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Preconditioning does not attenuate myocardial stunning.

M Ovize¹, K Przyklenk, S L Hale

¹Heart Institute Research, Hospital of the Good Samaritan, Los Angeles, CA 90017.

|June 1, 1992

Summary

Myocardial preconditioning does not protect against contractile dysfunction during reversible ischemia or prevent stunning after reperfusion. This study found no benefit of preconditioning in a canine model, challenging previous findings.

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Area of Science:

Cardiology
Cardiovascular Physiology
Ischemic Heart Disease

Background:

Myocardial preconditioning typically reduces infarct size after prolonged ischemia.
Previous research indicated preconditioning may not attenuate contractile dysfunction in peri-infarct tissue.
The effect of preconditioning on non-compromised myocardium subjected to short ischemia was unknown.

Purpose of the Study:

To investigate the effects of preconditioning on myocardial contractile function during reversible ischemia.
To determine if preconditioning prevents myocardial stunning following a short ischemic insult.
To assess preconditioning's impact on myocardium not compromised by the preconditioning regimen itself.

Main Methods:

Utilized a canine model of myocardial stunning.
Administered three treatment groups: control, 5-minute occlusion/5-minute reperfusion (PC5), and 2.5-minute occlusion/5-minute reperfusion (PC2.5) prior to a 15-minute ischemic insult.
Monitored segment shortening (SS) via sonomicrometry and assessed myocardial blood flow using radiolabeled microspheres.

Main Results:

All groups experienced similar ischemia levels during the 15-minute occlusion.
PC5 group showed significant stunning before the main insult, while PC2.5 did not.
No significant difference in segment shortening during ischemia or degree of stunning after reperfusion was observed among the groups.

Conclusions:

Myocardial preconditioning did not preserve contractile function during reversible ischemia.
Preconditioning did not prevent myocardial stunning in the initial hours of reperfusion.
The relationship between collateral blood flow and functional recovery was not altered by preconditioning.