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Related Experiment Videos

Improvement in ischemic parameters during repeated exercise testing: a possible model for myocardial preconditioning

S Maybaum1, M Ilan, J Mogilevsky

  • 1Bendheim Department of Cardiology, Jesselson Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel.

The American Journal of Cardiology
|November 15, 1996
PubMed
Summary

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Repeated exercise tests significantly reduce myocardial ischemia duration and recovery time in patients, suggesting a "warm-up" phenomenon is clinical myocardial preconditioning.

Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Myocardial preconditioning, a protective adaptation to ischemia, is observed in animals and during angioplasty.
  • The
  • warm-up
  • effect in exercise-induced ischemia is not well understood.

Purpose of the Study:

  • To investigate if repeated exercise tests can reduce myocardial ischemia extent in patients.
  • To explore the relationship between exercise-induced ischemia and myocardial preconditioning.

Main Methods:

  • Twenty-six patients with positive stress tests underwent three treadmill tests at 30-minute intervals.
  • Training effects were minimized by performing additional tests on prior days.
  • Ischemic parameters including total ischemic time, recovery time, and time to ST depression were measured.

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Main Results:

  • Total ischemic time decreased from 633 to 399 seconds (p <0.0001) and recovery time from 259 to 126 seconds (p <0.0001) between the first and second tests.
  • Time to 1-mm ST depression increased significantly (p = 0.004), indicating a higher ischemic threshold.
  • Most patients (76%) showed improvement in at least two ischemic parameters.

Conclusions:

  • Repeated exercise-induced ischemia leads to significant improvements in ischemic parameters in most patients.
  • This
  • warm-up
  • phenomenon is proposed as the clinical equivalent of myocardial preconditioning.
  • Preconditioning can occur during both reduced coronary flow and demand-induced ischemia.