Elias Bofilis

Preconditioning limits myocardial infarct size in hypercholesterolemic rabbits.

BACKGROUND Hypercholesterolemia predisposes to coronary artery disease and causes endothelial dysfunction; some reports suggest that endothelial derived substances are involved in ischemic preconditioning. OBJECTIVE Our aim was to examine the possibility that preconditioning maybe attenuated in a clinically relevant animal model of hypercholesterolemia with atherosclerosis. METHODS Male rabbits were fed with cholesterol enriched diet and then divided into two groups (A and B) without and with preconditioning, respectively. A second series of rabbits fed a normal diet were similarly divided into two groups (C and D) without and with preconditioning, respectively. All the animals were subjected to 30 min ischemia and 180 min reperfusion. Blood samples were collected for cholesterol assessment; arterial and heart samples were harvested at the end for histopathological examination. Infarct (I) and risk areas (R) were delineated with Zn-Cd particles and TTC staining. RESULTS Cholesterol in groups A and B was 58.3+/-8.7 mg% at baseline and 1402+/-125 mg% at 8 weeks (P<0.0001) and in groups C and D 57.5+/-5.8 mg% before the surgical procedure. I/R% was 39. 3+/-6.3% in group A, 16.7+/-3.9% in B (P<0.01), 41.4+/-7.5% in C and 10.8+/-3.3% in D (P<0.01). CONCLUSION We conclude that preconditioning is unlikely to be attenuated by hypercholesterolemia.

Short-Term Estrogen Reduces Myocardial Infarct Size in Oophororectomized Female Rabbits in a Dose-Dependent Manner

Abstract17β-estradiol, administered acutely, protects ischemic myocardium in male rabbits. In the present study we investigated the effect of short-term estrogen on myocardial infarct size in oophorectomized female rabbits. We oophorectomized 24 sexually mature New Zealand white female rabbits. Twelve animals were left untreated and 12 received oral conjugated estrogens, 0.15 mg/day, for 4 weeks. At a second stage, a third group of 12 oopherectomized female rabbits was treated with intramuscular conjugated estrogens, 1 mg/day, also for 4 weeks. All rabbits underwent 30 minutes of coronary artery occlusion and 2 hours of reperfusion while on anesthesia with IV pentobarbital. Infarct and risk area were delineated by Zn-Cd fluorescent particles and tetrazolium chloride staining. The infarct size was expressed as a percentage of the risk zone (I/R %). Data are reported on 26 animals that survived the treatment period and the experiment. Heart rate, systolic, and mean blood pressure and double product did not differ between the three groups at baseline, ischemia, and reperfusion. The infarct size of the risk zone was significantly smaller in the intramuscular group compared with both the oral and the placebo group (18.5 ± 3.5% vs. 41.3 ± 9.2% and 43 ± 8.4%, respectively, P = 0.03). Conjugated estrogens, administered intramuscularly at a high dose, protect ischemic myocardium in oophorectomized female rabbits.

Estrogen alone or combined with medroxyprogesterone but not raloxifene reduce myocardial infarct size

We investigated whether estrogen protects the ischemic myocardium in oophorectomized female rabbits fed with a cholesterol-enriched diet, whether the addition of a progestin compound attenuates the beneficial effect of estrogen and whether raloxifene also limits myocardial necrosis. We treated 32 female oophorectomized hypercholesterolemic rabbits with (a) placebo (N=8, group I), (b) conjugated estrogens alone (N=8, group II), (c) conjugated estrogens combined continuously with medroxyprogesterone acetate (N=8, group III) and (d) raloxifene (N=8, group IV) all for 4 weeks. All rabbits underwent 30 min of ischemia and 120 min of reperfusion. Both infarct size (0.38+/-0.08 and 0.45+/-0.05 in groups II and III, respectively, vs. 0.78+/-0.07 in group I, P<0.005) and infarct size/risk zone% (26.34+/-4.18 and 35.01+/-4.39 in groups II and III, respectively, vs. 52.18+/-7.84 in group I, P<0.05) were significantly smaller in the estrogen treatment groups compared to placebo. No significant difference was observed between groups II and III. There was no significant difference between groups I and IV for infarct size (0.78+/-0.07 vs. 0.69+/-0.08, respectively) or for infarct size/risk zone% (52.18+/-7.84 vs. 47.17+/-4.3). Short-term estrogen protects ischemic myocardium in hypercholesterolemic oophorectomized female rabbits; this effect is not attenuated by the addition of a progestin compound. Raloxifene, however, does not decrease infarct size compared to placebo.

Differential activation of mitogen-activated protein kinases in ischemic and nitroglycerin-induced preconditioning

Previous studies have shown that the cardioprotective effect of ischemic preconditioning (IPC) can be mimicked pharmacologically with clinically relevant agents, including nitric oxide (NO) donors. However, whether pharmacological preconditioning shares the same molecular mechanism with IPC is not fully elucidated. The present study aimed to determine the activation of mitogen-activated protein kinases (MAPKs) (ERK1/2, p38 MAPK and p46/p54 JNKs) during ischemia and at reperfusion in nitroglycerin-induced preconditioning as compared to IPC and to correlate this with the conferred cardioprotection in anesthetized rabbits. Sixty minutes of intravenous administration of nitroglycerin was capable of inducing both early and late phase preconditioning in anesthetized rabbits, as it was expressed by the reduction of infarct size. Despite the cardioprotective effect conferred by both ischemic and nitroglycerin-induced preconditioning, there was a differential phosphorylation of MAPKs between the studied groups. p38 MAPK was activated early in ischemia in both ischemic and the early nitroglycerin-induced preconditioning while JNKs were markedly increased only after IPC. Furthermore, in these groups, ERK1/2 were activated during reperfusion. A different profile was observed in the late preconditioning induced by nitroglycerin with increased p38 MAPK and ERK1/2 phosphorylation during late ischemia. No activation of JNKs was observed at any time point in this group. It seems that activation of individual MAPK subfamilies depends on the nature of preconditioning stimulus.

Enhanced Protection of Heat Shock in Myocardial Infarction: Inhibition of Detrimental Effect of Systemic Hyperthermia

Summary. We have shown that isolated blood-perfused heat-stressed hearts are protected only when the blood donor animal has not been exposed to hyperthermia. Systematic hyperthermia results in larger infarction of both isolated control and heat-stressed hearts. In this study we investigated whether indomethacin inhibits in vivo the detrimental effect of hyperthermia. Male rabbits were divided into four groups, that is A(30), B(30), C(30), and D(30), representing hearts that ultimately received 30 minutes of ischemia. In a second series, rabbits were divided into groups A(45), B(45), (C45), and D(45) representing hearts that ultimately received 45 minutes of ischemia, and in a third series were divided into groups A(HSP), B(HSP), C(HSP), and D(HSP) representing animals that were heat shocked and their hearts were used to measure heat shock proteins. All the A groups (heat shocked) were subjected to 42<8C hyperthermia, all the B groups to the same procedure but with the addition of indomethacin (heat shocked <1 indomethacin), all the C groups served as controls, and all the D groups were treated with indomethacin only (control <1 indomethacin). Twenty-four hours later, all (30) and (45) groups were subjected to ischemia, whereas hearts from all (HSP) groups were harvested for heat shock protein measurements. When the animals were exposed to 30-minute ischemia, a significant difference in the infarcted to risk zone ratio (%I/R) was observed: A(30): 33.0 <6 5.2, B(30): 16.1 <6 4.4 [conferring a 51.2% reduction in infarct size, P < 0.05], C(30): 48.9 <6 4.0, and D(30): 47.8 <6 3.8 [P < 0.001 vs. B (30) and P < 0.05 vs. A(30)]. However, the %I/R did not differ among any of the (45) groups. Heat shock proteins themselves were seen to increase in A(HSP) and B(HSP) groups. Indomethacin enhances the beneficial effect of heat shock after 30-minute ischemia in vivo, reducing the infarct size by 51.2% in comparison with heat shock.

CGMP Levels Following ANF Challenge are Markers of Subsequent Successful Reversion of Lone Atrial Fibrillation to Sinus Rhythm

The aim of the present study was to assess whether cGMP release to ANP stimulation can be a biochemical marker of subsequent successful electrical cardioversion of lone atrial fibrillation to sinus rhythm. For this purpose, we studied 13 patients with chronic, lone atrial fibrillation of less than one years duration who presented to our laboratory for electrical therapy of their arrhythmia. Prior to electrical cardioversion, peripheral venous cGMP levels were assessed at baseline and following an tntravenous challenge of 50 Ug human ANP. Venous blood samples for cGMP assessment were taken a) at baseline, b) 5 and 10 mins after the end of ANP infusion. ANOVA of repeated measures was used for statistical analysis. Eight of the study patients were successfully cardioverted to sinus rhythm, while the remaining 5 were not. Although no difference was noted between the two groups regarding the mean time of arrhythmia duration as well as left atrial and ventricular dimensions, ANP stimulation provoked significantly greater cGMP release in patients whose arrhythmia reverted to sinus rhythm, when compared with that of patients whose arrhythmia persisted (p<0.001). Therefore, cGMP levels following ANP challenge might discriminate between patients with chronic AF who are going to be successfully cardioverted and those who are not. These findings imply that the underlying atrial disease might be different in extent/nature between patients with lone AF responsive to cardioversion and those with resistant arrhythmia.