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Updated: May 27, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Neutrophil inhibition contributes to cardioprotection by postconditioning
A Granfeldt1, R Jiang, N-P Wang
1Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Denmark. granfeldt@gmail.com
Insights
Postconditioning significantly reduces heart attack size by involving neutrophils (PMNs). This study shows that inhibiting PMNs enhances the protective effects of postconditioning, suggesting PMN involvement in cardioprotection.
Area of Science:
- Cardiovascular Science
- Myocardial Infarction Research
- Inflammation and Immunity
Background:
- Postconditioning is known to reduce myocardial infarct size, superoxide generation, and neutrophil accumulation.
- The specific role of neutrophils (PMNs) in mediating the cardioprotective effects of postconditioning remains unclear.
Purpose of the Study:
- To investigate whether inhibiting PMNs affects myocardial salvage achieved by postconditioning.
- To determine if postconditioning directly inhibits PMN superoxide generation.
Main Methods:
- Rats subjected to myocardial ischemia-reperfusion were studied with and without PMN depletion, with or without postconditioning, to assess infarct size.
- Canine models were used to sample blood from the anterior interventricular vein (AIV) to measure PMN superoxide generation after postconditioning.
Main Results:
- Both postconditioning and PMN depletion independently reduced infarct size in rats.
- Combining postconditioning with PMN depletion did not result in further significant reduction of infarct size compared to postconditioning alone.
- Postconditioning significantly reduced PMN accumulation in the area at risk and decreased PMN superoxide generation in dogs.
Conclusions:
- Neutrophil (PMN) involvement is implied in the cardioprotective mechanisms of postconditioning.
- Inhibition of PMNs may enhance or be a key component of postconditioning-mediated cardioprotection.
Background:
Postconditioning (postcon) reduces infarct size, myocardial superoxide ((•)O(2)) generation, and neutrophil (PMN) accumulation. It is unknown whether inhibition of PMNs influence cardioprotection by postcon. The present study tested the following hypotheses: (1) myocardial salvage by postcon is modified by inhibition of PMNs and (2) postcon directly inhibits PMN (•)O(2) generation.
Methods:
For hypothesis 1, a deductive approach was used to determine infarct size in vivo with and without PMNs in rats, and for hypothesis 2, blood sampled from the anterior interventricular vein (AIV) in a canine model was used. Protocol 1: anesthetized rats, subjected to 30 min of coronary artery occlusion and 3 h of reperfusion, were randomized to control (n = 13), postcon (n = 13), PMN-depletion: (n = 9), and postcon in PMN-depleted rats (n = 9). Protocol 2: blood was sampled at baseline, 2 h and 24 h from the AIV, draining the area at risk (AAR) in anesthetized dogs with 60 min coronary occlusion ± postcon; whole blood was analyzed for (•)O(2) by luminol-enhanced chemiluminescence.
Results:
Postcon and PMN depletion reduced infarct size (42.6 ± 2.1%, P < 0.05 vs. control, and 43.9 ± 3.0%, P < 0.05 vs. control, respectively) vs. control (58.8 ± 0.9%), with no further decrease with postcon in PMN-depleted rats (37.2 ± 2.9%, P = 0.34 vs. postcon). PMN accumulation in AAR was less in postcon (21.2 ± 0.3%, P < 0.05 vs. control) and PMN-depleted (9.4 ± 0.3%, P < 0.05 vs. control) vs. control (30.5 ± 1.2%), with a further decrease in the postcon + PMN depletion group (5.4 ± 0.6%, P < 0.05 vs. control). In dogs, (•)O(2) release by PMNs increased at 2 h and 24 h of R, which was reduced to baseline levels by postcon.
Conclusions:
These data imply PMN involvement in cardioprotection by postconditioning.
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