Nonelectrocardiographic evidence that both ischemic preconditioning and adenosine preconditioning exist in humans
Massoud A. Leesar, MD*,
Marcus F. Stoddard, MD*,
Yu-Ting Xuan, PhD*,
Xian-Liang Tang, MD* and
Roberto Bolli, MD*,*
* Division of Cardiology, University of Louisville and Jewish Hospital Heart and Lung Institute, Louisville, Kentucky, USA
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Figure 1 ST-segment shift on the intracoronary electrocardiogram (ECG) (top), ST-segment shift on the surface ECG (middle), and chest pain score (bottom) at the end of the first, second, and third balloon inflations in control and adenosine-pretreated patients. Brackets indicate the pairwise comparisons that were performed. Values are means ± SEM.
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Figure 2 Chordal shortening in the ischemic/reperfused left ventricular (LV) region (upper panel) and Vp (bottom panel) at baseline; at the end of the adenosine infusion; at the end of the first, second, and third balloon inflations (Infl-1, Infl-2, and Infl-3); immediately before the second and third inflations (Pre-Infl-2 and Pre-Infl-3); and 5 min after the third inflation (5' post-Infl-3) in control and adenosine-treated patients. Pairwise comparisons were performed between groups during each inflation and among inflations within each group. Values are means ± SEM.
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Figure 3 Lactate extraction ratio in the ischemic/reperfused left ventricular region at baseline; immediately after the end of the first, second, and third balloon inflations (Infl-1, Infl-2, and Infl-3); and immediately before the second and third inflations (Pre-Infl-2 and Pre-Infl-3) in control and adenosine-treated patients. Brackets indicate the pairwise comparisons that were performed. Data are means ± SEM.
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Figure 4 Transcardiac gradient in coronary blood pH at baseline; immediately after the first, second, and third balloon inflations (Infl-1, Infl-2, and Infl-3); and immediately before the second and third inflations (Pre-Infl-2 and Pre-Infl-3) in control and adenosine-treated patients. Because arterial pH did not change significantly, the differences in the gradient indicate changes in great cardiac vein pH. Brackets indicate the pairwise comparisons that were performed. Data are means ± SEM. A-GCV = aorta-great cardiac vein.
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