However, myocardial protection also can be achieved by partial reduction of coronary flow, rapid cardiac pacing, or brief ischemia-reperfusion of a remote region of the heart. Our study assesses the effect on myocardial infarct size of preconditioning at a distance induced by partial reduction of blood flow to a hind limb with or without increase of demand by electrical stimulation of a skeletal muscle. METHODS AND RESULTS: Anesthetized rabbits were randomized to 30 minutes of waiting period (controls), 55% to 65% reduction of femoral artery blood flow (stenosis), electrical stimulation of the gastrocnemius muscle at a rate of one per second (stimulation), or stenosis+stimulation. Thereafter, rabbits underwent 30 minutes of coronary artery occlusion and 4 hours of reperfusion. Each group included 8 rabbits. Risk zones were comparable among groups. However, the ratio of infarct size to risk zone was smaller in the stenosis+stimulation group (0.09+/-0.02) compared with the control (0.26+/-0.03), stenosis (0.36+/-0.05), and stimulation (0.30+/-0.05) groups (P=.0006). ANCOVA performed on the fraction of infarction (infarct size/left ventricular weight) and the fraction of risk zone revealed a significant group effect (P=.0004). CONCLUSIONS: Remote ischemia of a skeletal muscle induced by muscle stimulation combined with restriction of blood flow preconditioned the myocardium. The combination of muscle stimulation with reduction of femoral arterial blood flow but not muscle stimulation without blood flow restriction or of flow restriction without muscle stimulation reduced myocardial infarct size considerably.
Y Birnbaum; S L Hale; R A Kloner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  96     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-10-23     Completed Date:  1997-10-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1641-6     Citation Subset:  AIM; IM    
Heart Institute, Good Samaritan Hospital, and the University of Southern California, Los Angeles 90017, USA.
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MeSH Terms
Cardiac Pacing, Artificial
Coronary Circulation
Electric Stimulation
Femoral Artery / physiopathology
Hindlimb / blood supply*
Ischemic Preconditioning*
Muscle, Skeletal / physiopathology*
Myocardial Infarction / pathology*
Myocardium / pathology
Regional Blood Flow

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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