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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Activation of an intracellular calcium-calmodulin complex may play an important role in myocardial injury induced by ischemia and reperfusion. Chlorpromazine and trifluoperazine, calmodulin inhibitors, were used to enhance myocardial preservation by preventing harmful effect of intracellular calcium accumulation. The experimental model used one-hour LAD coronary occlusion and subsequent two-hour reperfusion in 70 dogs divided into four groups. Reperfusion alone significantly increased regional myocardial blood flow and left ventricular enddiastolic pressure and significantly reduced infarct size, dp/dt max, V max, mean aortic pressure, cardiac index and index of left ventricular minute work. Phenothiazines, applied at the 30th minute of occlusion significantly reduced infarct size, left ventricular enddiastolic pressure and index of systemic resistance and significantly increased dp/dt max, V max, cardiac index and regional myocardial blood flow in ischemic and border zones. The physiological results tightly correlated with the biochemical results and ultrastructural findings. The present study suggests that phenothiazines can improve cardiac performance and preservation of myocytes by preventing calcium stimulatory effect on degradative enzymes and may represent a potential clinical tool in modifying myocardial injury induced by ischemia and reperfusion.
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PMID:Protective effect of calmodulin inhibitors on reperfusion injury. 202 60

Limitation on infarct size, using propionyl-L-carnitine (Sigma-Tau) by itself and with the calcium entry blocker, tiapamil (Hoffmann-LaRoche), was evaluated in two groups of ten dogs each, during chronic (9 days) myocardial infarction. There were eight dogs that served as the control group. A closed-chest model was used to produce the thrombus by placing a helically shaped copper wire in the LAD by catheter technique, under x-ray visualization. Necrotic tissue in serial transventricular sections were delineated by triphenyltetrazolium chloride and measured by computer technique, using an IBM PC interfaced with a digitizing pad, 9 days following occlusion. The mean total amount of necrosis in the propionyl-L-carnitine (7.4%) and the propionyl-L-carnitine/tiapamil (6.7%) groups were significantly less (p less than .01) than found in the control (14.1%) group, reflecting a difference of 50 and 58%, respectively, between the treated groups and control. A number of significant between-group comparisons (p less than .05 to p less than .001), under the same conditions, were found for various ischemia, hemodynamic, and hematologic variables followed before and at 30, 60, 90, 120, and 180 minutes after occlusion, as well as on the second and ninth day. The results of this study strongly suggest that propionyl-L-carnitine and propionyl-L-carnitine with tiapamil has a protective effect on myocardial function, following thrombotic occlusion of the LAD, as well as limiting the resulting infarct size.
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PMID:Effect of propionyl-L-carnitine on experimental myocardial infarction in dogs. 203 76

The approach to a proximal LAD stenosis in an asymptomatic patient depends on a number of factors. Most important among these are the presence and extent of ischemia, anatomic considerations, and the functional status of the myocardium subserved by the vessel. In patients with functionally and hemodynamically insignificant disease with no ischemia, it is appropriate simply to follow the patient and to modify the risk factors for atherosclerosis if they exist. All three of the currently available modalities are appropriate in individual patients, including medical management, percutaneous balloon angioplasty, and surgical revascularization. In ambiguous cases, the available studies suggest no benefit from aggressive strategies; therefore, a conservative approach that minimizes side effects and complications of treatment is best.
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PMID:Should the asymptomatic patient with a significant proximal LAD stenosis undergo PTCA? 211 33

The effects of the molsidomine metabolite SIN-I (0.5 mg) on tolerance to ischemia were studied in twelve patients during coronary angioplasty of the LAD. SIN-I resulted in a significant prolongation of time to ST-segment alteration one, five and ten minutes after intracoronary injection. Beside hemodynamic reasons the effects of SIN-I on circulating blood cells and collateral perfusion are discussed as mechanisms of action. The effects of molsidomine (2 X 8 mg/d) on restenosis rate after initially successful coronary angioplasty were studied in 393 patients in a prospective, randomized and controlled trial. 29% of patients treated with molsidomine experienced restenosis at control coronary angiography at six months. The control group receiving nifedipine (3 X 20 mg/d) and acetylsalicylic acid (1 X 500 mg/d) showed a restenosis in 33% of patients. Therefore, molsidomine seems as effective as nifedipine and acetylsalicylic acid in treating patients after coronary angioplasty.
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PMID:[Acute and chronic effects of molsidomine in therapeutic coronary angioplasty]. 218 4

The left descending coronary artery (LAD) was occluded in 16 open-chest cats for 10, 20, 40, or 60 minutes (four cats in each group). In addition, four sham-operated cats served as controls. Specimens for electron microscopy were obtained from the normal and ischemic zones, guided by in vivo injection of fluorescein, and verified by blood flow measurements with microspheres. The ultrastructure of 2,400 heart muscle cells and nuclei was studied. Fractional volumes of main cell components, mitochondrial surface density, and mitochondrial surface: volume ratio were calculated in 480 micrographs. After 10 minutes of ischemia we observed signs of sarcolemmal fragility, mitochondrial swelling, and lipid droplet accumulation. After 20 minutes of ischemia sarcolemmal fragmentation, chromatin clumping or margination and a maximal cytoplasmic edema were evident. The fractional volume of mitochondria was equally increased in ischemic zones of all groups. In both normal and ischemic zones there was a tendency toward smaller fractional volumes of lipid droplets during ischemia. In the normal zone there was mild cytoplasmic edema and slight mitochondrial swelling 10 minutes after occlusion as compared with the sham group. The present study demonstrates that a large proportion of cardiac myocytes undergoes severe damage within 20 minutes of coronary occlusion.
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PMID:Early morphologic changes in cat heart muscle cells after acute coronary artery occlusion. 230 31

Protective effects of prostacyclin (PGI2) and Iloprost in experimental cardiac ischemia are reported by several authors. However, the effects of continuous administration on the final outcome of myocardial infarction are not yet known. We investigated the effects of Iloprost on cardiac unperfused area (UA) and necrotic zone (NZ) as assessed by Evans blue perfusion and extraction and nitrobluetetrazolium staining, respectively, using osmotic minipumps for continuous intravenous drug administration. Starting 3-4 hours after left descending coronary artery-ligation (LAD-L) Iloprost was infused at doses of 0.1 microgram and 0.5 microgram X kg-1 X min-1. While the lower dose is below pharmacological effect level, the higher dose in rats slightly lowered blood pressure and effectively inhibited platelet aggregation. LAD-L in control rats resulted in UA and NZ extending to 34.2 and 16.9%, respectively, of total ventricular mass (VM) after 24 hours and 28.3 and 21.3% of VM, respectively, after 7 days. At the dose of 0.1 micrograms X kg-1 X min-1 Iloprost was ineffective in reducing UA 24 hours after LAD-L. However, at 0.5 microgram X kg-1 X min-1 Iloprost with UA and NZ of 16.3 and 8.4% of VM, respectively, after 24 hours and 8.5 and 5.2% of VM, respectively, after 7 days reduced the extension of myocardial infarction by approximately 50% after 24 hours and 70% after 7 days, as compared to controls. As assessed in unperfused ventricular tissue after LAD-L and normal myocardium of sham-operated rats following 24 hours of Iloprost infusion, myocardial tissue concentrations of Iloprost amount to approximately half of the plasma levels irrespective of LAD-L.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Limitation of myocardial unperfused area and necrotic zone 24 hours and 7 days after coronary artery ligation in rats by the stable prostacyclin analogue iloprost. 242 67

It has been implied that the increase of myocardial extracellular potassium activity [( K+]e) in the early stage of acute myocardial ischemia is a major cause of the increased likelihood of arrhythmia after acute coronary artery occlusion. There is also experimental evidence that some calcium antagonists reduce the occurrence of ischemia-induced early ventricular arrhythmias. In order to clarify the antiarrhythmic effect of gallopamil during the early phase of acute LAD occlusion, the influence of this calcium antagonist on the time course of [K+]e during acute ischemia was measured in open-chest anesthetized dogs using a K+-selective surface multielectrode. The regional myocardial blood flow was determined with 9 micron radioactive tracer microspheres. After application of gallopamil (bolus 25 micrograms/kg and infusion 2.5 micrograms/kg.min for 30 min) the maximal and mean rate of rise of [K+]e as well as the plateau of [K+]e reached during ischemia were significantly diminished compared with the control occlusions. 90 min after gallopamil, the rate of rise of [K+]e as well as the plateau of [K+]e reached were still significantly reduced, but 180 min after the gallopamil application, no significant differences between the time course of [K+]e and that of the two control occlusions could be found. Gallopamil significantly elevated myocardial blood flow in the non-ischemic area, but did not influence blood flow in the ischemic region. While collateral perfusion remains unchanged, the slowed and reduced increase of myocardial [K+]e during acute coronary artery occlusion may be an important component of the antiarrhythmic effect of gallopamil during early ischemia.
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PMID:Effects of the calcium antagonist gallopamil on the increase of myocardial extracellular potassium activity during LAD occlusion in dogs. 244 24

Several studies indicate that myocardial ischemia causes a redistribution of beta-adrenergic receptors from a presumably intracellular compartment to the cell surface. However, a decreased adenylate cyclase and contractile responsiveness to beta-adrenergic stimuli has also been reported. The aim of the present study was to investigate possible ischemia-induced changes in myocardial beta-adrenoceptor coupling to adenylate cyclase. Myocardial ischemia was induced by hydraulic occlusion of the LAD in mongrel dogs anesthetized with isoflurane. After 90 min of ischemia, tissue samples were removed from the ischemic and nonischemic regions for tissue catecholamine determinations and for the preparation of particulate fractions from tissue homogenates. Saturation experiments on microsomal fractions obtained from the ischemic and control areas did not reveal any significant changes in the calculated dissociation constant for (-)[125I]iodocyanopindolol binding nor in the calculated receptor density. Likewise, the relative numbers of beta 2-adrenergic receptors were comparable in both preparations (approximately 20%). On the other hand, the proportion of beta-adrenoceptors stabilized in the high-affinity state by (-)isoproterenol was significantly reduced in the ischemic region when compared with the control myocardium (17 +/- 5 vs. 41 +/- 4%). This change was accompanied by a significant decrease in the intrinsic activity of (-)isoproterenol in stimulating adenylate cyclase activity. We propose that the initial uncoupling of the beta-adrenoceptor from its effector is a physiologically important, protective mechanism which guards the ischemic myocardium against the deleterious effect of excessive sympathetic stimulation.
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PMID:Effects of ischemia on the canine myocardial beta-adrenoceptor-linked adenylate cyclase system. 244 7

The aim of the study was to examine a possible role for platelet activating factor (PAF) in experimental myocardial ischaemia and reperfusion. Anaesthetized open-chest greyhounds were subjected to 40 min of coronary artery (LAD) occlusion followed by reperfusion. Blood samples for platelet counting were obtained from a local coronary vein draining the ischaemic region. Pretreatment with PAF antagonists BN52021 (5 mg kg-1 i.v.) or SRI63441 (10 mg kg-1 i.v.), 15 min prior to occlusion reduced the ventricular ectopic count during the ischaemic period from 614 +/- 82 (controls) to 296 +/- 145 (BN52021) and 474 +/- 200 (SRI63441). Both drugs also reduced the incidence of ventricular fibrillation (VF) (during ischaemia and reperfusion) from 90% (controls), to 50% (BN52021) and 43% (SRI63441). Ischaemia was accompanied by a 32 +/- 7% reduction in coronary venous platelets; this was attenuated by both BN52021 (-2 +/- 6%) and SRI63441) (-1 +/- 5%). These results suggest that PAF may contribute to ischaemia and reperfusion-induced arrhythmias by activating platelets.
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PMID:The effects of PAF antagonists on arrhythmias and platelets during acute myocardial ischaemia and reperfusion. 246 94

Oxygen free radicals have been suggested to cause the myocardial damage resulting in the prolonged contractile depression following brief periods of regional ischemia. In pigs, we infused the natural antioxidant alpha-tocopherol as its water-soluble acetate [0.3 g/kg intravenously (i.v.), n = 6] three times during 1 week, prior to thoracotomy, 8-min distal left anterior coronary artery (LAD) occlusion and 90-min reperfusion. Plasma levels of alpha-tocopherol [high-performance liquid chromatography (HPLC)] on the experimental day were 148.91 +/- 21.47 micrograms/ml as compared to preinfusion control of 0.51 +/- 0.14 micrograms/ml. Myocardial levels of alpha-tocopherol were elevated to 93.15 +/- 14.78 micrograms/g as compared to 4.08 +/- 0.60 microgram/g in the control group (n = 6). Malondialdehyde levels in ischemic-reperfused myocardium of the treatment group were insignificantly lower (441.96 +/- 59.55 nmol/g) as compared to the control group (500.9 +/- 72.72 nmol/g). Heart rate was significantly higher in the treatment group by the end of the experiments (135 +/- 10 vs. 105 +/- 4 beats/min, p less than 0.01). Regional segment shortening (SS, sonomicrometry) became normal within 1 min of reperfusion in both the treatment and the control group. During the following 10 min, SS decreased to 52 +/- 6% of preischemic control in the alpha-tocopherol group and to 54 +/- 7% in the control group (NS). SS remained at these depressed values throughout the reperfusion period. Pretreatment with the antioxidant alpha-tocopherol resulted in a tendency to lower lipid peroxidation products but did not prevent development of contractile depression in reversibly ischemic reperfused myocardium.
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PMID:Effect of alpha-tocopherol (vitamin E) in a porcine model of stunned myocardium. 247 14


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