CARDIOPROTECTION BY ACE-INHIBITORS IN MYOCARDIAL ISCHAEMIA REPERFUSION - THE IMPORTANCE OF BRADYKININ/

Myocardial ischaemia, when severe and sustained for more than 40 minut es, results in irreversible damage, i.e. myocardial infarction. Howeve r, with early reperfusion, damage is reversible. Complete recovery of contractile function requires some time, despite fully or almost fully restored blood flow. This phenomenon has been termed myocardial stunn ing. There is experimental evidence showing that angiotensin convertin g enzyme (ACE) inhibitors limit the development of infarct size, reduc e the incidence of ischaemic and reperfusion arrhythmias, and enhance the recovery of contractile function of stunned myocardium. These card ioprotective effects of ACE inhibitors are mediated by an attenuated d egradation of bradykinin.