Adenosine type 1 (A1) receptors mediate protection against myocardial infarction produced by chronic, intermittent ingestion of ethanol in dogs

Cardioprotection afforded by chronic exercise is mediated by the sarcolemmal, and not the mitochondrial, isoform of the KATP channel in the rat

This study was conducted to examine the role of myocardial ATP-sensitive potassium (K(ATP)) channels in exercise-induced protection from ischaemia-reperfusion (I-R) injury. Female rats were either sedentary (Sed) or exercised for 12 weeks (Tr). Hearts were excised and underwent a 1-2 h regional I-R protocol. Prior to ischaemia, hearts were subjected to pharmacological blockade of the sarcolemmal K(ATP) channel with HMR 1098 (SedHMR and TrHMR), mitochondrial blockade with 5-hydroxydecanoic acid (5HD; Sed5HD and Tr5HD), or perfused with buffer containing no drug (Sed and Tr). Infarct size was significantly smaller in hearts from Tr animals (35.4 +/- 2.3 versus 44.7 +/- 3.0% of the zone at risk for Tr and Sed, respectively). Mitochondrial K(ATP) blockade did not abolish the training-induced infarct size reduction (30.0 +/- 3.4 versus 38.0 +/- 2.6 in Tr5HD and Sed5HD, respectively); however, sarcolemmal K(ATP) blockade completely eradicated the training-induced cardioprotection. Infarct size was 71.2 +/- 3.3 and 64.0 +/- 2.4% of the zone at risk for TrHMR and Sed HMR. The role of sarcolemmal K(ATP) channels in Tr-induced protection was also supported by significant increases in both subunits of the sarcolemmal K(ATP) channel following training. LV developed pressure was better preserved in hearts from Tr animals, and was not influenced by addition of HMR 1098. 5HD decreased pressure development regardless of training status, from 15 min of ischaemia through the duration of the protocol. This mechanical dysfunction was likely to be due to a 5HD-induced increase in myocardial Ca2+ content following I-R. The major findings of the present study are: (1) unlike all other known forms of delayed cardioprotection, infarct sparing following chronic exercise was not abolished by 5HD; (2) pharmacological blockade of the sarcolemmal K(ATP) channel nullified the cardioprotective benefits of exercise training; and (3) increased expression of sarcolemmal K(ATP) channels was observed following chronic training.

Mechanisms of myocardial protection produced by chronic ethanol consumption

Recent evidence suggests that chronic ingestion of small quantities of ethanol may protect myocardium from ischemic injury by activating many of the endogenous signal transduction elements that have been implicated during other forms of preconditioning. Studies conducted in a variety of animal models in vitro and in vivo have indicated that chronic ethanol consumption improves functional recovery after global ischemia, reduces biochemical markers of ischemic injury, and decreases myocardial infarct size. Many of these beneficial actions appear to occur independent of alterations in systemic and coronary hemodynamics and transmural myocardial perfusion. To date, adenosine type 1 (A(1)) receptors, alpha(1)-adrenoceptors, the epsilon isoform of protein kinase C (PKC), and adenosine triphosphate-dependent potassium (K(ATP)) channels have been shown to mediate cardioprotection associated with chronic ethanol ingestion. These data suggest another mechanism by which chronic, intermittent consumption of ethanol may reduce overall cardiovascular mortality, decrease the incidence of coronary artery disease, and improve survival after myocardial infarction in humans. In this brief review, we discuss current evidence supporting a role for endogenous signaling in chronic ethanol-induced myocardial protection against ischemic injury.

Protective and anti-protective effects of acute ethanol exposure in myocardial ischemia/reperfusion

Epidemiological data suggest that a cardioprotective effect of acute alcohol exposure exists in humans. Recent studies in animal models indicate that transient alcohol exposure can indeed reduce myocardial infarct size and exert a preconditioning-like protective effect akin to ischemic preconditioning (IPC). Moreover, the mechanism of alcohol-induced cardioprotection in part resembles the signaling cascade triggered by ischemic preconditioning, with adenosine receptors, PKC, protein tyrosine kinases, and mitochondrial K(ATP) channels all being implicated as key components. However, it was also seen, at least in the rabbit, that if alcohol were present during the ischemic insult, it could block its own protection. The primary protective effect of alcohol use is probably in the chronic setting where alcohol exposure causes a second window type of protection that persists for many days thereafter. Regular moderate drinking should keep the heart in a second window state indefinitely.