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Diez ER, Sánchez JA, Prado NJ, Ponce Zumino AZ, García-Dorado D, Miatello RM, Rodríguez-Sinovas A. Ischemic Postconditioning Reduces Reperfusion Arrhythmias by Adenosine Receptors and Protein Kinase C Activation but Is Independent of K ATP Channels or Connexin 43. Int J Mol Sci 2019; 20:E5927. [PMID: 31775376 PMCID: PMC6928819 DOI: 10.3390/ijms20235927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/20/2019] [Accepted: 11/22/2019] [Indexed: 12/18/2022] Open
Abstract
Ischemic postconditioning (IPoC) reduces reperfusion arrhythmias but the antiarrhythmic mechanisms remain unknown. The aim of this study was to analyze IPoC electrophysiological effects and the role played by adenosine A1, A2A and A3 receptors, protein kinase C, ATP-dependent potassium (KATP) channels, and connexin 43. IPoC reduced reperfusion arrhythmias (mainly sustained ventricular fibrillation) in isolated rat hearts, an effect associated with a transient delay in epicardial electrical activation, and with action potential shortening. Electrical impedance measurements and Lucifer-Yellow diffusion assays agreed with such activation delay. However, this delay persisted during IPoC in isolated mouse hearts in which connexin 43 was replaced by connexin 32 and in mice with conditional deletion of connexin 43. Adenosine A1, A2A and A3 receptor blockade antagonized the antiarrhythmic effect of IPoC and the associated action potential shortening, whereas exogenous adenosine reduced reperfusion arrhythmias and shortened action potential duration. Protein kinase C inhibition by chelerythrine abolished the protective effect of IPoC but did not modify the effects on action potential duration. On the other hand, glibenclamide, a KATP inhibitor, antagonized the action potential shortening but did not interfere with the antiarrhythmic effect. The antiarrhythmic mechanisms of IPoC involve adenosine receptor activation and are associated with action potential shortening. However, this action potential shortening is not essential for protection, as it persisted during protein kinase C inhibition, a maneuver that abolished IPoC protection. Furthermore, glibenclamide induced the opposite effects. In addition, IPoC delays electrical activation and electrical impedance recovery during reperfusion, but these effects are independent of connexin 43.
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Affiliation(s)
- Emiliano Raúl Diez
- Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza 5500, Argentina; (E.R.D.); (N.J.P.); (A.Z.P.Z.); (R.M.M.)
- Institute of Medical and Experimental Biology of Cuyo, CONICET, Mendoza 5500, Argentina
| | - Jose Antonio Sánchez
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d’Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, Departament de Medicina, Pg. Vall d’Hebron 119-129, 08035 Barcelona, Spain; (J.A.S.); (D.G.-D.)
- Centro de Investigación Biomédica en Red sobre Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Natalia Jorgelina Prado
- Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza 5500, Argentina; (E.R.D.); (N.J.P.); (A.Z.P.Z.); (R.M.M.)
- Institute of Medical and Experimental Biology of Cuyo, CONICET, Mendoza 5500, Argentina
| | - Amira Zulma Ponce Zumino
- Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza 5500, Argentina; (E.R.D.); (N.J.P.); (A.Z.P.Z.); (R.M.M.)
- Institute of Medical and Experimental Biology of Cuyo, CONICET, Mendoza 5500, Argentina
| | - David García-Dorado
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d’Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, Departament de Medicina, Pg. Vall d’Hebron 119-129, 08035 Barcelona, Spain; (J.A.S.); (D.G.-D.)
- Centro de Investigación Biomédica en Red sobre Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Roberto Miguel Miatello
- Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza 5500, Argentina; (E.R.D.); (N.J.P.); (A.Z.P.Z.); (R.M.M.)
- Institute of Medical and Experimental Biology of Cuyo, CONICET, Mendoza 5500, Argentina
| | - Antonio Rodríguez-Sinovas
- Cardiovascular Diseases Research Group, Department of Cardiology, Vall d’Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona, Departament de Medicina, Pg. Vall d’Hebron 119-129, 08035 Barcelona, Spain; (J.A.S.); (D.G.-D.)
- Centro de Investigación Biomédica en Red sobre Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
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Effect of Ischemic Preconditioning and Postconditioning on Exosome-Rich Fraction microRNA Levels, in Relation with Electrophysiological Parameters and Ventricular Arrhythmia in Experimental Closed-Chest Reperfused Myocardial Infarction. Int J Mol Sci 2019; 20:ijms20092140. [PMID: 31052231 PMCID: PMC6540096 DOI: 10.3390/ijms20092140] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/24/2019] [Accepted: 04/28/2019] [Indexed: 12/11/2022] Open
Abstract
We investigated the antiarrhythmic effects of ischemic preconditioning (IPC) and postconditioning (PostC) by intracardiac electrocardiogram (ECG) and measured circulating microRNAs (miRs) that are related to cardiac conduction. Domestic pigs underwent 90-min. percutaneous occlusion of the mid left anterior coronary artery, followed by reperfusion. The animals were divided into three groups: acute myocardial infarction (AMI, n = 7), ischemic preconditioning-acute myocardial infarction (IPC-AMI) (n = 9), or AMI-PostC (n = 5). IPC was induced by three 5-min. episodes of repetitive ischemia/reperfusion cycles (rI/R) before AMI. PostC was induced by six 30-s rI/R immediately after induction of reperfusion 90 min after occlusion. Before the angiographic procedure, a NOGA endocardial mapping catheter was placed again the distal anterior ventricular endocardium to record the intracardiac electrogram (R-amplitude, ST-Elevation, ST-area under the curve (AUC), QRS width, and corrected QT time (QTc)) during the entire procedure. An arrhythmia score was calculated. Cardiac MRI was performed after one-month. IPC led to significantly lower ST-elevation, heart rate, and arrhythmia score during ischemia. PostC induced a rapid recovery of R-amplitude, decrease in QTc, and lower arrhythmia score during reperfusion. Slightly higher levels of miR-26 and miR-133 were observed in AMI compared to groups IPC-AMI and AMI-PostC. Significantly lower levels of miR-1, miR-208, and miR-328 were measured in the AMI-PostC group as compared to animals in group AMI and IPC-AMI. The arrhythmia score was not significantly associated with miRNA plasma levels. Cardiac MRI showed significantly smaller infarct size in the IPC-AMI group when compared to the AMI and AMI-PostC groups. Thus, IPC led to better left ventricular ejection fraction at one-month and it exerted antiarrhythmic effects during ischemia, whereas PostC exhibited antiarrhythmic properties after reperfusion, with significant downregulaton of ischemia-related miRNAs.
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Tavares JGP, Errante PR, Govato TCP, Vasques ÊR, Ferraz RRN, Taha MO, Menezes-Rodrigues FS, Caricati-Neto A. Cardioprotective effect of preconditioning is more efficient than postconditioning in rats submitted to cardiac ischemia and reperfusion1. Acta Cir Bras 2018; 33:588-596. [PMID: 30110060 DOI: 10.1590/s0102-865020180070000004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/24/2018] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To investigate the cardioprotective effects of ischemic preconditioning (preIC) and postconditioning (postIC) in animal model of cardiac ischemia/reperfusion. METHODS Adult rats were submitted to protocol of cardiac ischemia/reperfusion (I/R) and randomized into three experimental groups: cardiac I/R (n=33), preCI + cardiac I/R (n=7) and postCI + cardiac I/R (n=8). After this I/R protocol, the incidence of ventricular arrhythmia (VA), atrioventricular block (AVB) and lethality (LET) was evaluated using the electrocardiogram (ECG) analysis. RESULTS After reestablishment of coronary blood flow, we observed variations of the ECG trace with increased incidence of ventricular arrhythmia (VA) (85%), atrioventricular block (AVB) (79%), and increase of lethality (70%) in cardiac I/R group. The comparison between I/R + preIC group with I/R group demonstrated significant reduction in VA incidence to 28%, AVB to 0% and lethality to 14%. The comparison of I/R + postIC group with I/R group was observed significance reduction in AVB incidence to 25% and lethality to 25%. CONCLUSION The preconditioning strategies produce cardioprotection more efficient that postconditioning against myocardial dysfunctions and lethality by cardiac ischemia and reperfusion.
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Affiliation(s)
- José Gustavo Padrão Tavares
- Fellow PhD degree, Postgraduate Program in Pharmacology, Universidade Federal de São Paulo (UNIFESP), Brazil. Conception and design of the study, analysis and interpretation of data, manuscript writing
| | - Paolo Ruggero Errante
- Fellow PhD degree, Postgraduate Program in Pharmacology, UNIFESP, Sao Paulo-SP, Brazil. Analysis and interpretation of data, manuscript writing
| | - Tânia Carmem Peñaranda Govato
- Assistant Professor, Department of Pharmacology, Faculdade de Medicina do ABC (FMABC), Santo Andre-SP, Brazil. Statistical analysis
| | - Ênio Rodrigues Vasques
- Fellow PhD degree, Department of Gastroenterology, Faculty of Medicine, Universidade de São Paulo (USP), Brazil. Interpretation of electrocardiogram
| | - Renato Ribeiro Nogueira Ferraz
- Full Professor, Program in Management of Health System (PMPA-GSS), Universidade Nove de Julho (UNINOVE), Sao Paulo-SP, Brazil. Critical revision
| | - Murched Omar Taha
- Associate Professor, Department of Surgery, UNIFESP, Sao Paulo-SP, Brazil. Technical procedures
| | | | - Afonso Caricati-Neto
- Associate Professor, Department of Pharmacology, UNIFESP, Sao Paulo-SP, Brazil. Conception and design of the study, critical revision
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Araszkiewicz A, Grygier M, Pyda M, Rajewska J, Lesiak M, Grajek S. Postconditioning attenuates early ventricular arrhythmias in patients with high-risk ST-segment elevation myocardial infarction. J Cardiol 2015; 65:459-65. [PMID: 25828740 DOI: 10.1016/j.jjcc.2015.02.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 02/09/2015] [Accepted: 02/19/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND It has been demonstrated that postconditioning (postcon), brief episodes of ischemia during reperfusion period, in patients with ST-segment elevation myocardial infarction (STEMI) confers protection against ischemia-reperfusion injury and as a result, postcon might reduce infarct size. However, whether postcon may exert its beneficial effect on STEMI patients by reducing the occurrence of early malignant ventricular arrhythmias (VA) is still unknown. The aim of the study was to evaluate the influence of postcon on the presence of VA in early presenters with high-risk STEMI treated with primary coronary intervention (PCI). METHODS Seventy-five STEMI patients treated with primary PCI within 6h from symptoms onset were randomly assigned to postcon group (n=37) or conventional PCI group (n=38) in 1:1 ratio. Postcon was performed immediately after restoration of coronary flow as follows: the angioplasty balloon was inflated 4× 1min with low-pressure inflations, each separated by 1min of deflation. After that the patients were continuously monitored electrographically for 48h. The end-point of the study was the occurrence of VA (ventricular fibrillation-VF, sustained ventricular tachycardia-sVT, non-sustained ventricular tachycardia-nsVT) within 48h after the procedure. RESULTS In the postcon group, the occurrence of VAs was significantly lower: VF-3, sVT-0, nsVT-15, i.e. (18 patients - 48.6%) in comparison to control group: VF-2, sVT-4, nsVT-23 (29 patients - 76.3%); p=0.013. The occurrence of accelerated idioventricular rhythm varied insignificantly between both groups (postcon - 45.9% vs control - 34.2%; p=NS). CONCLUSIONS Postcon may reduce the occurrence of malignant VA in patients with STEMI treated with primary PCI.
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Affiliation(s)
| | - Marek Grygier
- 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland
| | - Małgorzata Pyda
- 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland
| | - Justyna Rajewska
- 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland
| | - Stefan Grajek
- 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland
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Kolettis TM, Vilaeti AD, Tsalikakis DG, Zoga A, Valenti M, Tzallas AT, Papalois A, Iliodromitis EK. Effects of Pre- and Postconditioning on Arrhythmogenesis in the In Vivo Rat Model. J Cardiovasc Pharmacol Ther 2013; 18:376-85. [DOI: 10.1177/1074248413482183] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The antiarrhythmic potential of postconditioning in in vivo models remains poorly defined. We compared the effects of pre- and postconditioning on ventricular arrhythmogenesis against controls with and without reperfusion. Wistar rats (n = 40, 269 ± 3 g) subjected to ischemia (30 minutes)–reperfusion (24 hours) were assigned to the following groups: (1) preconditioning (2 cycles), (2) postconditioning (6 cycles), or (3) no intervention and were compared with (4) nonreperfused infarcts and (5) sham-operated animals. Infarct size was measured, and arrhythmogenesis was evaluated with continuous telemetric electrocardiographic recording, heart rate variability indices, and monophasic action potentials (MAPs). During a 24-hour observation period, no differences in mortality were observed. Reperfusion decreased infarct size and ameliorated sympathetic activation during the late reperfusion phase. Preconditioning decreased infarct size by a further 35% ( P = .0017), but only a marginal decrease (by 18%, P = .075) was noted after postconditioning. Preconditioning decreased arrhythmias during ischemia and early reperfusion, whereas postconditioning almost abolished them during the entire reperfusion period. No differences were noted in MAPs or in the magnitude of sympathetic activation between the 2 interventions. Compared to postconditioning, preconditioning affords more powerful cytoprotection, but both interventions exert antiarrhythmic actions. In the latter, these are mainly evident during the ischemic phase and continue during early reperfusion. Postconditioning markedly decreases reperfusion arrhythmias during a prolonged observation period. The mechanisms underlying the antiarrhythmic effects of pre- and postconditioning are likely different but remain elusive.
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Affiliation(s)
- Theofilos M. Kolettis
- Medical School, University of Ioannina, Ioannina, Greece
- Cardiovascular Research Institute, Ioannina and Athens, Greece
| | - Agapi D. Vilaeti
- Cardiovascular Research Institute, Ioannina and Athens, Greece
- Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Dimitrios G. Tsalikakis
- Department of Engineering Informatics and Telecommunications, Computational Cardiology and Modeling, University of Western Macedonia, Kozani, Greece
| | - Anastasia Zoga
- Second Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Mesele Valenti
- Cardiovascular Research Institute, Ioannina and Athens, Greece
| | - Alexandros T. Tzallas
- Department of Informatics & Telecommunications Technology, Technological Educational Institute of Epirus, Arta, Greece
| | - Apostolos Papalois
- Cardiovascular Research Institute, Ioannina and Athens, Greece
- ELPEN Research Laboratory, Pikermi, Athens, Greece
| | - Efstathios K. Iliodromitis
- Second Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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