Treadmill exercise test with dual isotope scintigraphy documents the second window of preconditioning in humans

Iliodromitis, Efstathios K.; Koutelou, Maria; Paraskevaidis, Ioannis; Theodorakos, Athanasios; Farmakis, Dimitrios; Tsoutsanis, John; Kremastinos, Dimitrios Th.

doi:10.1016/j.atherosclerosis.2007.10.036

Cited by 9 publications

(7 citation statements)

References 31 publications

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“…Time to 1 millimeter ST segment depression during sequential stress tests. Twenty-two studies were included in the FWOP analysis 1,4,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] (Table 1). The difference between the first and second stress test for 1 mm STD, as estimated by the meta-analysis, was 91s (95% CI: 75-108), p < 0.001 (Figure 2(a)).…”

Section: Results Of Meta-analysismentioning

confidence: 99%

“…Maximal ST segment depression during sequential stress tests. Seventeen studies assessed maximal STD for the FWOP 1,11,12,14,18,19,21,22,25,29,[33][34][35][36][37][38][39] (Table 1). The difference between the first and second stress test for maximal STP was À0.38 mm (95% CI: À0.66 to À0.10), p < 0.01 (Figure 2(b)) and the test for heterogeneity was nonsignificant, Q (df ¼ 21) ¼ 3.2, p ¼ 1.000.…”

Section: Results Of Meta-analysismentioning

confidence: 99%

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Exercise-induced ischemic preconditioning detected by sequential exercise stress tests: A meta-analysis

Lalonde

Poirier

Sylvestre

et al. 2013

Eur J Prev Cardiolog

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Exercise-induced ischemic preconditioning (IPC) can be assessed with the second exercise stress test during sequential testing. Exercise-induced IPC is defined as the time to 1 mm ST segment depression (STD), the rate-pressure product (RPP) at 1 mm STD, the maximal ST depression and the rate-pressure product at peak exercise. The purpose of this meta-analysis is to validate the parameters used to assess exercise-induced IPC in the scientific community. A literature search was performed using electronic database. The main key words were limited to human studies, which were (a) ischemic preconditioning, (b) warm-up phenomenon, and (c) exercise. Meta-analyses were performed on the study-specific mean difference between the clinical measures obtained in the two consecutive stress tests (second minus first test score). Random effect models were fitted with inverse variance weighting to provide greater weight to studies with larger sample size and more precise estimates. The search resulted in 309 articles of which 34 were included after revision (1053 patients). Results are: (a) time to 1 mm ST segment depression increased by 91 s (95% confidence interval (CI): 75-108), p < 0.001; (b) peak ST depression decreased by -0.38 mm (95% CI: -0.66 to -0.10), p < 0.01; and (c) rate-pressure product at 1 mm STD increased by 1.80 × 10(3)mmHg (95% CI: 1.0-2.0), p < 0.001. This is the first meta-analysis to set clinical parameters to assess the benefit of exercise-induced ischemic preconditioning in sequential stress testing. The results of this first meta-analysis on the sequential stress test confirm what is presented in the literature by independent studies on exercise-induced ischemic preconditioning. From now on, the results could be used in further research to set standardized parameters to assess the phenomenon.

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Section: Results Of Meta-analysismentioning

confidence: 99%

Section: Results Of Meta-analysismentioning

confidence: 99%

Exercise-induced ischemic preconditioning detected by sequential exercise stress tests: A meta-analysis

Lalonde

Poirier

Sylvestre

et al. 2013

Eur J Prev Cardiolog

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“…These uncontrollable variables may explain the discrepancies that appear in the literature regarding the benefit of pre-infarction angina. Consequently, the benefit of the SWOP is more easily demonstrated in interventional studies that use exercise treadmill tests, isotope scintigraphy or coronary angioplasty to cause and document myocardial ischaemia [ 14 , 121 , 143 , 190 ].…”

Section: Second Window Of Protectionmentioning

confidence: 99%

Ischaemic conditioning and targeting reperfusion injury: a 30 year voyage of discovery

Barrabés²,

et al. 2016

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To commemorate the auspicious occasion of the 30th anniversary of IPC, leading pioneers in the field of cardioprotection gathered in Barcelona in May 2016 to review and discuss the history of IPC, its evolution to IPost and RIC, myocardial reperfusion injury as a therapeutic target, and future targets and strategies for cardioprotection. This article provides an overview of the major topics discussed at this special meeting and underscores the huge importance and impact, the discovery of IPC has made in the field of cardiovascular research.

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“…In addition, the existence and the effectiveness of the second window of protection have been confirmed with objective control methods in man. In particular, the existence and the effectiveness of delayed preconditioning have been shown with an exercise test at day one and a new exercise test or coronary angioplasty 24 h later [24]. …”

Section: Main Characteristics Of Conditioningmentioning

confidence: 99%

Ischemic and Postischemic Conditioning of the Myocardium in Clinical Practice: Challenges, Expectations and Obstacles

et al. 2014

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Conditioning refers to endogenous mechanisms rendering the myocardium more tolerant against reperfusion injury. Application of brief ischemia-reperfusion cycles prior to the index ischemia has a beneficial effect and limits the infarct size. This is called preconditioning and is mainly mediated by activation of adenosine, bradykinin, opioid and other receptors, with subsequent activation of intracellular mediators leading to mitochondrial protection. A clinical equivalent of preconditioning is preinfarction angina. Benefits for the ischemic and reperfused myocardium are also provided by repetitive short-lived cycles of ischemia-reperfusion applied after the index ischemia. This is termed postconditioning, shares a common pathway with preconditioning, and is more useful and relevant in clinical practice. Finally, benefits are also derived from remote conditioning, i.e. ischemia applied in a remote vascular territory parallel with or immediately after the index myocardial ischemia. Several pharmacological interventions may interfere with these mechanisms leading to enhanced protection of the myocardium and limitation of the infarct size. Despite the huge interest and the great body of evidence that verify the effectiveness of conditioning, clinical application has remained limited due to controversies over the appropriate intervention protocol, but also interference of medication, comorbidities and other factors that may enhance or blur the protective effect.

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Treadmill exercise test with dual isotope scintigraphy documents the second window of preconditioning in humans

Cited by 9 publications

References 31 publications

Exercise-induced ischemic preconditioning detected by sequential exercise stress tests: A meta-analysis

Exercise-induced ischemic preconditioning detected by sequential exercise stress tests: A meta-analysis

Ischaemic conditioning and targeting reperfusion injury: a 30 year voyage of discovery

Ischemic and Postischemic Conditioning of the Myocardium in Clinical Practice: Challenges, Expectations and Obstacles

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