Document Detail


'Postconditioning' the human heart: multiple balloon inflations during primary angioplasty may confer cardioprotection.
MedLine Citation:
PMID:  17235447     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Growing evidence from experimental models suggests that relief of myocardial ischemia in a stuttering manner (i.e., 'postconditioning' [PostC] with brief cycles of reperfusion-reocclusion) limits infarct size. However, the potential clinical efficacy of PostC has, to date,been largely unexplored. Using a retrospective study design, our aim was to test the hypothesis that creatine kinase release (CK: clinical surrogate of infarct size) would be attenuated in ST-segment elevation myocardial infarction (STEMI) patients requiring multiple balloon inflations-deflations during primary angioplasty versus STEMI patients who received minimal balloon inflations and/or direct stenting. To investigate this concept, we reviewed the records of all STEMI patients with single vessel occlusion who presented to our institution from November 2004 - April 2006 for primary angioplasty. Exclusion criteria were: previous MI, cardiogenic shock, patients resuscitated from cardiac arrest, or pre-infarct angina. Patients were prospectively divided into two subsets: those receiving 1-3 balloon inflations (considered the minimum range to achieve patency and stent placement) versus those in whom 4 or more inflations were applied. Peak CK release was significantly lower in patients requiring > or =4 versus 1-3 inflations (1655 versus 2272 IU/L; p<0.05), an outcome consistent with the concept that relief of sustained ischemia in a stuttered manner (analogous to postconditioning) may evoke cardioprotection in the clinical setting.
Authors:
Chad E Darling; Patrick B Solari; Craig S Smith; Mark I Furman; Karin Przyklenk
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Publication Detail:
Type:  Journal Article     Date:  2007-01-23
Journal Detail:
Title:  Basic research in cardiology     Volume:  102     ISSN:  0300-8428     ISO Abbreviation:  Basic Res. Cardiol.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-06     Completed Date:  2007-11-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0360342     Medline TA:  Basic Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  274-8     Citation Subset:  IM    
Affiliation:
Dept. of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue, North Worcester , MA, 01655, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Creatine Kinase / blood
Electrocardiography
Female
Heart Conduction System
Humans
Ischemic Preconditioning, Myocardial / methods*
Male
Middle Aged
Myocardial Infarction / blood,  therapy*
Retrospective Studies
Chemical
Reg. No./Substance:
EC 2.7.3.2/Creatine Kinase

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


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