Protective effect of ischemic postconditioning on myocardial ischemia-reperfusion injury during primary coronary angioplasty
- Author:
- No author available
- Journal Title:
- China Medicine
- Issue:
- 5
- DOI:
- 10.3760/cma.j.issn.1673-4777.2012.05.006
- Key Word:
- 心肌梗死;血管成形术,经皮,经腔;心肌再灌注;缺血后适应;Myocardial infarction;Angioplasty,transluminal,percutaneous,coronary;Myocardial reperfusion;Ischemic postconditioning
Abstract： Objective To explore if postconditioning may protect the human heart during coronary angioplasty treating acute myocardial infarction.Methods A total of 140 patients undergoing coronary angioplasty for acute myocardial infarction were randomly assigned into postconditionong group and control group.The patients in postconditioning group were performed within 1 minute of reflow by 4 episodes of 1-minute inflation and 1-minute deflation of the angioplasty balloon.The creatine kinase peaks were measured and thormbolysis in myocardial infarction (TIMI) flow and blush grade were analyzed for all patients after the procedure.Ejection fraction was measured in one and six months after the procedure by echocardiography.Results The creatine kinase peak was significantly lower than tha in control group[ (1634 ±522)U/L vs (2476 ±619) U/L,P ＜0.05].TIMI flow and blush grade were significantly higher than those in control group [ 5.7％ (4/70) vs 20.0％ ( 14/70),P ＜ 0.05 ].In 1 and 6 months ejection fraction was improved greatly in the postconditioning group compared with control group [ (54.0 ±14.0)％ vs (50.0±9.0)％,(56.0±12.0)％ vs (52.0±11.0)％,P＜0.05)].Conclusion Postconditioning improves the infarcted related artery flow and blood flow in the cardiac tissue,reduces infarct size reduction and improves functional recovery.
- [1]杨大成,李勇,侯彬.非创伤性双上肢缺血后适应对急性心肌梗死溶栓再通患者心律失常的影响[J].2006,(28).
- [2]李维琼,马依彤,杨毅宁.心肌缺血后适应[J].2010,(3).
- [3]王印华,刘晓堃,李莉,等.缺血后适应在急性心肌梗死再灌注损伤中的保护作用[J].2008,(11).
- [4]Patrick, Staat,Gilles, Rioufol,Christophe, Piot,etc.Postconditioning the human heart.[J].2005,112(14).
- [5]Hajime, Kin,Zhi-Qing, Zhao,He-Ying, Sun,etc.Postconditioning attenuates myocardial ischemia-reperfusion injury by inhibiting events in the early minutes of reperfusion.[J].2004,62(1).
- [6]Fang J,Wu L,Chen L.Postconditioning attenuates cardiocyte ultrastructure injury and apoptosis by blocking mitochondrial permeability transition in rats.[J].2008,63(3).
- [7]Pravdic D,Bienengraeber M,Auchampach JA,etc.Isoflurane postconditioning protects against reperfusion injury by preventing mitochondrial permeability transition by an endothelial nitric oxide synthase-dependent mechanism.[J].2010,112(1).
- [8]Norfleet EA,Jang Y,Mueller RA,etc.Postconditioning prevents reperfusion injury by activating delta-opioid receptors.[J].2008,108(2).
- [9]June Hong, Kim,Kook Jin, Chun,Yong Hyun, Park,etc.Morphine-induced postconditioning modulates mitochondrial permeability transition pore opening via delta-1 opioid receptors activation in isolated rat hearts.[J].2011,61(1).
- [10]Yikui Tian,Wenjuan Zhang,Dachuan Xia,etc.Postconditioning inhibits myocardial apoptosis during prolonged reperfusion via a JAK2-STAT3-Bcl-2 pathway[J].2011,18(1).
- [11]Saunamaki K,Holmvang L,Helqvist S,etc.Cardioprotective effects of ischemic postconditioning in patients treated with primary percutaneous coronary intervention, evaluated by magnetic resonance.[J].2010,3(1).
- [12]Rossi R,Aupetit JF,Andre-Fouet X,etc.Long-term benefit of postconditioning.[J].2008,117(8).
- [13]Corvera JS,Vinten-Johansen J,Kerendi F,etc.Inhibition of myocardial injury by ischemic postconditioning during reperfusion: comparison with ischemic preconditioning.[J].2003,285(2).