Abstract
Sudden cardiac death accounts for 300,000 to 400,000 deaths annually in the United States, it is the most common and often first manifestation of coronary heart disease and is responsible for approximately 50% of mortality for cardiovascular diseases in the United States and other developed countries [1–2]. Sudden cardiac death describes the unexpected natural death from a cardiac cause within a short period, generally ≤ 1 hour from onset of symptoms, in a person without any prior condition that would appear fatal [1]. Cardiopulmonary resuscitation (CPR) effectively restores haemodynamic stability and return to spontaneous circulation (ROSC) in 40% to 60% of arrests. Prolonged survival is significantly lower because of an underlying illness and postresuscitation syndrome, specifically central nervous system injury and left ventricular stunning after resuscitation [3].
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References
Zipes DP, Wellens HJJ (1998) Sudden cardiac death. Circulation 98:2334–2351
American Heart Association (1991) Heart and Stroke Facts. Dallas: American Heart Association
Thel MC, O’Connor CM, Durham ( 1999) Cardiopulmonary resuscitation: Historical prespective to recent investigations. Am Heart J 137:39–48
Liberthson RR, Nagel EL, Hirschman JC (1974) Prehospital ventricular fibrillation. Prognosis and follow-up course. N Engl J Med 291:317–321
Brain Resuscitation Clinical Trial II Study Group (1991) A randomized clinical study of a calcium-entry blocker (lidoflazine) in the treatment of comatose survivors of cardiac arrest. N Engl J Med 324:1125–1231
Becker LB, Ostrander MP, Barrett J et al (1991) CPR Chicago: outcome of cardiopulmonary resuscitation in a large metropolitan area-where are the survivors? Ann Emerg Med 20:355–361
Brown CG, Martin DR, Pepe PE (1992) A comparison of standard-dose and high-dose epinephrine in cardiac arrest outside the hospital. N Engl J Med 327:1051–1055
Stiell IG, Herbert PC, Weitzman BN (1992) High-dose epinephrine in adult cardiac arres.t N Engl J Med 327:1045–1050
Lombardi G, Gallagher J, Gennis P (1994) Outcome of out-of-hospital cardiac arrest in New York city: the Pre-hospital Arrest Survival Evaluation (PHASE) study. JAMA 271:678–683
Tang W, Weil MH, Sun S et al (1993) Progressive myocardial dysfunction after cardiac resuscitation. Crit Care Med 21:1046–1050
Gazmuri RJ, Weil MH, Bisera J et al (1996) Myocardial dysfunction after successful resuscitation from cardiac arrest. Crit Care Med 24:992–1000
Brain Resuscitation Clinical Trial I Study Group (1986) A randomized clinical study of thiopental loading in comatose survivors of cardiac arrest. N Engl J Med 314:397–403
Gray WA, Capone RJ, Most AS (1991) Unsuccessful emergency medical resuscitation-are continued efforts in the emergency department justified? N Engl J Med 325:1393–1398
Tang Z, Weil MH, Sun S et al (1997) High energy countershocks increase ventricular ectopy after successful CPR [abstract]. Crit Care Med 25:A57
Tang W, Weil MH, Sun S et al (1995) Epinephrine increases the severity of post-resuscitation myocardial dysfunction. Circulation 92:3089–3093
Sun SJ, Weil MH, Tang W et al (1996) Effects of buffer agents on post-resuscitation myocardial dysfunction. Crit Care Med 24:2035–2041
Xie J, Weil MH, Sun SJ et al (1997) High power defibrillation increases the severity of post-resuscitation myocardial dysfunction. Circulation 96:683–688
De Antonio HJ, Kaul S, Lerman BB (1990) Reversible myocardial depression survivors of cardiac arrest. Pacing Clin Electrophysiol 13:982–985
Lewes SJ, Holmberg S, Quinn E (1993) Out-of-hospital resuscitation in EastSussex: 1981-1989. Br Heart J 70:568–573
United States Statistical Abstract 116th Edition, 1994
Steenbergen C, Murphy E, Watts JA et al (1990) Correlation between cytosolic free calcium, contracture, ATP, and irreversible ischemic injury in perfused rat heart. Circ Res 66:135–146
Murry CE, Richard VJ, Jennings RB et al (1991) Myocardial protection is lost before contractile function recovers from preconditioning. Am J Physiol 260:H796-H804
Johnson BA, Weil MH, Tang W et al (1995) Mechanisms of myocardial acidosis during arrest J Appl Physiol 78:1579–1584
Hoffmeister HM, Mauser M, Schaper W (1985) Effects of adenosine and AICAR on ATP content and regional contractile function in reperfused canine myocardium. Basic Res Cardiol 80:445–458
Kusuoka H, Porterfield JK, Weisman HF et al (1987) Pathophysiology and pathogenesis of stunned myocardium: depressed Ca2+ activation overload in ferret hearts. J Clin Invest 79:950–961
Schafer S, Heusch G (1990) Recruitment of a time-dependent inotropic reserve by postextrasystolic potentiation in normal and reperfused myocardium. Basic Res Cardiol 85:257–269
Kida M, Fujiwara H, Uegaito T et al (1993) Dobutamine prevents both myocardial stunning and phosphocreatine overshoot without affecting ATP level. J Mol Cell Cardiol 25:875–8135
Marban E (1991) Myocardial stunning and hibernation. The physiology behind the colloquialisms. Circulation 83:681–688
Li XY, McCay PB, Zughaib M et al (1993) Demonstration of free radical generation in the “stunned” myocardial in the conscious dog and identification of major differences between conscious and open-chest dogs. J Clin Invest 92:1025–1041
Ehring T, Bohm M, Heusch G (1992) The calcium antagonist shows the functional recovery of reperfused myocardium only when given before ischemia. J Cardiovasc Pharmacol 20:63–74
Du Toit EF, Opie LH (1992) Modulation of severity of reperfusion stunning in the isolated rat heart by agents altering calcium flux at the onset of reperfusion. Circ Res 70:960–967
Ehring T, Heusch G (1995) Stunned myocardium and the attenuation of stunning by calcium antagonists. Am J Cardiol 75:61E–67E
Schwartz A (1992) Molecular and cellular aspects of calcium channel antagonism. Am J Cardiol 70(suppl):6F–8F
Ferrari R, Visioli O (1994) How do calcium antagonists differ in clinical practice? Cardiovasc Drug Ther 8:565–575
Tanskela JS, Shoubridge EA (1996) Intercellular calcium dynamics and cellular energetics in ischemic cells studied by concurrent and doublequantum filtered spectroscopy. J Neurochem 66:266–276
Reimer KA, Murry CE, Yamasawa I et al (1986) Four brief periods of ischemia cause no cumulative ATP loss or necrosis. Am J Physiol 251:H1306-H1305
Murry CE, Jennings RB, Reimer KA (1986) Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation 74:1124–1136
Schott RJ, Rohmann S, Braun ER et al(1990) Ischemic preconditioning reduces infarct size in swine myocardium. Circ Res 66:1133–1142
Iwamoto T, Miura T, Adachi T et al (1991) Myocardial infarct size-limiting effect if ischemic preconditioning was not attenuated by oxygen free-radical scavengers in the rabbit. Circulation 83:1015–1022
Yellon DM, Alkhulaifi AM, Browne EE et al (1992) Ischemic preconditioning limits infarct size in the rat heart. Cardiovasc Res 26:983–987
Menasche P, Kevelaitis E, Mouuas C et al (1995) Preconditioning with potassium channel openers: a new concept for enhancing cardioplegic protection? J Thorac Cardiovasc Surg 110:1606–1614
Takeda S, Satoh T, Osada M et al (1995) Protective effect of pacing on reperfusion-induced ventricular arrhythmias in isolated rat hearts. Can J Cardiol 11:573–579
Shiki K, Hearse DJ (1987) Preconditioning of ischemic myocardium: reperfusion-induced arrhythmias. Am J Physiol 253:H1470-H1476
Cohen MV, Liu GS, Downey JM (1991) Preconditioning causes improved wall motion as well as smaller infarcts after transient coronary occlusion in rabbits. Circulation 84:341–349
Sun JZ, Tang XL, Park SW et al (1996) Evidence for an essential role of reactive oxygen species in the genesis of late preconditioning against myocardial stunning in conscious pigs. J Clin Invest 97:562–576
Xu C, Chen Y, Lu M (1995) A clinical study on limitation of infarct size ischemic preconditioning in 100 cases of acute myocardial infraction. Chung Hua Nei Ko Tsa Chih 34:16–18
Pasceri V, Lanza GA, Parti G (1996) Preconditioning by transient myocardial ischemia confers protection against ischemia-induced ventricular arrhythmias in variant angina. Circulation 94:1850–1856
Mei DA, Gross GJ (1995) Evidence for the involvement of the ATP-sensitive potassium channel in a novel model of hypoxic preconditioning in dogs. Cardiovasc Res 30:222–230
Koning MM, Gho BC, van Klaarwater E et al (1996) Rapid ventricular pacing produces myocardial protection by nonischemic activation of KATP channels. Circulation 93:178–186
Murphy E, Penman M, London RE et al (1991) Amiloride delays the ischemic-induced rise in cytosolic free calcium. Circ Res 68:1250–1258
Van Winkle DM, Thornton RB, Downey JM (1991) Cardioprotection from ischemic preconditioning is lost following prolonged reperfusion in the rabbit. Coron Artery Dis 2:613–619
Li YW, Whittaker P, Kloner RA (1992) The transient nature of the effect of ischemic preconditioning on myocardial infarct size and ventricular arrhythmia. Am Heart J 123:346–353
Simkhovich BA, Whittaker P, Przyklenk K et al (1995) Transient preischemic acidosis protects the isolated rabbit heart subject to 30 minutes, but not 60 minutes, of global ischemia. Basic Res Cardiol 90:397–403
Liu GS, Thornton J, Van Win et al (1991) Protection against infarction afforded by preconditioning is mediated by Al, adenosine receptors in the rabbit heart. Circulation 84:350–356
Thornton JD, Liu GS, Downey JM (1993) Pretreatment with pertussis toxin blocks the protective effects of preconditioning: evidence for a Gprotein mechanism. J Mol Cell Cardiol 25:311–320
Gross GJ, Auchampach JA (1992) Blockade of ATP-sensitive potassium channels prevents myocardial preconditioning in dogs. Circ Res 70:223–233
Auchampach JA, Grover GJ, Gross GJ (1992) Blockade of ischemic preconditioning in dogs by the novel ATP dependent potassium channel antagonist sodium 5-hydroxydecanoate. Cardiovasc Res 26:1054–1062
Behling RW, Malone HJ (1995) KATP-channel openers protect against increased cytosolic calcium during ischemia and reperfusion. J Mol Cell Cardiol 27:1809–1817
Shigematsu S, Sato T, Abe T (1995) Pharmacological evidence for the persistent activation of ATP-sensitive K+ channels in early phase of reperfusion and its protective role against myocardial stunning. Circulation 92:2266–2275
Mizumura T, Nithipatikom K, Gross GJ (1995) Bimakalin, an ATP-sensitive potassium channel opener, mimics the effects of ischemic preconditioning to reduce infarct size, adenosine release, and neutrophil function in dogs. Circulation 92:1236–1245
Lawton JS, Sepic JD, Allen CT et al (1996) Myocardial protection with potassium-channel openers is as effective as St Thomas’ solution in the rabbit heart. Ann Thorac Surg 61:31–38
Cleveland JC, Meldrum DR, Rowland RT et al (1997) Adenosine preconditioning of human myocardium is dependent upon the ATP-sensitive K channel. J Mol Cell Cardiol 29:175–182
Liu Y, Gao WD, O’Rourke B (1996) Synergistic modulation of ATP-sensitive K+ currents by protein kinase C and adenosine. Implications for ischemic preconditioning. Circ Res 78:443–454
Katsuda Y, Egashira K, Ueno H et al (1996) ATP-sensitive K+ channel opener pinacidil augments b1-adrenoceptor-induced coronary vasodilation in dogs. Am J Physiol 270:H2210-H2215
Vegh A, Papp JG, Parratt J (1994) Attenuation of the antiarrhythmic effects of ischemic preconditioning by blockage of bradykinin Bs receptors. Br J Pharmacol 113:1167–1172
Parratt J, Vegh A, Papp JG (1995) Pronounced antiarrhythmic effects of ischemic preconditioning-are there possibilities for pharmacological exploitation? Pharmacol Res 31:225–234
Gross GJ, Mei DA, Schultz JJ (1996) Criteria for a mediator or effector of myocardial preconditioning: do KATP channels meet the requirements? Basic Res Cardiol 91:31–34
Tang W, Weil MH, Sun SJ (1997) KATP channel activation improves post resuscitation myocardial function [abstract]. Circulation 96:1366
Tang W, Weil MH, Sun S et al (2000) K(ATP) channel activation reduces the severity of post resuscitation myocardial dysfunction. Am J Physiol Heart Circ Physiol 279: H1609-H1615
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Pellis, T., Tang, W. (2002). Myocardial Preservation during Cardiopulmonary Resuscitation. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2099-3_6
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DOI: https://doi.org/10.1007/978-88-470-2099-3_6
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