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Myocardial Ischemia and Preconditioning pp 423–442Cite as

Exercise and Delayed Preconditioning in the Protection of the Heart against Ventricular Arrhythmias: Crucial Role of Nitric Oxide

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Part of the book series: Progress in Experimental Cardiology ((PREC,volume 6))

Summary

Ischaemic preconditioning results not only in a reduction in myocardial ischaemic damage but also a marked suppression of those ventricular arrhythmias that result from a prolonged period of ischaemia and reperfusion insult. This protection is time-dependent and occurs in two distinct phases. There is an “early phase” of the antiarrhythmic protection which occurs immediately after the preconditioning stimulus but fades within 1 or 2 hours. However, the protection against arrhythmias reappears 20–24 hours later and this phase is termed as “delayed protection”. Protection against ischaemia and reperfusion-induced severe, often life-threatening arrhythmias can also result from brief periods of cardiac pacing, which leads to both immediate and delayed protection, and from vigorous physical exercise. Both cardiac pacing and exercise results in marked reduction in the incidence and severity of ischaemia and reperfusion-induced ventricular arrhythmias 24 hours later. This delayed protection against arrhythmias is less marked 48 and 72 hours after preconditioning but can be reinstated, and lasts for a more prolonged period, if either pacing or exercise are repeated at a time when the protection from the initial stimulus begins to wane. Although the precise mechanisms of the delayed protection results from cardiac pacing and exercise are not yet fully understood, there is some evidence that nitric oxide plays a privotal role in the antiarrhythmic protection achieved either by cardiac pacing or exercise.

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Authors and Affiliations

  1. Department of Pharmacology and Pharmacotherapy, University of Szeged, Albert Szent Györgyi Medical Center, Dóm tér 12, P.O. Box 115, H-6701, Szeged, Hungary

    Ágnes Végh, László Babai, Zsolt Szigeti & Julius Gy. Papp

  2. Department of Physiology and Pharmacology, Strathclyde Institute for Biomedical Sciences, 27 Taylor Street, G4 ONR, Glasgow, UK

    James R. Parratt

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  1. Ágnes Végh
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Correspondence to Ágnes Végh .

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Editors and Affiliations

  1. Institute of Cardiovascular Sciences St. Boniface General Hospital Research Centre Faculty of Medicine, University of Manitoba, Winnipeg, Canada

    Naranjan S. Dhalla PhD, MD (Hon), DSc (Hon) (Distinguished Professor and Director) & Anton Lukas PhD (Associate Professor) (Distinguished Professor and Director) &  (Associate Professor)

  2. Aoto Hospital, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan

    Nobuakira Takeda MD, PhD (Associate Professor) (Associate Professor)

  3. Dept. of Pharmaceutical Sciences & Drug Research, Punjabi University, Patiala, India

    Manjeet Singh PhD (Professor & Head) (Professor & Head)

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Végh, Á., Parratt, J.R., Babai, L., Szigeti, Z., Papp, J.G. (2003). Exercise and Delayed Preconditioning in the Protection of the Heart against Ventricular Arrhythmias: Crucial Role of Nitric Oxide. In: Dhalla, N.S., Takeda, N., Singh, M., Lukas, A. (eds) Myocardial Ischemia and Preconditioning. Progress in Experimental Cardiology, vol 6. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-0355-2_30

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