Abstract:
:Cardioprotection aims at infarct size reduction and improvement of clinical outcome from myocardial infarction. The translation of cardioprotection from preclinical and promising proof-of-concept studies to clinical benefit for patients has been largely disappointing. Almost all of these studies which did not translate into clinical benefit had infarct size reduction as the primary endpoint and used protocols selected to achieve infarct size reduction. The present review puts forward the hypothesis that the coronary circulation is a so far neglected target of cardioprotection. Mechanisms of ischemia-reperfusion injury to the coronary circulation are detailed. Clinical methods and measures to assess coronary microvascular impairment in reperfused acute myocardial infarction are presented. A comparison of magnetic resonance imaging data on infarct size vs. coronary microvascular obstruction is made. Finally, the design of studies which are optimized not only for infarct size reduction but also for salvage of the coronary microcirculation is advocated.
journal_name
Basic Res Cardioljournal_title
Basic research in cardiologyauthors
Heusch Gdoi
10.1007/s00395-019-0756-8subject
Has Abstractpub_date
2019-10-15 00:00:00pages
45issue
6eissn
0300-8428issn
1435-1803pii
10.1007/s00395-019-0756-8journal_volume
114pub_type
杂志文章,评审abstract::Apart from local heterogeneities of myocardial blood flow, the regulation of vascular tone is equally complex. Changes in vascular tone are essential for the adaptation of coronary blood flow to varying metabolic demands. The majority of coronary vascular resistance is found in the microcirculation, that is, in vessel...
journal_title:Basic research in cardiology
pub_type: 杂志文章,评审
doi:10.1007/s003950050114
更新日期:1998-12-01 00:00:00
abstract::We have compared in open-chest dogs the evolution of adenine nucleotides and creatine phosphate to that of regional mechanical function during ischemia and reperfusion. Reperfusion restored normal value of creatine phosphate whereas adenine nucleotide level remained depressed. The percentage of systolic shortening, wh...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01908316
更新日期:1982-11-01 00:00:00
abstract::Six dogs were subjected to an acute stenosis of the left anterior descending coronary artery. The mean aortic pressure was fixed with a windkessel and an occluder on four different levels. A significant decrease of coronary blood flow and poststenotic coronary pressure was closely related to the level of mean aortic ...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01906456
更新日期:1976-05-01 00:00:00
abstract::Receptor for advanced glycation end products (RAGE) is associated with inflammation and the progression of cardiovascular diseases. The current study tested the hypothesis that RAGE is involved in the pathogenesis of aortic valve (AV) calcification. Pioglitazone attenuated AV calcification in experimental hypercholest...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/s00395-012-0306-0
更新日期:2012-11-01 00:00:00
abstract::Ca2+ overload followed by after-contractions was induced by perfusion of mammalian papillary muscles with O-K0+, high Ca2+ solution. The effect of lipotrophic agents (dexamethasone, indomethacin) or free radical scavengers (alpha-tocopherol, reduced glutathione, synthetic antioxidant) was tested at different stages of...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01908177
更新日期:1985-07-01 00:00:00
abstract::The cardiac renin angiotensin system (RAS) is the target for number of therapeutic interventions which proved successful in heart failure. Angiotensin converting enzyme (ACE) inhibitors belong to the most efficient strategies available and angiotensin receptor (ATR) antagonists may be comparably effective. The direct ...
journal_title:Basic research in cardiology
pub_type: 杂志文章,评审
doi:10.1007/s003950050207
更新日期:1998-01-01 00:00:00
abstract::Increase of Ca2+ concentration to 7.5 mM in the presence of 10 mM or 20 mM caffeine shifted length-tension relationships of 5 rat trabecular muscles and 5 cat papillary muscles to higher tensions. At 1max diastolic tension was enhanced from (formula: see text), for all measured points of stress-strain relationships af...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01906525
更新日期:1978-09-01 00:00:00
abstract::The effects of regional hypoxemia and ischemia on epicardial electrogram were studied in anesthetized, open-chest dogs. The left circumflex artery (LCx) was cannulated and perfused with either arterial blood or hypoxic solution. A contact electrode for recording monophasic action potential (MAP) was applied to the epi...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00788537
更新日期:1995-11-01 00:00:00
abstract::Sarcoplasmic reticulum (SR) from left ventricles of rats that developed spontaneous hypertension was studied in vitro. Similar increases of left ventricular mass were found when grouping the animals into mild and severe hypertensives (average systolic arterial pressure of 168 +/- 4 and 202 +/- 6 mmHg, respectively). T...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01907362
更新日期:1988-05-01 00:00:00
abstract::Mesenchymal stromal cells (MSCs) exhibit antiapoptotic and proangiogenic functions in models of myocardial infarction which may be mediated by secreted small extracellular vesicles (sEVs). However, MSCs have frequently been harvested from aged or diseased patients, while the isolated sEVs often contain high levels of ...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/s00395-020-0785-3
更新日期:2020-03-07 00:00:00
abstract::We investigated whether preconditioning could protect several cultured cell lines, to determine whether the protection is specific for cells derived from different myogenic and non-myogenic sources. Ischemia was simulated by centrifugation of cells into a pellet, and cell viability was determined by hypotonic trypan b...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00788726
更新日期:1996-11-01 00:00:00
abstract::To investigate the effect of nifedipine on hypercalcemic electrocardiographical alterations, steadily increasing hypercalcemia was induced in guinea-pigs by continuous calcium gluconate infusion until cardiac arrest occurred. During the experimental time the electrocardiograms were continuously recorded and compared i...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01908127
更新日期:1982-01-01 00:00:00
abstract::Ultrasonic techniques for the measurement of ventricular dimensions are widely used in acute and chronic experiments. Implantation of ultrasonic crystals is associated with reversible and irreversible myocardial damage which might limit the interpretation of the obtained results, in particular during acute experiments...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01907029
更新日期:1987-07-01 00:00:00
abstract::We measured the amount of 1,2-diacylglycerol (DAG) and its fatty acid composition in hamster hearts of various ages because 1,2-DAG has been recognized to be one of the intracellular second messengers. The highest level in 1,2-DAG was detected in 30-day-old hamster hearts. The heart weight increased about 2.5 times be...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01906969
更新日期:1990-03-01 00:00:00
abstract::In open-chest pigs during severe myocardial ischemia [K+]e, [Ca2+]e and [H+]e increase, [Na+]e increases transiently reaching control values after 30 min. Extracellular osmolality of the ischemic area increases due to an H2O-shift from the ECS to the ICS. The increase of [Na+]e and [Ca2+]e must b explained by the shri...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01908341
更新日期:1981-07-01 00:00:00
abstract::For the quantitative evaluation of myocardial damage induced by isoprenaline (ISO) a method based on the uptake of 203Hg-labelled Mercurascan (MSC) in the heart was used. The increase of myocardial uptake of MSC in ISO-treated rats over control values was very rapid and might be directly proportional to the number of ...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01910409
更新日期:1977-09-01 00:00:00
abstract::The PKC hypothesis and its variants are attractive but unproved. The chief difficulty is the lack of an objective means to assess whether or not PKC has been activated in hearts preconditioned in vivo with ischemia or in hearts preconditioned by pharmacologic means. The strongest evidence is supporting the PKC hypothe...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00797206
更新日期:1997-01-01 00:00:00
abstract::Cardiac hypertrophy which occurs during chronic mechanical overload is one of the numerous examples of biological adaptation to environmental requirements. As such, it is obtained at random by trial and error, and adaptation represents the sum of various modifications in gene expression, including the shift in isoform...
journal_title:Basic research in cardiology
pub_type: 杂志文章,评审
doi:10.1007/978-3-642-72474-9_15
更新日期:1992-01-01 00:00:00
abstract::Although epicardial blood flow can be restored by an early intervention in most cases, a lack of adequate reperfusion at the microvascular level is often a limiting prognostic factor of acute myocardial infarction (AMI). Our group has recently found that paracrine factors secreted from apoptotic peripheral blood monon...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/s00395-012-0292-2
更新日期:2012-09-01 00:00:00
abstract::The aim of this study was to investigate the mechanism of beta-adrenergic preconditioning (BPC). The roles of adenosine and its receptor subtypes, the generation of oxygen free radicals (ROS) and activation of the K(ATP) channels as well as the phosphoinositide-3-kinase (PI(3)K)/PKB/Akt and extracellular signal-regula...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/s00395-012-0281-5
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:The clinical usefulness of class III antiarrhythmic drugs for the treatment of tachyarrhythmias is limited by their potential proarrhythmic effects, mainly torsades-depointes (TdP). The goal of this experimental study was to develop an isolated whole-heart model exhibiting typical characteristics of class III...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/s003950050073
更新日期:1998-04-01 00:00:00
abstract::The influence of perfusion pressure (5-8 kPa) on coronary flow and myocardial Ca2+-washout during Ca2+-free perfusion, and on the occurrence of calcium paradox after subsequent Ca2+-reperfusion, was studied in isolated, stimulated, rat heart ventricles. During the Ca2+-free perfusion period (3 min) the following chang...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01907580
更新日期:1980-03-01 00:00:00
abstract::We tested the hypothesis that isoproterenol would increase myocardial work and O2 consumption at reduced efficiency and that both left ventricular hypertrophy and chemical sympathectomy would lead to changes in this myocardial efficiency response. Left ventricular hypertrophy was produced by aortic valve plication in ...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00789303
更新日期:1996-07-01 00:00:00
abstract::The influence of cardiac cholinergic activation was studied in rats and cats on the induction and maintenance of ventricular fibrillation (VF). Acetylcholine (ACH 2-25 micrograms/kg), in doses which did not cause bradycardia or hypotension, induced appearance of spontaneous VF (duration 2-60 sec.) in 9/20 rats which h...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01908386
更新日期:1984-11-01 00:00:00
abstract::The effect of 0.1 mg/kg Verapamil on the extent of the ischemic area following ligation of a branch of the left descending coronary artery was studied in anesthetized open chest dogs. The sum of the ST-segment elevation during the entire period of occlusion in the epicardial ECG was 15 mV in control infarction compare...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01905620
更新日期:1975-03-01 00:00:00
abstract::It has been investigated whether calcium- and verapamil-dependent sensitivities of carotis baroreceptors also exist in man. To answer this question, we pre- and postoperatively measured changes in heart rate during carotid sinus stimulation before and after intravenous administration of 5 mg verapamil in 23 patients w...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00795058
更新日期:1992-09-01 00:00:00
abstract::PDE3 cyclic nucleotide phosphodiesterase inhibitors raise cAMP and cGMP content in cardiac and vascular myocytes. Their administration to patients with dilated cardiomyopathy leads to improvements in hemodynamic parameters in the short term but reduces survival with chronic administration. The reasons for this 'biphas...
journal_title:Basic research in cardiology
pub_type: 杂志文章,评审
doi:10.1007/s003950200035
更新日期:2002-01-01 00:00:00
abstract::A methodological approach based on Frank's pressure-volume (P-V) diagram and model calculations for analyzing the determinants of stroke volume (SV) under conditions of altered ventricular geometrical configuration is discussed with respect to the underlying geometrical models. The approach is generalized in the sense...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF02190551
更新日期:1991-03-01 00:00:00
abstract::Guinea-pig left atria were loaded with 10 microCi 7-[3H]noradrenaline, and noradrenaline release from sympathetic nerve endings was then elicited by refractory period field stimulation. When one pulse of 0.2 ms duration was applied during each refractory period, the resulting transmitter release was halved by 3 x 10(-...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF00788873
更新日期:1993-11-01 00:00:00
abstract::In anaesthetized, artificially respirated mongrel dogs, the intravenous infusion of oxprenolol (0.3 mg and 1 mg/kg over 10 minutes) led to an increase in heart rate and cardiac output. Blood pressure in the pulmonary capillaries and right atrium, and vascular resistance were reduced. The pressure in the aorta was tran...
journal_title:Basic research in cardiology
pub_type: 杂志文章
doi:10.1007/BF01906388
更新日期:1975-09-01 00:00:00