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PubMed · 14045346

SOME OBSERVATIONS ON MYOCARDIAL REVASCULARIZATION.

J L WELLINGTON·R B LYNN
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Abstract

Since 1929 various surgical procedures have been devised to revascularize the ischemic heart to provide it with blood from extracoronary sources. A comparative study has been carried out in 80 mongrel dogs over a two-year period to evaluate the relative merits of cardio-omentopexy, left atrial pulmonary artery anastomosis and the Ivalon sponge operation. The Ivalon sponge procedure proved to be most effective in relieving artificially produced myocardial ischemia. The procedure has subsequently been carried out in two patients with crippling angina pectoris, and a complete relief of symptoms has been achieved in both.

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Angina PectorisAnimalsCardiac Surgical ProceduresCoronary Artery DiseaseCoronary DiseaseDogsHumansMyocardial IschemiaMyocardial RevascularizationResearchThoracic SurgeryCORONARY DISEASEDOGSEXPERIMENTAL LAB STUDYHEART SURGERYJournal Article

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J L WELLINGTON, R B LYNN. 1963-09-14. SOME OBSERVATIONS ON MYOCARDIAL REVASCULARIZATION.. https://pubmed.ncbi.nlm.nih.gov/14045346/

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PubMed2007

Effect of a hypoglycemic agent on ischemic preconditioning in patients with type 2 diabetes and stable angina pectoris.

OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

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