Intermittent aortic crossclamping prevents cumulative adenosine triphosphate depletion, ventricular fibrillation, and dysfunction (stunning): Is it preconditioning?

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Presentation transcript:

Intermittent aortic crossclamping prevents cumulative adenosine triphosphate depletion, ventricular fibrillation, and dysfunction (stunning): Is it preconditioning? Anwar S. Abd-Elfattah, PhD, Mai Ding, MD, Andrew S. Wechsler, MD The Journal of Thoracic and Cardiovascular Surgery Volume 110, Issue 2, Pages 328-339 (August 1995) DOI: 10.1016/S0022-5223(95)70228-8 Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Effect of sustained global ischemia on ATP metabolism and ventricular performance with and without nucleoside trapping. Effect of sustained warm ischemia (60 minutes) on ATP, adenosine inosine levels, and ventricular performance in presence and absence of EHNA/NBMPR. A, Effect of sustained ischemia on ATP. Levels of ATP were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. B, Effect of sustained ischemia on adenosine. Adenosine levels were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. C, Effect of sustained ischemia on inosine. Inosine levels were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. D, Effect of sustained ischemia on left ventricular performance. Left ventricular performance was determined before and after vehicle of EHNA/NBMPR administration to determine the effect of drugs on normal myocardial function. There were no significant differences between groups before ischemia. Significant recovery of ventricular function after 60 minutes of sustained ischemia was observed in EHNA/NBMPR-treated group, whereas recovery was severely impaired in control group (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. CPBP, Cardiopulmonary bypass; G × T, group and time; SW/EDL, stroke work/end-diastolic length. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 328-339DOI: (10.1016/S0022-5223(95)70228-8) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Effect of sustained global ischemia on ATP metabolism and ventricular performance with and without nucleoside trapping. Effect of sustained warm ischemia (60 minutes) on ATP, adenosine inosine levels, and ventricular performance in presence and absence of EHNA/NBMPR. A, Effect of sustained ischemia on ATP. Levels of ATP were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. B, Effect of sustained ischemia on adenosine. Adenosine levels were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. C, Effect of sustained ischemia on inosine. Inosine levels were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. D, Effect of sustained ischemia on left ventricular performance. Left ventricular performance was determined before and after vehicle of EHNA/NBMPR administration to determine the effect of drugs on normal myocardial function. There were no significant differences between groups before ischemia. Significant recovery of ventricular function after 60 minutes of sustained ischemia was observed in EHNA/NBMPR-treated group, whereas recovery was severely impaired in control group (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. CPBP, Cardiopulmonary bypass; G × T, group and time; SW/EDL, stroke work/end-diastolic length. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 328-339DOI: (10.1016/S0022-5223(95)70228-8) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Effect of sustained global ischemia on ATP metabolism and ventricular performance with and without nucleoside trapping. Effect of sustained warm ischemia (60 minutes) on ATP, adenosine inosine levels, and ventricular performance in presence and absence of EHNA/NBMPR. A, Effect of sustained ischemia on ATP. Levels of ATP were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. B, Effect of sustained ischemia on adenosine. Adenosine levels were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. C, Effect of sustained ischemia on inosine. Inosine levels were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. D, Effect of sustained ischemia on left ventricular performance. Left ventricular performance was determined before and after vehicle of EHNA/NBMPR administration to determine the effect of drugs on normal myocardial function. There were no significant differences between groups before ischemia. Significant recovery of ventricular function after 60 minutes of sustained ischemia was observed in EHNA/NBMPR-treated group, whereas recovery was severely impaired in control group (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. CPBP, Cardiopulmonary bypass; G × T, group and time; SW/EDL, stroke work/end-diastolic length. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 328-339DOI: (10.1016/S0022-5223(95)70228-8) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Effect of sustained global ischemia on ATP metabolism and ventricular performance with and without nucleoside trapping. Effect of sustained warm ischemia (60 minutes) on ATP, adenosine inosine levels, and ventricular performance in presence and absence of EHNA/NBMPR. A, Effect of sustained ischemia on ATP. Levels of ATP were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. B, Effect of sustained ischemia on adenosine. Adenosine levels were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. C, Effect of sustained ischemia on inosine. Inosine levels were determined before, during, and after 60 minutes of ischemia (37° C). There were statistically significant differences between groups (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. D, Effect of sustained ischemia on left ventricular performance. Left ventricular performance was determined before and after vehicle of EHNA/NBMPR administration to determine the effect of drugs on normal myocardial function. There were no significant differences between groups before ischemia. Significant recovery of ventricular function after 60 minutes of sustained ischemia was observed in EHNA/NBMPR-treated group, whereas recovery was severely impaired in control group (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. CPBP, Cardiopulmonary bypass; G × T, group and time; SW/EDL, stroke work/end-diastolic length. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 328-339DOI: (10.1016/S0022-5223(95)70228-8) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 2 Effect of intermittent ischemia on ATP with and without nucleoside trapping. Effect of intermittent global normothermic ischemia and reperfusion on myocardial ATP in presence and absence of EHNA/NBMPR is depicted. There were no significant differences between groups with respect to ATP levels as demonstrated by ANOVA (p = NS, n = 8 each group). However, at one point only there was significant increase in ATP between groups, as represented by asterisk. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 328-339DOI: (10.1016/S0022-5223(95)70228-8) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Effect of intermittent ischemia on ventricular performance with and without nucleoside trapping. Effect of intermittent global normothermic ischemia and reperfusion on left ventricular function in presence and absence of EHNA/NBMPR is depicted. There were significant differences between groups after reperfusion (p < 0.05, ANOVA, n = 8 each group). Significant differences between groups at each point are represented by asterisks. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 328-339DOI: (10.1016/S0022-5223(95)70228-8) Copyright © 1995 Mosby, Inc. Terms and Conditions