Ischemic postconditioning of the isolated human myocardium: role of the applied protocol

Background: Ischemic postconditioning (IPostC), has been proposed as a useful approach to reduce infarct size in all species, but its clinical utility remains unclear. Objective: To investigate the role played by the protocol used on the efficacy of IPostC in protecting the diseased human myocardium...

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Detalles Bibliográficos
Autores: Casós, Kelly, Pérez, María-Llanos, Blasco Lucas, Arnau, Ferrer Curriu, Gemma, Gracia Baena, Juan Manuel, Sureda, Carlos, Permanyer, Eduard, Igual, Alberto, Galiñanes, Manuel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Institución:Universitat de Lleida (UdL)
Repositorio:Repositori Obert UdL
OAI Identifier:oai:repositori.udl.cat:10459.1/83889
Acceso en línea:https://doi.org/10.1016/j.ijcha.2015.05.009
http://hdl.handle.net/10459.1/83889
Access Level:acceso abierto
Palabra clave:Ischemic postconditioning
Human myocardium
Ischemic injury
Right atrial appendage
Descripción
Sumario:Background: Ischemic postconditioning (IPostC), has been proposed as a useful approach to reduce infarct size in all species, but its clinical utility remains unclear. Objective: To investigate the role played by the protocol used on the efficacy of IPostC in protecting the diseased human myocardium. Methods: Myocardial atrial samples from patients were subjected to a 90 min ischemia/120 min reoxygenation followed by different IPostC protocols to investigate the role of the time of ischemia (30, 60, 90 and 120 s) and the number of cycles (1, 2, 3 and 4) with 60 and 120 s of total ischemic time. Muscles were also subjected to ischemic preconditioning (IPreC). The release of lactate dehydrogenase (LDH) and the measurement of tetrazolium bromide (MTT) were determined. Results: IPostC increased the LDH and decreased the MTT values from those of control, independently of the duration of the conditioning ischemia. LDH and MTT values also worsened by augmenting the number of IPostC cycles whereas they were significantly improved by IPreC. However, analysis of individual results indicated that in approximately 1/3 of the cases IPostC exhibited some degree of protection especially in the presence of increased ischemic injury. Conclusions: The present findings show that IPostC of the human myocardium may be influenced by the protocol used and also by the degree of the preceding ischemic injury. IPostC was beneficial in approximately 1/3 of the cases; however in the remaining cases it increased ischemic damage and, therefore, these results raise a word of caution on its broad clinical use.