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Ischemic preconditioning by repeated exercise tests involves nitric oxide up-regulation.

D Zdrenghea1, G Bódizs, M C Ober

  • 1Cardiology Department, Rehabilitation Clinical Hospital, 46-50, Viilor Str., 3400 Cluj-Napoca, Romania. zdrenghea@hotmail.co

Romanian Journal of Internal Medicine = Revue Roumaine De Medecine Interne
|November 6, 2004
PubMed
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Two exercise tests increased plasma nitrates/nitrites (NOx), indicating nitric oxide's role in ischemic preconditioning. This led to reduced ST depression, suggesting clinical improvement in heart disease patients.

Area of Science:

  • Cardiology
  • Physiology
  • Biochemistry

Background:

  • Animal studies suggest nitric oxide (NO) involvement in delayed ischemic preconditioning.
  • Nitric oxide plays a crucial role in cardiovascular adaptations to stress.

Purpose of the Study:

  • To investigate if plasma nitrates/nitrites (NOx), a marker for nitric oxide, change after two consecutive exercise tests.
  • To determine if these NOx level changes correlate with clinical improvements in patients with ischemic heart disease.

Main Methods:

  • 22 ischemic heart disease patients underwent two exercise stress tests 24 hours apart.
  • Plasma NOx levels were measured before and after each test.
  • Clinical endpoints including peak effort, double product, and ST segment depression were compared between tests.

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Main Results:

  • Plasma NOx levels showed a slight increase after the first test and a significant rise after the second test (p < 0.03).
  • Peak effort and double product remained unchanged, but maximal ST segment depression decreased significantly after the second test (p < 0.01).

Conclusions:

  • Consecutive exercise stress tests increase plasma NOx levels in ischemic heart disease patients.
  • The observed decrease in ST depression suggests a protective effect, consistent with nitric oxide-mediated ischemic preconditioning.
  • Findings support nitric oxide's role as both a trigger and effector in ischemic preconditioning.