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...

In clinical therapy of evolving acute myocardial infarction, coronary reperfusion has proven to be the only way to limit infarct size, provided it occurs soon enough after coronary artery occlusion. However, there is also evidence that reperfusion is accompanied by detrimental manifestations known as ‘reperfusion injury’. Reperfusion injury refers to a causal event associated with reperfusion t...

Myocardial stunning involves a profound and slowly recovering decrease in contractility that follows a brief but severe episode of ischemia (1). A report in this issue of the Journal of the American College of Cardiology (2) challenges the prevailing view that the mechanisms underlying stunning are cellular in origin. Interestingly, Chandrashekhar et al. (2) found there was little difference in...

Patients on hemodialysis have a high incidence of cardiac morbidity and mortality, and echocardiographic evidence of hemodialysis-related myocardial stunning supports a potential link between the hemodialysis treatment itself and cardiac sequelae. Fluid removal rates exceeding 13 mL/kg/hour during hemodialysis have been implicated in the development of myocardial stunning. Providers caring for ...

Late preconditioning (PC) against myocardial stunning develops after coronary artery occlusion (CAO) at rest and subsequent reperfusion. We investigated whether late PC occurs after exercise-induced ischemia (high-flow ischemia) in dogs. A circumflex coronary artery stenosis (by using occluders) was set up before the onset of treadmill exercise in nine chronically instrumented dogs to suppress ...