Intracoronary acid infusion as an alternative to ischemic postconditioning in pigs |
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Authors: | Antonio Rodríguez-Sinovas Alberto Cabestrero Bruno García del Blanco Javier Inserte Angeles García David García-Dorado |
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Institution: | 1.Laboratorio de Cardiología Experimental, Servicio de Cardiología,Hospital Universitari Vall d’Hebron,Barcelona,Spain;2.Institut de Recerca Hospitals Vall d’Hebron,Hospital Universitario Vall d’Hebron,Barcelona,Spain |
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Abstract: | Previous studies suggested that prolongation of acidosis during reperfusion is protective and may be an important mechanism
of postconditioning protection. The aim of this study was to analyze the therapeutic value of this intervention during in
vivo coronary reperfusion, and to compare it with ischemic postconditioning. Pigs were submitted to 48 or 60 min of ischemia
and 2 h of reperfusion. Animals were allocated to either intracoronary infusion of Krebs solution at dose and duration previously
described as optimal in rat hears (pH 6.4 for the first 3 min of reperfusion), ischemic postconditioning (8 cycles of 30 s
ischemia/reperfusion) or their respective control groups (n = 9–11 per group). Neither prolongation of acidosis nor postconditioning modified infarct size after 48 min of ischemia as
compared to pooled controls. In contrast, in animals submitted to 60 min of coronary occlusion, infarct size was reduced both
by infusion of acid Krebs and ischemic postconditioning (57.92 ± 18.15% and 56.91 ± 7.50 vs. 75.37 ± 9.29% in controls, P < 0.01), despite having similar areas at risk. However, an increased incidence of ventricular fibrillation was observed in
pigs reperfused with acid Krebs as compared to ischemic postconditioning (11 out of 20 vs. 3 out of 19 pigs, P < 0.05). In conclusion, in pigs submitted to coronary occlusion, intracoronary acid infusion and postconditioning offered
protection against cell death only after prolonged coronary occlusion. Both interventions were equally effective, but intracoronary
acid infusion was associated with high risk of ventricular fibrillation. These results are strongly against translation of
acidic reperfusion to patients with acute myocardial infarction. |
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