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PubMed · 3968858

Myocardial ischemia.

M Nakamura
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Abstract

As one of the cause of acute myocardial ischemia, coronary vasospasm has attracted attention increasingly in clinical cardiology. We developed animal model of coronary vasospasm associated with transient myocardial ischemia by administration of histamine or serotonin in atherosclerotic miniature swine. Early systolic dysfunction as well as subendocardial NADH production of the ischemic region occurred within 10 sec after coronary occlusion, but ST segment started to elevate around 30 sec after occlusion in the isolated rat heart. As the important determinant factors of myocardial infarct size, the preocclusive perfusion area as well as collateral flow area could be measured quantitatively by use of double isotopes autoradiograms, and the close correlation was found between the salvaged area and collateral flow area in dogs. An importance of advancement in basic cardiology and development of new research techniques have been emphasized.

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Angina PectorisAnimalsCollateral CirculationCoronary AngiographyCoronary CirculationCoronary DiseaseCoronary VasospasmElectrocardiographyMyocardial InfarctionMyocardiumOxygen ConsumptionRatsJournal ArticleResearch Support, Non-U.S. Gov't

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M Nakamura. 1985. Myocardial ischemia.. https://doi.org/10.1253/jcj.49.1

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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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