title: Response of the human myocardium to ischemic injury and preconditioning: The role of cardiac and comorbid conditions, medical treatment, and basal redox status.
abstract: BACKGROUND
  The diseased human myocardium is highly susceptible to ischemia/reoxygenation (I/R)-induced injury but its response to protective interventions such as ischemic preconditioning (IPreC) is unclear. Cardiac and other pre-existing clinical conditions as well as previous or ongoing medical treatment may influence the myocardial response to I/R injury and protection. This study investigated the effect of both on myocardial susceptibility to I/R-induced injury and the protective effects of IPreC.
  
  
  RESULTS
  Atrial myocardium from cardiac surgery patients (n = 300) was assigned to one of three groups: aerobic control, I/R alone, and IPreC. Lactate dehydrogenase leakage, as a marker of cell injury, and cell viability were measured. The basal redox status was determined in samples from 90 patients. The response to I/R varied widely. Myocardium from patients with aortic valve disease was the most susceptible to injury whereas myocardium from dyslipidemia patients was the least susceptible. Tissue from females was better protected than tissue from males. Myocardium from patients with mitral valve disease was the least responsive to IPreC. The basal redox status was altered in the myocardium from patients with mitral and aortic valve disease.
  
  
  CONCLUSIONS
  The response of the myocardium to I/R and IPreC is highly variable and influenced by the underlying cardiac pathology, dyslipidemia, sex, and the basal redox status. These results should be taken into account in the design of future clinical studies on the prevention of I/R injury and protection.
authors.affiliation: Reparative Therapy of the Heart, Vall d'Hebron Research Institute (VHIR), University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: Kelly
authors.initials: K
authors.lastname: Casós
authors.affiliation: Reparative Therapy of the Heart, Vall d'Hebron Research Institute (VHIR), University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Ferrer-Curriu
authors.affiliation: Reparative Therapy of the Heart, Vall d'Hebron Research Institute (VHIR), University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Soler-Ferrer
authors.affiliation: Reparative Therapy of the Heart, Vall d'Hebron Research Institute (VHIR), University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: María L
authors.initials: ML
authors.lastname: Pérez
authors.affiliation: Department of Cardiac Surgery, University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: Eduard
authors.initials: E
authors.lastname: Permanyer
authors.affiliation: Department of Cardiac Surgery, University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: Arnau
authors.initials: A
authors.lastname: Blasco-Lucas
authors.affiliation: Department of Cardiac Surgery, University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Gracia-Baena
authors.affiliation: Department of Cardiac Surgery, University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Castro
authors.affiliation: Department of Cardiac Surgery, University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Sureda
authors.affiliation: Gene & Cell and Therapy Laboratory VHIR, UAB, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Barquinero
authors.affiliation: Reparative Therapy of the Heart, Vall d'Hebron Research Institute (VHIR), University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.|Department of Cardiac Surgery, University Hospital Vall d'Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain.
authors.forename: Manuel
authors.identifier: http://orcid.org/0000-0002-0888-976X
authors.initials: M
authors.lastname: Galiñanes
mesh_terms: D000368:Aged; D002374:Catalase / Q000378:metabolism; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000009:adverse effects; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D015428:Myocardial Reperfusion Injury / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D009569:Nitric Oxide / Q000378:metabolism; D010084:Oxidation-Reduction; D012307:Risk Factors; D012737:Sex Factors; D013482:Superoxide Dismutase / Q000378:metabolism; D013481:Superoxides / Q000378:metabolism
chemical_list: D013481:Superoxides; D009569:Nitric Oxide; D002374:Catalase; D013482:Superoxide Dismutase