Comparative Analysis of Early and Delayed Cardioprotective and Antiarrhythmic Efficacy of Hypoxic Preconditioning

Maslov, L. N.; Lishmanov, Yu. B.; Sementsov, A. S.; Портниченко, А. Г.; Podoksenov, Yu. K.; Khaliulin, Igor

doi:10.1007/s10517-014-2439-7

Cited by 11 publications

(11 citation statements)

References 9 publications

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“…ceed 6% in contrast to the comparison group. This suggests that HP increases the tolerance of the myocardium to the damaging effects of "ischemiareperfusion", increases the resistance of vital organs to ischemic and reperfusion stress, and, consequently, reduces the number and severity of postoperative complications [8,15]. Our results, indicating the cardioprotective effect of HP in patients who underwent CABG with EC, are consistent with the data of other researchers [8,16,17].…”

Section: Discussionsupporting

confidence: 91%

“…The nature of cardiac recovery and the degree of inotropic support are among the main indicators of adequate myocardial protection after global ischemia [21]. Based on the results of hemodynamic assessment, it can be argued that HP prevents necrosis of cardiomyocytes and improves cardiac contractile function during the reperfusion period of long-term ischemia and reperfusion [15].…”

Section: Discussionmentioning

confidence: 99%

“…Both early and delayed variants of HP are associated with infarct-limiting effect. At the same time, a more pronounced increase in heart tolerance to the action of IR can be achieved with early HP [15].…”

mentioning

confidence: 90%

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Radionuclide Assessment of Cardioprotective Efficiency of Hypoxic Preconditioning

Vesnina¹,

Кривоногов²,

Arsenjeva³

et al. 2019

Rejr

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Using radiocardiopulmonography to evaluate the cardioprotective effectiveness of hypoxic preconditioning (HP) during myocardial revascularization under extracorporeal circulation (EC). Material and methods. A total of 63 patients (mean age of 52.8 ± 1.4 years) who underwent coronary bypass surgery (CABG) under EC condition were examined. All patients had chronic heart failure of NYHA class I-III. Patients were randomized into 2 groups: study group comprised 33 patients who received HP during CABG; comparison group comprised 30 patients. Patients of both groups were comparable in regard to clinical and intraoperative data. The preconditioning was performed as a single-cycle 10-minute hypoxemia session followed by 5-min period of reoxygenation before global ischemia. Radiocardiopulmonography with 99mТс-pertechnetate was performed before and 6-8 days after surgery with the calculation of the parameters of cardiopulmonary hemodynamics. Results. In the examined patients before CABG we observed a decrease in the mean values of the cardiac output (MO), cardiac index (HI), stroke index (SI) and circulation efficiency ratio (CER) as a consequence of a decrease in the pumping function of the heart, as well as an increase in the pulmonary circulation time (TPUL) due to both arterial and venous components, which indicated the development of pulmonary hypertension and venous congestion of the left heart. In the postoperative period, positive statistically significant change in most parameters of cardiopulmonary hemodynamics occurred as a result of successful myocardial revascularization in patients of both groups: the values of MO, SI, CER increased, and halfemptying period of the left and right ventricles and the value of TPUL decreased. It should be noted that the positive dynamics of these parameters was statistically more pronounced in the patients of the study group. Also, in contrast to the comparison group, the arterial component of circulation in the lungs and the half-emptying period of the right ventricle significantly decreased in patients with HP, which indicated a reduction in pulmonary hypertension and a regression of right ventricular failure. On day 2 after surgery blood levels of creatine-kinase (CK) and CK-MB were increased in patients of both groups. The mean level of CK-MB was significantly higher (by 33%) in the comparison group relative to the study group (p = 0.046825), and the relative index (RI = CK-MB/CK x 100) in the study group did not exceed 6%. This data suggested that HP increased the tolerance of the heart to the effects of "ischemia-reperfusion". Conclusion. Hypoxic preconditioning exerted cardioprotective activity in patients undergoing open-heart surgery under EC.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Radionuclide Assessment of Cardioprotective Efficiency of Hypoxic Preconditioning

Vesnina¹,

Кривоногов²,

Arsenjeva³

et al. 2019

Rejr

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“…It has been firmly established that the diminished oxygen delivery to the tissues in response to hypoxia is countered by a combination of the increased regional blood flow and the enhanced functional capillary density in the microcirculation [ 16 ]. A recent study has pointed out an important role of hypoxia signaling in the protection from organ injury, including myocardial infarction, acute respiratory distress syndrome, and acute kidney or gut injury [ 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of Hypoxic and Hyperoxic Preconditioning on Endothelial Function in a Model of Myocardial Ischemia-Reperfusion Injury with Cardiopulmonary Bypass (Experimental Study)

Mandel

Podoksenov

Suhodolo

et al. 2020

IJMS

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The aim of the experiment was to evaluate the effect of preconditioning based on changes in inspiratory oxygen fraction on endothelial function in the model of ischemia-reperfusion injury of the myocardium in the condition of cardiopulmonary bypass. The prospective randomized study included 32 rabbits divided into four groups: hypoxic preconditioning, hyperoxic preconditioning, hypoxic-hyperoxic preconditioning, and control group. All animals were anesthetized and mechanically ventilated. We provided preconditioning, then started cardiopulmonary bypass, followed by induced acute myocardial infarction (ischemia 45 min, reperfusion 120 min). We investigated endothelin-1, nitric oxide metabolites, asymmetric dimethylarginine during cardiopulmonary bypass: before ischemia, after ischemia, and after reperfusion. We performed light microscopy of myocardium, kidney, lungs, and gut mucosa. The endothelin-1 level was much higher in the control group than in all preconditioning groups after ischemia. The endothelin-1 even further increased after reperfusion. The total concentration of nitric oxide metabolites was significantly higher after all types of preconditioning compared with the control group. The light microscopy of the myocardium and other organs revealed a diminished damage extent in the hypoxic-hyperoxic preconditioning group as compared to the control group. Hypoxic-hyperoxic preconditioning helps to maintain the balance of nitric oxide metabolites, reduces endothelin-1 hyperproduction, and enforces organ protection.

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“…Фаза 3 -первые 45 мин реперфузии. В фазу 1 нарушения ритма возника-ют по механизму reentry, в фазу ишемии 2 и при репер-фузии -как по механизму reentry, так и при участии эктопического автоматизма [2].…”

Section: методыunclassified

Myocardium protection against ischemic-reperfusion injury by nitric oxide supplied to the extracorporeal circulation line during cardiopulmonary bypass (experimental study)

Каменщиков¹,

Mandel²,

Подоксенов³

et al. 2017

PKiK

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Aim. The study was designed to assess the efficiency of exogenous nitric oxide supply to the extracorporeal circulation line for myocardial protection against ischemic-reperfusion injury in acute myocardial infarction simulation during cardiopulmonary bypass (CPB) in the experiment. Methods. Acute ischemia was simulated in rabbits (n = 20) with subsequent myocardial reperfusion. All animals were anesthetized and mechanically ventilated through a nasotracheal tube. The experiment included occlusion of the left coronary artery by its clamping with a ligature for 45 min with subsequent reperfusion for 120 min during CPB. All animals were divided into 2 equal groups: 10 rabbits received nitric oxide supply to the extracorporeal circulation line in a dose of 40 ppm throughout the entire CPB period (the main group); 10 rabbits made up the control group. The ratio of the infarction area to the risk area was determined, and the quantity and nature of ventricular arrhythmias were accessed. Results. It was established that nitric oxide supply through the extracorporeal circulation line during CPB had a pronounced infarct-limiting effect, the infarct area to the risk area ratio decreased by 15% as compared to the control group, р = 0.0002. There was also a significant antiarrhythmic effect. A lesser quantity of polytopic and polymorphic ventricular extrasystoles were observed in the main group during periods of ischemia and reperfusion (p = 0.003 and p = 0.012). A statistically significant decrease in the venoarterial gradient of the partial pressure of carbon dioxide in the main group was associated with an increase in the urine flow rate amounting to 1.4 [1.3; 1.5] ml/kg/h in the main group and 1.15 [1; 1.3] ml/kg/h in the control group, p = 0.013. Conclusion. The data obtained during the experiment demonstrate the presence of cardioprotective properties of nitric oxide delivered to the extracorporeal circulation line when simulating myocardial ischemic-reperfusion injury. These properties manifest themselves as a 15% decrease of the infarction zone-risk area ratio, a fewer number of arrhythmias and improvement of tissue perfusion during CPB. Intraoperative myocardial protection by nitric oxide in patients operated with CPB should be the object of further clinical research.Received 19 June 2017. Revised 9 October 2017. Accepted 15 October 2017.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions: All the authors comply with 4 ICMJE authorship criteria and contributed equally at every stage of the study.Acknowledgement: The authors express their gratitude to Ekaterina S. Tokareva and Aleksandra A. Nenakhova for support in preparation of the article.

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Comparative Analysis of Early and Delayed Cardioprotective and Antiarrhythmic Efficacy of Hypoxic Preconditioning

Cited by 11 publications

References 9 publications

Radionuclide Assessment of Cardioprotective Efficiency of Hypoxic Preconditioning

Radionuclide Assessment of Cardioprotective Efficiency of Hypoxic Preconditioning

Influence of Hypoxic and Hyperoxic Preconditioning on Endothelial Function in a Model of Myocardial Ischemia-Reperfusion Injury with Cardiopulmonary Bypass (Experimental Study)

Myocardium protection against ischemic-reperfusion injury by nitric oxide supplied to the extracorporeal circulation line during cardiopulmonary bypass (experimental study)

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