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Angiotensin-converting enzyme inhibition enhances a subthreshold stimulus to elicit delayed preconditioning in pig myocardium.

AbstractOBJECTIVES:
We assessed the effect of angiotensin-converting enzyme (ACE) inhibition in combination with a subthreshold preconditioning (PC) stimulus to elicit delayed preconditioning against infarction in pig myocardium.
BACKGROUND:
Bradykinin triggers early PC. Angiotensin-converting enzyme inhibitors increase local bradykinin levels via inhibition of kinin breakdown and have been shown in experimental studies to augment early protection afforded by PC. A role for bradykinin in eliciting delayed PC has not so far been identified.
METHODS:
We used a two-day protocol. On day 1 (closed chest), pigs were either sham-operated (group 1) or preconditioned, using balloon catheter inflation of the left anterior descending (LAD) coronary artery, with either a full (4 x 5 min PC, group 2) or subthreshold PC stimulus (2 x 2 min PC, group 3). Additional groups were pre-treated with perindoprilat (0.06 mg/kg i.v.) before sham (group 4) or subthreshold PC (group 5). On day 2 (open chest), all pigs were subjected to 40 min occlusion of the LAD followed by 3 h of reperfusion. Infarct size was determined by tetrazolium staining.
RESULTS:
Group 1 had a mean infarct size of 42.8+/-3.2% of the risk zone. Preconditioning with 4 x 5 min reduced the infarct size to 19.5+/-3.9% (p < 0.05). Groups 3 and 4 had infarct sizes not statistically different from group 1. However, combining perindoprilat with subthreshold PC resulted in a significant limitation of the infarction (18.4+/-3.1% p < 0.05), comparable with group 2.
CONCLUSIONS:
This is the first study to show that ACE inhibition can augment a mild ischemic stimulus to induce a protected state 24 h later.
AuthorsM T Jaberansari, G F Baxter, C A Muller, S E Latouf, E Röth, L H Opie, D M Yellon
JournalJournal of the American College of Cardiology (J Am Coll Cardiol) Vol. 37 Issue 7 Pg. 1996-2001 (Jun 01 2001) ISSN: 0735-1097 [Print] United States
PMID11401144 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Angiotensin-Converting Enzyme Inhibitors
Topics
  • Angiotensin-Converting Enzyme Inhibitors (pharmacology)
  • Animals
  • Arrhythmias, Cardiac
  • Female
  • Ischemic Preconditioning, Myocardial (methods)
  • Male
  • Myocardial Infarction
  • Swine
  • Time Factors

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