Daniel R. Meldrum, MD, Joseph C. Cleveland, MD, Brett C

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Presentation transcript:

Cardiac preconditioning with calcium: Clinically accessible myocardial protection Daniel R. Meldrum, MD, Joseph C. Cleveland, MD, Brett C. Sheridan, MD, Robert T. Rowland, MD, Anirban Banerjee, PhD, Alden H. Harken, MD The Journal of Thoracic and Cardiovascular Surgery Volume 112, Issue 3, Pages 778-786 (September 1996) DOI: 10.1016/S0022-5223(96)70065-X Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 1 Effect of preischemic administration of CaCl2, with and without PKC inhibition, on myocardial DP during ischemia-reperfusion. During equilibration, DP averaged approximately 110 mm Hg in all groups. After agent or vehicle administration, there was a transient increase in DP in CaCl2 and CaCl2 plus chelerythrine (Chel) groups; DP rapidly returned to baseline after the 2-minute infusion. During ischemia, DP decreased to 0 mm Hg in all groups. During reperfusion, DP recovery of CaCl2-treated group was increased with respect to control, CaCl2 plus chelerythrine, and chelerythrine groups. n = 6 to 8 per group. Equil, Equilibration. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 778-786DOI: (10.1016/S0022-5223(96)70065-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Effect of preischemic administration of CaCl2, with and without PKC inhibition, on CF during ischemia-reperfusion. During equilibration, CF averaged approximately 20 ml/min in all groups. After agent or vehicle administration, there was a transient increase in CF in CaCl2 and CaCl2 plus chelerythrine (Chel) groups; CF rapidly returned to baseline after the 2-minute infusion. During ischemia, CF decreased to 0 ml/min in all groups. During reperfusion, CF recovery of the CaCl2-treated group was increased with respect to control, CaCl2 plus chelerythrine, and chelerythrine groups. n = 6 to 8 per group. Equil, Equilibration. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 778-786DOI: (10.1016/S0022-5223(96)70065-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 3 Effect of preischemic administration of CaCl2, with and without PKC inhibition, on EDP during reperfusion. After 20 minutes of ischemia, EDP was 57 mm Hg in the control group; EDP decreased to approximately 45 mm Hg after 40 minutes of reperfusion. CaCl2 pretreatment decreased postischemic EDP to 38 mm Hg, which decreased further to 29 mm Hg after reperfusion. PKC inhibition with chelerythrine (Chel) abolished CaCl2-induced protective effects (CaCl 2 +Chel). Chelerythrine alone did not result in any additional injury when administered before an indentical ischemia-reperfusion insult. n = 6 to 8 per group. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 778-786DOI: (10.1016/S0022-5223(96)70065-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 Effect of preischemic administration of CaCl2, with and without PKC inhibition, on CK leakage during reperfusion. At 10, 20, 30, and 40 minutes of reperfusion, 1 ml coronary effluent was collected and assayed for CK activity in all groups. At 10 minutes of reperfusion, CK activity in the CaCl2 group averaged approximately 40 U/L, whereas CK activity in control, CaCl2 plus chelerythrine (Chel), and chelerythrine groups averaged approximately 60 U/L. At 20 minutes of reperfusion, CK activities were similar to those at the 10-minute time point for each group. At 30 and 40 minutes of reperfusion, CK leakage decreased in the CaCl2 group to approximately 20 U/L by 40 minutes of reperfusion, different from both control and CaCl2 plus chelerythrine groups, which both averaged approximately 55 U/L at 40 minutes of reperfusion (p < 0.05). n = 6 to 8 per group. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 778-786DOI: (10.1016/S0022-5223(96)70065-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 5 Immunohistofluorescence images of PKC translocation after CaCl2 treatment; transverse 5 μm cryosections of rat heart incubated with rabbit polyclonal antibody against αPKC. A, Control heart incubated with rabbit polyclonal antibody against αPKC demonstrates diffuse cytoplasmic staining (original magnification ×63). B, CaCl2-treated heart incubated with rabbit polyclonal antibody against αPKC demonstrates translocation of this isoform to the sarcolemma (arrows) from the cytoplasm, suggesting that exogenous CaCl2 administration activates αPKC (original magnification ×63). The Journal of Thoracic and Cardiovascular Surgery 1996 112, 778-786DOI: (10.1016/S0022-5223(96)70065-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 5 Immunohistofluorescence images of PKC translocation after CaCl2 treatment; transverse 5 μm cryosections of rat heart incubated with rabbit polyclonal antibody against αPKC. A, Control heart incubated with rabbit polyclonal antibody against αPKC demonstrates diffuse cytoplasmic staining (original magnification ×63). B, CaCl2-treated heart incubated with rabbit polyclonal antibody against αPKC demonstrates translocation of this isoform to the sarcolemma (arrows) from the cytoplasm, suggesting that exogenous CaCl2 administration activates αPKC (original magnification ×63). The Journal of Thoracic and Cardiovascular Surgery 1996 112, 778-786DOI: (10.1016/S0022-5223(96)70065-X) Copyright © 1996 Mosby, Inc. Terms and Conditions