The antiarrhythmic effect and clinical consequences of ischemic preconditioning.
Potentially hazardous short ischemic episodes increase the tolerance of myocardium to ischemia paradoxically. This condition decreases the infarct area markedly caused by a longer duration of coronary occlusion. This phenomenon is known as 'ischemic preconditioning' and its powerful cardioprotective effect has been shown in experimental and clinical studies. Ischemic preconditioning decreases cardiac mortality markedly by preventing the development of left ventricular dysfunction and ventricular and supraventricular arrhythmias after acute myocardial infarction. Ischemia-induced opening of ATP-sensitive potassium channels and synthesis of stress proteins via activation of adenosine, bradykinin and prostaglandin receptors seem to be the possible mechanisms. By understanding the underlying mechanisms of ischemic preconditioning, it may be possible to develop new pharmacologic agents that cause ischemic preconditioning with antiischemic and antiarrhythmic properties without causing myocardial ischemia.
Evrengul
Harun
H
Department of Cardiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey. harunevrengul@hotmail.com
Seleci
Deniz
D
Tanriverdi
Halil
H
Kaftan
Asuman
A
D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control*; D001026:Coronary Artery Bypass; D006360:Heat-Shock Proteins / Q000096:biosynthesis; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D009203:Myocardial Infarction / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D024661:Potassium Channels, Inwardly Rectifying / Q000378:metabolism; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000517:prevention & control
D000889:Anti-Arrhythmia Agents; D006360:Heat-Shock Proteins; D024661:Potassium Channels, Inwardly Rectifying