title: Ischemic preconditioning reduces unloaded myocardial oxygen consumption in an in-vivo sheep model.
abstract: OBJECTIVE
  Ischemic preconditioning (IP) describes the adaptation of the myocardium to ischemic stress preceded by short periods of ischemia and reperfusion. However, its cardioprotective mechanisms are not completely understood. We assessed the effect of IP on ventricular energetics in an in-vivo sheep model.
  
  
  METHODS
  IP was performed in six sheep by three 5 min aortic cross-clamping periods interspersed with 5 min of reperfusion during cardiopulmonary bypass and with six sheep as time-matched controls. Global myocardial ischemia was subsequently achieved by 30 min aortic cross-clamping with left ventricular unloading during normothermic cardiopulmonary bypass. Weaning from cardiopulmonary bypass was performed 40 min after reperfusion. At baseline, after treatment (IP or time-matched cardiopulmonary bypass), and up to 100 min after reperfusion, left ventricular pressure-volume loops were measured using a conductance catheter during a right heart bypass preparation. Contractility, diastolic function, and ventriculo-arterial coupling were evaluated. Ventricular energetics [the relation between myocardial oxygen consumption (MVO(2)) and systolic pressure-volume area (PVA)] was also evaluated. A right heart bypass was instituted to control the preload and to decompress the right ventricle completely, thereby eliminating parallel conductance variation and minimizing the contribution of the right ventricle to MVO(2).
  
  
  RESULTS
  IP reduced unloaded MVO(2) (PVA-independent MVO(2)). Contractility, diastolic function, and ventriculo-arterial coupling in the IP group were better preserved than in the control group after ischemia-reperfusion.
  
  
  CONCLUSIONS
  IP reduces unloaded MVO(2), and preserves contractility, diastolic function, and ventriculo-arterial coupling after 30 min global myocardial ischemia in an in-vivo sheep model.
authors.affiliation: Center for Experimental Surgery and Anaesthesiology (C.E.H.A.), Cardiovascular Research Unit, Katholieke Universiteit Leuven, Minderbroedersstraat 17, Belgium.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Tanoue
authors.forename: Paul
authors.initials: P
authors.lastname: Herijgers
authors.forename: Bart
authors.initials: B
authors.lastname: Meuris
authors.forename: Eric
authors.initials: E
authors.lastname: Verbeken
authors.forename: Veerle
authors.initials: V
authors.lastname: Leunens
authors.forename: Marleen
authors.initials: M
authors.lastname: Lox
authors.forename: Willem
authors.initials: W
authors.lastname: Flameng
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D002315:Cardiopulmonary Bypass; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D023421:Models, Animal; D009203:Myocardial Infarction / Q000378:metabolism* / Q000517:prevention & control*; D015428:Myocardial Reperfusion Injury / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism*; D010101:Oxygen Consumption; D011897:Random Allocation; D012756:Sheep