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22 May 2003

Adenosine-activated myocardial ischemia does not induce delayed preconditioning

Med Sci Monit 2003; 9(5): CR157-161 :: ID: 11065


Background: Our objective was to determine whether adenosine-induced ischemia exerts a delayed cardiac protective effect in patients with stable effort angina ischemic heart disease.
Methods: The study group was comprised of 32 patients (men) with symptoms of stable effort angina, aged 38–65 years (Group 1), and 18 clinically healthy subjects (3 women, 15 men), aged 35–55
years (Control group). The study protocol included baseline ECG and treadmill echocardiogram (ET1); ECG and adenosine echocardiogram performed 7 days after ET1; repeated exercise test exactly 24 h after adenosine infusion (ET2). Increases in heart rate (HR), systolic
(SBP) and diastolic (DBP) blood pressure, maximum ST-segment depression (max ØST) and
total ST-segment depression (SØST) on ECG were compared, as well as left ventricular enddiastolic volume (LVEDV), end-systolic (LVESV) volume, ejection fraction (EF), and wall motion synergy index (WMSI).
Results: No statistically significant differences were found in the increased values of the investigated electrocardiographic and echocardiographic parameters in either group on either exercise
test. The only positive trend was observed in LVEDV. In Group 1 LVEDV increased significantly from rest values during ET1, whereas during ET2 LVEDV did not change.
Conclusions: Adenosine-induced ischemia does not exert a delayed protective effect in respect to cardiac bioelectrical and mechanical functions in patients with ischemic heart disease in the form of
stable effort angina.

Keywords: Adenosine - diagnostic use, Adenosine - pharmacology, Angina Pectoris - diagnosis, Case-Control Studies, Echocardiography, Electrocardiography, Exercise Test, Ischemic Preconditioning, Myocardial - methods, Myocardial Ischemia - diagnosis, Myocardial Ischemia - physiopathology, Ventricular Function, Left - drug effects

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750