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La isquemia transitoria de las extremidades induce el precondicionamiento isquémico remoto in vivo
R K Kharbanda1, U M Mortensen, P A White
1University College, London, UK. rk285@cam.ac.uk
Circulation
|December 4, 2002
Resumen
El precondicionamiento isquémico remoto utilizando isquemia de extremidades protege contra la disfunción endotelial en humanos y reduce el tamaño del ataque cardíaco en cerdos. Este método simple tiene aplicaciones clínicas potenciales para reducir el daño tisular por lesión de isquemia-reperfusión.
Área de la Ciencia:
- Fisiología cardiovascular fisiología cardiovascular.
- Biología de la Isquemia-Reperfusión Biología de la Isquemia-Reperfusión
Sus antecedentes:
- El precondicionamiento isquémico (IP) mitiga el daño local del tejido por isquemia-reperfusión (IR).
- La evidencia sugiere que la IP también puede proteger los tejidos remotos de la lesión IR.
- Este estudio investigó si la isquemia de las extremidades induce el precondicionamiento remoto, afectando la función endotelial humana y el infarto de miocardio experimental.
Objetivo del estudio:
- Para determinar si la isquemia de las extremidades puede inducir el precondicionamiento remoto en humanos.
- Evaluar el efecto del precondicionamiento remoto en la lesión endotelial IR en humanos.
- Evaluar el impacto del precondicionamiento remoto en el tamaño experimental del infarto de miocardio en cerdos.
Principales métodos:
- La función endotelial del antebrazo humano se evaluó a través de la respuesta de acetilcolina después de la isquemia-reperfusión de la extremidad.
- El precondicionamiento remoto en humanos implicó breves ciclos de isquemia en la extremidad contralateral.
- El tamaño del infarto de miocardio en cerdos se midió después de la oclusión de la arteria LAD, con y sin precondicionamiento de extremidades remotas.
Principales resultados:
- El precondicionamiento remoto impidió la reducción en la respuesta del flujo sanguíneo del antebrazo a la acetilcolina observada en los controles después de IR.
- En cerdos, la isquemia de extremidad remota redujo significativamente el tamaño del infarto de miocardio (26% frente al 53% del área de riesgo).
Conclusiones:
- El acondicionamiento isquémico remoto previene eficazmente la disfunción endotelial inducida por IR en humanos.
- La isquemia de extremidades como un estímulo de precondicionamiento remoto reduce el tamaño del infarto de miocardio en modelos experimentales.
- La isquemia transitoria de las extremidades es una estrategia de precondicionamiento simple y prometedora con una potencial utilidad clínica.
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