HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Joseph C. Cleveland, Jr Daniel R. Meldrum Alden H. Harken Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cleveland, J. C. Articles by Harken, A. H. Search for Related Content PubMed PubMed Citation Articles by Cleveland, J. C., Jr Articles by Harken, A. H. Related Collections Related Article

Ann Thorac Surg 1997;63:147-152
© 1997 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Preconditioning and Hypothermic Cardioplegia Protect Human Heart Equally Against Ischemia

Department of Surgery, University of Colorado Health Sciences Center, Denver, Colorado

Accepted for publication August 1, 1996.

Background. The purpose of this study was to determine whether transient ischemic preconditioning protects human myocardium against normothermic ischemic injury.

Methods. Isolated human right atrial trabeculae were suspended in an organ bath with oxygenated Tyrode's solution at 37°C and field stimulated at 1 Hz. Developed force was recorded. Trabeculae (Warm I/R) received normoxic perfusion before 45 minutes of normothermic simulated ischemia (hypoxic, substrate-free buffer with pacing at 3 Hz) and 120 minutes of reperfusion. Preconditioned trabeculae (Warm IPC) were subjected to 5 minutes of normothermic simulated ischemia and 10 minutes of perfusion before normothermic simulated ischemia-reperfusion injury. Trabeculae (Cold I/R) were subjected to hypothermic (4°C) ischemia (hypoxic buffer) for 4 hours and 60 minutes of reperfusion (37°C). Preconditioned trabeculae (Cold IPC) were pretreated with 5 minutes of normothermic simulated ischemia before hypothermic ischemia and 60 minutes of reperfusion. At the end of reperfusion, trabeculae were frozen at -70°C and assayed for tissue creatine kinase activity.

Results. At the end of reperfusion, warm preconditioned trabeculae (Warm IPC) recovered 51% ± 5% of baseline developed force, whereas warm I/R trabeculae recovered 24% ± 3% (p < 0.05). Tissue creatine kinase levels reflecting preserved tissue viability were sustained in Warm IPC trabeculae (1,183 ± 204 U/g), whereas nonpreconditioned control trabeculae (Warm I/R) exhibited lower levels of enzymatic activity (403 ± 32 U/g) (p < 0.05). In contrast, Cold IPC trabeculae recovered 47% ± 5% and Cold I/R, 56% ± 8% of baseline developed force at the end of reperfusion (p > 0.05).

Conclusions. We conclude that transient ischemic preconditioning protects human myocardium against normothermic ischemic injury.

Related Article

Invited Commentary

Ann. Thorac. Surg. 63: 152-152. [Full Text]

This article has been cited by other articles:

				J. Feng, C. Bianchi, J. Li, and F. W. Sellke Bradykinin Preconditioning Preserves Coronary Microvascular Reactivity During Cardioplegia-Reperfusion Ann. Thorac. Surg., March 1, 2005; 79(3): 911 - 916. [Abstract] [Full Text] [PDF]

				H. J. Penttila, M. V.K. Lepojarvi, P. K. Kaukoranta, K. T. Kiviluoma, K. V. Ylitalo, and K. J. Peuhkurinen Ischemic preconditioning does not improve myocardial preservation during off-pump multivessel coronary operation Ann. Thorac. Surg., April 1, 2003; 75(4): 1246 - 1252. [Abstract] [Full Text] [PDF]

				W. E. Johnston Preconditioning the Brain and Heart: Implications for Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 2000; 4(2): 70 - 79. [Abstract] [PDF]

				L. P. Perrault and P. Menasche Preconditioning: can nature’s shield be raised against surgical ischemic-reperfusion injury? Ann. Thorac. Surg., November 1, 1999; 68(5): 1988 - 1994. [Abstract] [Full Text] [PDF]

				G. H. Li, S. X. Chen, E. X. Lu, Q. Q. Liu, and Y. J. Li Ischemic Preconditioning Improves Protection with Cold Blood Cardioplegia Asian Cardiovasc Thorac Ann, September 1, 1999; 7(3): 173 - 176. [Abstract] [Full Text] [PDF]

				S. L. Hale and R. A. Kloner Ischemic preconditioning and myocardial hypothermia in rabbits with prolonged coronary artery occlusion Am J Physiol Heart Circ Physiol, June 1, 1999; 276(6): H2029 - H2034. [Abstract] [Full Text] [PDF]

				G. Li, S. Chen, E. Lu, and Y. Li Ischemic preconditioning improves preservation with cold blood cardioplegia in valve replacement patients Eur. J. Cardiothorac. Surg., May 1, 1999; 15(5): 653 - 657. [Abstract] [Full Text] [PDF]

				D. R. Meldrum Tumor necrosis factor in the heart Am J Physiol Regulatory Integrative Comp Physiol, March 1, 1998; 274(3): R577 - R595. [Abstract] [Full Text] [PDF]

				L. P. Perrault, P. Menasche, K. V. Ylitalo, and K. J. Peuhkurinen Ischemic Preconditioning Before Normothermic Retrograde Cardioplegia Ann. Thorac. Surg., December 1, 1997; 64(6): 1874 - 1876. [Full Text]

				L. P. Perrault and P. Menasche Hypothermia during preconditioned ischemia-reperfusion attenuates the myocardial protection of preconditioning J. Thorac. Cardiovasc. Surg., September 1, 1997; 114(3): 515 - 516. [Full Text]