Mw. Botsford et A. Lukas, ISCHEMIC PRECONDITIONING AND ARRHYTHMOGENESIS IN THE RABBIT HEART - EFFECTS ON EPICARDIUM VERSUS ENDOCARDIUM, Journal of Molecular and Cellular Cardiology, 30(9), 1998, pp. 1723-1733
The goals of this study were: (1) to determine if preconditioning prot
ects against arrhythmias and contractile dysfunction, and if protectio
n for these two endpoints occurs in parallel; and (2) to investigate t
he anti-arrhythmic action of preconditioning by examining its effect o
n electrical activity in epicardium nu endocardium. Mie monitored ECGs
, epicardial and endocardial monophasic action potentials (MAP), left-
ventricular developed pressure (LVDP) and end-diastolic pressure (EDP)
in isolated rabbit hearts. Hearts were subjected to a 30-min test isc
hemia and 45 min of reperfusion. Preconditioning cycles (PC) consisted
of 1-4 ischemic episodes (5 min each separated by 10 min of reperfusi
on) administered 30 min before the test protocol. The test ischemia ca
used ventricular fibrillation (VF) in 42% of non-PC hearts. One PC tot
ally suppressed VF (0%). The incidence of VF was 30% in 2 PC, 72% in 3
PC and 47% in 4 PC hearts. A large rise in EDP occurred in non-PC and
1 PC hearts, and this rise was prevented by 2, 3 or 4 PC. None of the
protocols improved post-ischemic recovery of LVDP or EDP. The test is
chemia generated a large dispersion in MAP duration between epicardium
and endocardium (39 ms). but this dispersion was markedly reduced aft
er 1 PC (14 ms). In conclusion, our results demonstrate that 1 PC comp
letely protects against ischemia-induced VF in rabbit hearts, whereas
2 or more PC are required to prevent the ischemia-induced rise in EDP.
Thus, preconditioning against arrhythmias and contractile dysfunction
does not occur in parallel. Our data also suggest that 1 PC may exert
its anti-arrhythmic effect through reduction of the substrate for ree
ntrant arrhythmias during ischemia (dispersion of repolarization) via
effects on MAP changes in endocardium. (C) 1998 Academic Press