Adenosine-activated myocardial ischemia does not induce delayed preconditioning.
BACKGROUND
Our objective was to determine whether adenosine-induced ischemia exerts a delayed cardiac protective effect in patients with stable effort angina ischemic heart disease.


METHODS
The study group was comprised of 32 patients (men) with symptoms of stable effort angina, aged 38-65 years (Group 1), and 18 clinically healthy subjects (3 women, 15 men), aged 35-55 years (Control group). The study protocol included baseline ECG and treadmill echocardiogram (ET1); ECG and adenosine echocardiogram performed 7 days after ET1; repeated exercise test exactly 24 h after adenosine infusion (ET2). Increases in heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure, maximum ST-segment depression (max IST) and total ST-segment depression (SIST) on ECG were compared, as well as left ventricular end-diastolic volume (LVEDV), end-systolic (LVESV) volume, ejection fraction (EF), and wall motion synergy index (WMSI).


RESULTS
No statistically significant differences were found in the increased values of the investigated electrocardiographic and echocardiographic parameters in either group on either exercise test. The only positive trend was observed in LVEDV. In Group 1 LVEDV increased significantly from rest values during ET1, whereas during ET2 LVEDV did not change.


CONCLUSIONS
Adenosine-induced ischemia does not exert a delayed protective effect in respect to cardiac bioelectrical and mechanical functions in patients with ischemic heart disease in the form of stable effort angina.
Gawor
Zenon
Z
Department of Cardiology, 2nd University Hospital, Łódź, Poland. kardiolog@skwan.lodz.pl
Granosik
Andrzej
A
Grabowicz
Włodzimierz
W
Piotrowski
Grzegorz
G
Grycewicz
Tomasz
T
Goch
Aleksander
A
Markuszewski
Leszek
L
Goch
Jan H
JH
D000241:Adenosine / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis; D016022:Case-Control Studies; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects
D000241:Adenosine