Gritsopoulos G, Iliodromitis E K, Zoga A, Farmakis D, Demerouti E, Papalois A, Paraskevaidis I A, Kremastinos D T
Second Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece.
Cardiovasc Drugs Ther. 2009 Jun;23(3):193-8. doi: 10.1007/s10557-009-6168-5.
Postconditioning confers protection to the heart after a potentially lethal episode of prolonged ischemia. There is evidence that it may also be protective when applied at a distal artery. In the present study, we sought to determine whether remote postconditioning within the heart (local) or outside the heart (distal) is effective in salvaging the ischemic heart in vivo and to compare its effect with that of the classic postconditioning.
Twenty seven open chest New Zealand white anesthetized male rabbits were divided into four groups and were exposed to 30 min regional myocardial ischemia (isc), after ligation of a prominent coronary artery, followed by 3 h reperfusion (rep) after releasing the snare. Control group (n = 7) was subjected to no additional interventions, postC group (n = 6) was subjected to four cycles of 1 min isc/1 min rep of the same coronary artery at the beginning of reperfusion, remote local postC group (n = 7) to four cycles of 1 min isc/1 min rep of another coronary artery 30 s before the end of index isc and remote distal postC group (n = 7) to four cycles of 1 min isc/1 min rep of another (carotid) artery again 30 s before the end of index isc. Infarct size (I) and area at risk (R) were delineated with the aid of TTC staining and green fluorescent microspheres respectively and their ratio was expressed in percent (%I/R).
Remote local and remote distal postC reduced the % I/R ratio (17.7 +/- 1.7% and 18.4 +/- 1.6%, respectively vs 47.0 +/- 2.5% in the control group, P < 0.01). Classic PostC had an intermediate protective effect (33.1 +/- 1.7%, P < 0.05 vs all the other groups).
Remote postconditioning consisted of 1 min isc/1 min rep protects the ischemic rabbit heart in vivo, independently of the site of the remote artery. This intervention seems to confer a stronger protection than the classic postconditioning.
后适应可在长时间缺血这一潜在致死性发作后为心脏提供保护。有证据表明，在远端动脉应用时它可能也具有保护作用。在本研究中，我们试图确定心脏内（局部）或心脏外（远端）的远程后适应在体内挽救缺血心脏方面是否有效，并将其效果与经典后适应的效果进行比较。
将27只开胸的新西兰白色麻醉雄性兔分为四组，在结扎一条明显冠状动脉后使其经历30分钟的局部心肌缺血（isc），然后在松开圈套器后进行3小时再灌注（rep）。对照组（n = 7）不进行额外干预，后适应组（n = 6）在再灌注开始时对同一冠状动脉进行4个周期的1分钟缺血/1分钟再灌注，远程局部后适应组（n = 7）在指数缺血结束前30秒对另一条冠状动脉进行4个周期的1分钟缺血/1分钟再灌注，远程远端后适应组（n = 7）在指数缺血结束前30秒对另一条（颈动脉）动脉进行4个周期的1分钟缺血/1分钟再灌注。分别借助TTC染色和绿色荧光微球描绘梗死面积（I）和危险区域（R），其比值以百分比（%I/R）表示。
远程局部和远程远端后适应降低了%I/R比值（分别为17.7±1.7%和18.4±1.6%，而对照组为47.0±2.5%，P<0.01）。经典后适应具有中等保护作用（33.1±1.7%，与所有其他组相比P<0.05）。
由1分钟缺血/1分钟再灌注组成的远程后适应可在体内保护缺血的兔心脏，与远程动脉的部位无关。这种干预似乎比经典后适应提供更强的保护。
