By Robert M. Mentzer Jr., Masafumi Kitakaze, James M. Downey, Masatsugu Hori
The colossal progress within the variety of articles on adenosine cardioprotection lately has been similar largely to the speculation that adenosine performs a task in ischemic preconditioning. Ischemic preconditioning is the phenomenon within which a quick interval of ischemia (and reperfusion) sooner than a extra lengthy occlusion reduces myocardial infarct measurement. this kind of myocardial safety has bought a lot curiosity simply because ischemic preconditioning has been proven to be the main effective technique of lowering infarct dimension in all animal versions up to now demonstrated.
in the final six years, the primary concentration of adenosine cardioprotection learn has headquartered at the position of adenosine receptors. it's presently concept that adenosine protects the ischemic middle essentially through the activation of adenosine A1 receptors situated at the cardiac myocytes.
Adenosine is used clinically for terminating supraventricular tachycardia, and as a diagnostic software in coronary imaging, and has been used postoperatively for blood strain keep watch over after center surgical procedure. There also are contemporary experiences that adenosine could be adequately tolerated and a almost certainly invaluable additive to cardioplegic options in the course of open middle surgical procedure in people. there's even facts that ischemic preconditioning may perhaps take place in people below a variety of medical events.
This quantity includes chapters from members to the 1st 3 symposia on `Adenosine, Cardioprotection, and its medical Application'. All facets of adenosine cardioprotection and ischemic preconditioning, together with power mechanisms and medical purposes, are mentioned by way of specialists in those parts. The reader will locate this ebook to be a superb resource of knowledge on those themes, in addition to a consultant to destiny experiments.
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Additional resources for Adenosine, Cardioprotection and Its Clinical Application
It is of note that protective effect of ischemic preconditioning against infarct persists no longer than two hrs, and there must be some "memory" mechanism in the signal transduction. More recently, a delayed protective response ("second window of protection") has been observed 24 hrs after periods of brief ischemia in dogs and rabbits. In the dog hearts this delayed response of protection is associated with an induction of an antioxidant enzyme, MnSOD, whereas in rabbit hearts it is reported that expression ofHSPs may contribute to the delayed effect of protection.
In aerobic condition, myocardium depends on oxygen delivered by the arterial blood to support high-energy phosphate production. When the blood supply is insufficient to meet the requirements for mitochondrial respiration, high- 19 II. CARDIOPROTECTION AND MECHANISMS OF ISCHEMIC AND REPERFUSION INJURY energy phosphate production by anaerobic glycolysis is not enough, and accordingly, the contractile function is reduced and lactate is accumulated. In the early period of ischemia, cellular dysfunction is reversible, but eventually damage occurs to some critical subcellular organelles.
4. 5. Bolli R. The early and late phases of preconditioning against myocardial stunning and the essential role of oxyradicals in the late phase: an overview. Basic Res Cardiol 1996;91 :57-63. Sun J-Z, Tang X-L, Knowlton AA et al. Late preconditioning against myocardial stunning: An endogenous protective mechanism that confers resistance to postischemic dysfunction 24 hours after brief ischemia in conscious pigs. J Clin Invest 1995; 95:388-403 . Tang X-L, Qiu Y, Park SoW, et al. Time course oflate preconditioning against myocardial stunning in conscious pigs.
Adenosine, Cardioprotection and Its Clinical Application by Robert M. Mentzer Jr., Masafumi Kitakaze, James M. Downey, Masatsugu Hori