Ischemic Preconditioning Effect of Prodromal Angina Is Attenuated in Acute Myocardial Infarction Patients With Hypertensive Left Ventricular Hypertrophy

• Takeuchi Toshiharu

  Division of Cardiology, Department of Internal Medicine, Asahikawa Medical University

• Ishii Yoshinao

  Division of Cardiology, Department of Internal Medicine, Asahikawa City Hospital

• Kikuchi Kenjiro

  Division of Cardiology, Department of Internal Medicine, Asahikawa Medical University

• Hasebe Naoyuki

  Division of Cardiology, Department of Internal Medicine, Asahikawa Medical University

抄録

Background: Several animal experiments on acute myocardial infarction (AMI) have shown that the cardioprotective effects of ischemic preconditioning are more significant in hypertensive subjects. However, because there are no clinical data on the impact of hypertension on ischemic preconditioning in patients with AMI, whether clinical ischemic preconditioning of prodromal angina was beneficial in AMI patients with hypertension was investigated in the present study. Methods and Results: 125 patients with a first anterior AMI who had undergone successful reperfusion therapy were divided into 2 groups, with or without hypertension, and into 2 further subgroups based on the presence or absence of prodromal angina. Dual-isotope (thallium-201(TL)/Tc-99m pyrophosphate) single-photon emission computed tomography (SPECT) was performed within 1 week of reperfusion therapy. Left ventricular (LV) function and LV mass index (LVMI) were measured by left ventriculography and echocardiography, respectively. In patients without hypertension, prodromal angina resulted in significantly less myocardial damage on TL-SPECT, better LV ejection fraction and a greater myocardial blush grade compared to patients without prodromal angina. However, these cardioprotective effects of prodromal angina were significantly diminished in hypertensive patients. Importantly, the myocardial salvage effects of prodromal angina showed a significant negative correlation with LVMI, which was significantly greater in hypertensive patients. Conclusions: The cardioprotective effects of prodromal angina were attenuated in patients with hypertension. Hypertensive LV hypertrophy may crucially limit the effects of ischemic preconditioning in AMI. (Circ J 2011; 75: 1192-1199)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 75 (5), 1192-1199, 2011

  一般社団法人 日本循環器学会

キーワード

• Acute myocardial infarction
• Hypertension
• Left ventricular hypertrophy
• Reperfusion

詳細情報

• CRID: 1390282680081096064
• NII論文ID: 10028147722
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-10-0906
• ISSN: 13474820
• ISSN: 13469843
• Web Site: http://www.jstage.jst.go.jp/article/circj/75/5/75_CJ-10-0906/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2011257833
• 本文言語コード: en
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