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Postischemic Stunning—The Case for Calcium as the Ultimate Culprit

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Stunning, Hibernation, and Calcium in Myocardial Ischemia and Reperfusion

Summary

Two phases of the stunning phenomenon are proposed. The first causative phase occurs almost immediately with reperfusion and is thought to be associated with cytosolic calcium overload and an apparently normal or nearly normal mechanical function. Agents enhancing calcium influx, if introduced at this stage, may worsen subsequent stunning, whereas those inhibiting calcium influx may lessen the extent of subsequent stunning. The second phase, true stunning, is associated with established hypocontractility and responds favorably to agents enhancing calcium influx, whereas calcium antagonists further impair mechanical function when given at this stage. These patterns, derived from data obtained on isolated rat-heart studies, cannot directly be extrapolated to the large animal heart, such as that of the dog, where the presence of added circulating leukocytes may confound the issue and explain the apparently contradictory benefit of the late administration of calcium antagonists. The harmful effects of free radicals are not discounted but could be explained, at least in part, by multiple membrane damage, with a consequent rise of cytosolic calcium during the reperfusion period.

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Authors
  1. L. H. Opie
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Editors and Affiliations

  1. University of Cape Town, Cape Town, South Africa

    Lionel H. Opie MD, DPhil. (Professor of Medicine, Visiting Professor) (Professor of Medicine, Visiting Professor)

  2. Division of Cardiology, Stanford University Medical Center, Stanford, California, USA

    Lionel H. Opie MD, DPhil. (Professor of Medicine, Visiting Professor) (Professor of Medicine, Visiting Professor)

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© 1992 Kluwer Academic Publishers

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Opie, L.H. (1992). Postischemic Stunning—The Case for Calcium as the Ultimate Culprit. In: Opie, L.H. (eds) Stunning, Hibernation, and Calcium in Myocardial Ischemia and Reperfusion. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1517-9_6

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  • DOI: https://doi.org/10.1007/978-1-4613-1517-9_6

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-7923-1793-7

  • Online ISBN: 978-1-4613-1517-9

  • eBook Packages: Springer Book Archive

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