The Effect of Acute Versus Delayed Remote Ischemic Preconditioning on Reperfusion Induced Ventricular Arrhythmias
The Effect of Acute Versus Delayed Remote Ischemic Preconditioning on Reperfusion Induced Ventricular Arrhythmias
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DOI：
10.1111/j.1540-8167.2012.02397.x
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发表时间：
2012-12-01
影响因子：
2.7
通讯作者：
Kloner, Robert A.
中科院分区：
文献类型：
--
作者：
Dow, Joan;Bhandari, Anil;Kloner, Robert A.
远程缺血预适应与心律失常。前言：在活体动物模型中，远端缺血预适应(RIPC)对心律失常的影响尚不清楚。我们的目的是确定急性和延迟RIPC对心律失常的影响。方法和结果：麻醉开胸大鼠左冠状动脉近端阻断(CAO)5min，再灌流10min。未处理组(IR组，n=17)或RIPC组(n=14)，双侧股动脉阻断5min，再灌注5min，再灌注3min，于CAO前30min开始。再灌注时，RIPC组的室性心动过速(VT)发作时间(25.7秒)较IR组(8.8秒)延迟(P=0.04)。室速持续时间IR组为54.1秒，RIPC组为4.9秒(P=0.019)。室性早搏(VPC)数IR组为26.0，RIPC组为10.0(P=0.04)。再灌流1分钟和10分钟，IR和RIPC心脏危险区的磷酸化Akt和磷酸化p70S6的表达水平均高于非缺血区。第1天诱导延迟RIPC，第2天诱导心肌IR。延迟的RIPC不影响VT或VPC。结论：急性肢体RIPC对IR诱发的室性心律失常有明显的延缓和减少作用，但不诱发危险通路，未出现RIPC对心律失常的晚期保护期。(《心脏电生理杂志》，第23卷，第1374-1383页，2012年12月)
Remote Ischemic Preconditioning and Cardiac Arrhythmias. Introduction: The effect of remote ischemic preconditioning (RIPC) on arrhythmias in in vivo models is unknown. Our purpose was to determine effects of both acute and delayed RIPC on arrhythmias. Methods and Results: In the acute protocol anesthetized open chest rats were exposed to 5 minutes of proximal left coronary artery occlusion (CAO) and 10 minutes of reperfusion. Rats were either untreated (ischemia/reperfusion, IR group, n = 17) or received RIPC (n = 14) with 5 minutes bilateral femoral occlusions followed by 5 minutes of reperfusion times 3, started 30 minutes before CAO. At reperfusion, onset of ventricular tachycardia (VT) was delayed in RIPC group (25.7 seconds) versus IR (8.8 seconds; P = 0.04). Number of episodes of VT was 17.0 in IR versus 3.0 in the RIPC group (P = 0.01) and duration of VT was 54.1 seconds in IR versus 4.9 seconds in RIPC (P = 0.019). Number of ventricular premature complexes (VPC) was 26.0 in IR and 10.0 in RIPC rats (P = 0.04). Levels of reperfusion injury salvage kinases (RISK), that is, phospho-Akt and phospho-p70S6 in the risk area of IR and RIPC hearts were similarly higher compared to the nonischemic areas both at 1 and 10 minutes into reperfusion. Delayed RIPC was induced on day 1 and on day 2, myocardial IR was induced. Delayed RIPC did not affect VT or VPC. Conclusion: Acute RIPC of the lower limbs induced a powerful delay in/and reduction in IR induced ventricular arrhythmias, but without evoking the RISK pathway; a late protective phase of RIPC on arrhythmias did not occur. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1374-1383, December 2012)