ischaemic preconditioning of the human heart. - Leicester Research ...

myocardium. Several investigators [22,59] including work from this laboratory 11971
have observed that norepinephrine or phenylephrine triggered PC and that the
protection was prevented by adrenergic blockade. Similarly, Thornton et al
13041 have
demonstrated that tyramine, an agent that causes the release of endogenous
catecholamines, reduced infarct size in rabbits when given prior to a sustained period
of ischaernia. Certainly, more studies are required to elucidate the mechanism of
card ioprotection effected by CPB.
Clinical Implicagions
Cardiac surgical practice is rapidly evolving and an increasing number of surgeons are
adopting surgery on the beating heart, without the use of CPB, in their practice
Cardioplegic solutions cannot be used in this situation and the demonstration that
interventions such as ischaemic preconditioning are protective can have important
clinical implications. It should be however, recognised that the clinical application of
ischaemic preconditioning may still be difficult and cumbersome, particularly it'
minimally invasive approaches are used. Because of this, the pharmacological
manipulation of the signal transduction cascade of preconditioning may appear a more
attractive. In this regard, several investigators including ourselves, are endeavouring
to fully elucidate the mechanism of preconditioning in man to make this intervention
a clinical reality.
CPB is known to induce a systemic Inflammatory reaction that is believed to be
responsible fior increased morbidity. The present studies have demonstrated that CPI1
can also trigger preconditioning and be cardioprotective
Is's