T he progress of medicine is often driven by the development of new ideas in the experimental laboratory and their subsequent application to clinical practice. Sometimes the clinical usefulness of these ideas may not be evident when they are first formulated but becomes apparent after a period of time. The concept of postischemic myocardial dysfunction, or "myocardial stunning,"' is a classic e...

Conscious pigs underwent a sequence of 10 2-min coronary occlusions, each separated by 2 min of reperfusion, for three consecutive days (days 1, 2, and 3). On day 1, pigs received an i.v. infusion of a combination of antioxidants (superoxide dismutase, catalase, and N-2 mercaptopropionyl glycine; group II, n = 9), nisoldipine (group III, n = 6), or vehicle (group I [controls], n = 9). In the co...

Introduction Conscious pigs underwent a sequence of 10 2-min coronary occlusions, each separated by 2 min of reperfusion, for three consecutive days (days 1, 2, and 3 of stage I). The recovery of systolic wall thickening (WTh) after the 10th reperfusion was markedly improved on days 2 and 3 compared with day 1, indicating that the myocardium had become preconditioned against "stunning." 10 d af...

Although protein tyrosine kinases (PTKs) signaling has been implicated in the late phase of ischemic preconditioning (PC), it is unknown whether PTK signaling is necessary for the development of nitric oxide (NO) donor-induced late PC. Thus conscious rabbits underwent a sequence of six 4-min coronary occlusion (O)/4-min reperfusion (R) cycles followed by a 5-h recovery period of reperfusion for...

Previous studies have shown that administration of nitric oxide (NO) donors induces a delayed cardioprotective effect indistinguishable from the late phase of ischemic preconditioning (PC). However, the ability of clinically relevant NO donors to elicit this phenomenon has not been evaluated. In this study we tested whether an NO-releasing agent that is nitroglycerin (NTG), which is widely used...

In this article we describe a rare clinical condition of stress cardiomyopathy (takotsubo cardiomyopathy) for which we, despite controversy and lack data, identified the main pathogenic pathways (including direct toxic effect catecholamines on myocardium, catecholamine-mediated myocardial stunning, microcirculation disorders). After systematic review, distinct pathology features new diagnostic ...

BACKGROUND Myocardial preservation during open heart surgery is a subject of intense investigation. A prerequisite for further improvement is a better understanding of the underlying pathophysiologic mechanisms responsible for postoperative myocardial stunning. In this report, we analyzed the role of apoptosis in myocardial stunning. METHODS Myocardial samples were obtained from 11 patients u...

Dirk J. Duncker , Rainer Schulz , Roberto Ferrari , David Garcia-Dorado , Carlo Guarnieri , Gerd Heusch , Pieter D. Verdouw a,) a Experimental Cardiology, Thoraxcenter, Erasmus UniÕersity Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, Netherlands b Department of Pathophysiology, UniÕersity of Essen, Essen, Germany c Fondazione Clinica del LaÕoro, Brescia, Italy d Hospital General UniÕersitairi, V...

Introduction Dysfunctional myocardium that remains viable has the potential for contractile recovery after reperfusion. Dysfunctional but viable myocardium has been broadly divided into two closely linked pathophysiological states, myocardial hibernation and stunning. Stunned myocardium is the result of an ischemic insult leading to contractile dysfunction despite adequate reperfusion. Hibernat...