The phenomenon ofintermittent myocardial ischemia and myocardial reserve inmyocardial infarction survivors


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Abstract

Aim. To study coronary and myocardial reserves in myocardial infarction survivors (MIS) with consideration of development of intermittent ischemia during transesophageal pacing (ТЕР).
Material and methods. 320 MIS were examined 1.5-2 months after myocardial infarction onset. 30
healthy male volunteers served control. Stepwise overdrive ТЕР was made in all the examinees with
parallel estimation of central hemodynamics by tetrapolar chest rheography with assessment of systolic
and diastolic parameters.
Results. In the course of ТЕР, 39.4% MIS developed intermittent ischemia (II) at frequencies HOMO imp/min. II presented as a significantly depressed ST segment on ECG. There was a simultaneous
lengthening (1.4-fold) of diastole and a fall (1.5-fold) of end-diastolic pressure in the left ventricle
(EDP). At frequencies 140-160 imp/min the length of the diastole shortened while EDP rose.
Conclusion. The II phenomenon demonstrates a key role of coronary reserve. Changes in coronary
and myocardial reserves during ТЕР in II development are interrelated. They may represent unknown
adaptive mechanisms of the myocardium protecting against unfavourable outcomes of ischemic episodes.

About the authors

V S Volkov

A P foanov

I A Elgardt

References

  1. Murray С. Е., Jennings R. В., Reimer К. A. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation 1986; 74: 1124-1136.
  2. Sakata K., Kashiro S., Hirata S. et al. Prognostic value of Doppler transmitral flow velocity patterns in acute myocardial infarction. Am. J. Cardiol. 1997; 79: 1165-1169.
  3. Schlaifer J. D., Mancini. G. В., O'Neil B. J. et al. Influence of smoking, status on ACE inhibition - related improvement in coronary endothelial function. Eur. Heart J. 1997; 18 (suppl. 15): 223.
  4. Richard V., Kaeffer N., Thuillez C. Delayed protection on the ischemic heartfrom pathophysiology to therapeutic application. Fundam. Clin. Pharmacol. 1996. 10: 409-415.
  5. Lawson C. S. Preconditioning in man: progress and prospects.J. Mol. Cell. Cardiol. 1995; 27: 961-967.
  6. Denys B. S., Lee J., Reddy P. S. et al. Is the adaptation to ischemia during PTCA? Eur. Heart. J. 1992; 13: 246.
  7. Шабалин Ф. В,, Никитин Ю. П. Защита кардиомиоцита. Современное состояние и перспективы. Кардиология 1999; 3: 4-10.
  8. Голиков А. П., Овчинников В. П., Белозеров Г. Е., Скороходов С. И. Варианты течения стресс-теста со стимуляцией предсердий в сопоставлении с ангиографической картиной коронарных артерий. Там же 1996; 12: 18-21.
  9. Marakami Т., Mizuno S., Kaku В. Clinical morbidities in subject with Doppler-evaluated endothelial dysfunction of coronary artery J. Am. Coll. Cardiol. 1998; 31 (Suppl.): 418A.
  10. Jenkins D. P., Steare S. E., Yellon D. M. Preconditioning the human myocardium. Recent advances and aspirations for de velopment of a new means of cardioprotection in clinical prac- tical. Cardiovasc. Drugs Ther. 1995; 9: 739-747.
  11. Козлов С. Г., Миронова И. Ю., Лякишев А. А. и др. Значение чреспищеводной электрокардиостимуляции предсердий в диагностике ишемической болезни сердца. Тер. арх. 1991; 1: 108-111.
  12. Куимов А. Д., Хомякова Л. И. Определение коронарного и миокардиального резервов у больных инфарктом миокарда с помощью чреспищеводной электростимуляции сердца. Кардиология 1995; 3: 20-23.
  13. Cave А. С. Preconditioning induced protection against postischemic contractile dysfunction: characteristics and mechanisms. J. Mol. Cell. Cardiol. 1995; 27: 969-979.
  14. Okazaki Y., Kazuhisa K., Sato J. J. et al. Attentuation of increased regional myocardial oxygen consumption during exercise as a major cause of warm-up phenomen, J. Am. Coll. Cardiol. 1993; 21: 1597-1604.
  15. Kolocassides K. G., Seymour A. M., Galinunes M. et al. Paradoxical effect of ischemic preconditiong on ischemic contractile? NMR studies of metabolism and intracellular pH of the rat heart. J. Mol. Cell. Cardiol. 1996; 28: 1045-1057.

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