Cardiac Ischemia: From Injury to Protection: From Injury to Protection

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Springer Science & Business Media, Oct 31, 1999 - Medical - 173 pages
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Cardiac Ischemia: From Injury to Protection has been divided into six parts. The first part describes the differences between hypoxia and ischemia, animal models, the effects of ischemia on myocardial function and metabolism, and the electrophysiological consequences of ischemia. The second part deals with the mechanisms of cardiomyocyte death in ischemia, structural aspects of irreversible ischemic injury, necrosis and apoptosis of cardiac cells, the role of calcium, and the concept of calcium antagonism. The third chapter is a brief description of reperfusion injury, its clinical relevance, and possible prevention. The fourth part summarizes changes in myocardial vasculature during ischemia and reperfusion. The fifth part is the survey of two main possibilities for increasing cardiac resistance to ischemia and hypoxia, i.e. long-lasting adaptation to chronic hypoxia and short-lasting preconditioning. The last part of the book deals with comparative and ontogenetic aspects of cardiac sensitivity to oxygen deprivation; this chapter also summarizes the ontogenetic differences and limitations in endogenous and exogenous protection of the ischemic/hypoxic heart.
 

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Contents

MYOCARDIAL HYPOXIA AND ISCHEMIA
1
12 ANIMAL MODELS
3
121 Experimental animals
4
123 In vitro models
6
124 Isolated cardiac myocytes
8
126 Animal models in the future
9
13 METABOLISM OF THE ISCHEMIC HEART
10
131 Early consequences of coronary occlusion
12
MYOCARDIAL VASCULATURE DURING ISCHEMIA AND REPERFUSION
81
42 MICROVASCULAR INJURY
82
43 RESPONSE OF THE CAPILLARY NETWORK TO INFARCTION
85
44 ANGIOGENESIS IN ISCHEMIC HEART DISEASE
86
CARDIAC PROTECTION
89
51 ADAPTATION TO CHRONIC HYPOXIA
90
512 Protective effects of adaptation
91
513 Possible protective mechanisms
93

1311 Ischemia and glucose metabolism
13
1312 Ischemia and lipid metabolism
15
1313 Calcium homeostasis
16
132 Metabolism during the late phase of ischemia
17
142 Silent ischemia
20
1431 Abnormalities of calcium homeostasis calcium hypothesis
22
1432 Generation of oxygenderived free radicals oxyradical hypothesis
23
144 Hibernation
27
1442 Longterm hibernation
28
1443 Cellular mechanisms of hibernation
29
1444 Detecting hibernating myocardium
30
15 ELECTROPHYSIOLOGICAL CONSEQUENCES OF ISCHEMIA
31
151 Role of potassium ions
32
152 Roles of sodium calcium and magnesium ions
35
153 Role of amphipathic lipid metabolites
37
155 Role of circulating peptides
38
157 Summary of ischemiainduced electrophysiological changes
39
158 Ischemiarelated ventricular arrhythmias
40
IRREVERSIBLE MYOCARDIAL ISCHEMIC INJURY
45
211 Necrosis and apoptosis
47
212 Induction of apoptosis
50
213 Infarct size determination
51
22 ROLE OF CALCIUM IN ISCHEMIC INJURY
52
2221 Cardioprotective effects of calcium antagonists
53
23 ROLE OF OXYGENDERIVED FREE RADICALS IN ISCHEMIC INJURY
55
24 VENTRICULAR REMODELING FOLLOWING INFARCTION
57
242 Hyperplasia of viable myocytes
60
243 Myocardial fibrosis
61
244 Myocardial infarction and ventricular loading
62
REPERFUSIONINDUCED INJURY
65
31 REPERFUSIONINDUCED ARRHYTHMIAS
66
32 LETHAL REPERFUSIONINDUCED INJURY
67
322 Possible mechanisms
69
3221 Role of reenergization
70
3222 Role of rapid normalization of tissue pH
71
3223 Role of rapid normalization of tissue osmolality
73
323 Spreading of necrosis
74
34 CLINICAL RELEVANCE OF REPERFUSION INJURY
76
35 PREVENTION OF REPERFUSION INJURY
77
5132 Energy metabolism
95
5133 Neurohumoral factors
96
5134 Stress proteins
97
5136 Adenosine
98
5137 ATPsensitive potassium channels
99
5138 Other possible mechanisms
100
514 Adverse effects of adaptation
101
5142 Right ventricular hypertrophy
102
515 Regression of adaptive changes
103
52 ISCHEMIC PRECONDITIONING
104
522 Induction of ischemic preconditioning
108
523 End points of ischemic preconditioning
109
524 Models of ischemic preconditioning
112
525 Triggers of ischemic preconditioning
113
526 Postreceptor signaling pathway
116
5262 Tyrosine kinase and mitogenactivated protein kinases
117
528 Other pathways
118
529 Delayed preconditioning
121
5292 Triggers of delayed preconditioning
122
5293 Signaling pathway and end effector of delayed preconditioning
123
5210 Pharmacological preconditioning
124
52102 Modulation of the trigger
125
52104 Modulation of the end effector KATP channels
126
52105 Manipulation with second window of protection
127
5212 Preconditioning in the diseased heart
130
5213 Ischemic preconditioning vs adaptation to chronic hypoxia
132
DEVELOPMENTAL ASPECTS OF CARDIAC ISCHEMIA AND PROTECTION
135
61 COMPARATIVE ASPECTS
136
612 Myocardial energy supply
137
613 Cardiac sensitivity to oxygen deprivation
138
62 ONTOGENETIC ASPECTS
139
622 Myocardial energy supply
140
623 Cardiac sensitivity to oxygen deprivation
141
624 Possible mechanisms of higher tolerance of the immature heart
143
63 PROTECTION OF THE DEVELOPING HEART
146
632 Ischemic preconditioning of the immature heart
147
REFERENCES
149
INDEX
169
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Page 163 - In: Fozzard HA, Haber E, Jennings RB, Katz AM, Morgan HE (eds) The heart and cardiovascular system.
Page 163 - wavefront phenomenon" of myocardial ischemic cell death: II. Transmural progression of necrosis within the framework of ischemic bed size (myocardium at risk) and collateral flow, lab Invest 1979;40:633-644.

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