Bradykinin and endothelial-cardiac myocyte interactions in ischemic preconditioning

J. Parratt, A. Végh, I. Jack Zeitlin, Maqsood Ahmad, Keith Oldroyd, Karoly Kaszala, J. Papp

Research output: Contribution to journalArticle

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Abstract

Myocardial ischemia results in the release of a variety of vasoactive substances from coronary vascular endothelial cells and/or from cardiac myocytes. Some of these substances appear to be protective and include nitric oxide and bradykinin. One hypothesis for the pronounced antiarrhythmic effects of preconditioning involves the early generation of bradykinin and, subsequently, nitric oxide. Evidence for early bradykinin release has come from clinical studies involving patients undergoing coronary angioplasty where, in 4 of 5 patients, there was evidence for elevated kinin levels in coronary sinus blood either during balloon inflation (i.e., ischemia) or deflation (reperfusion). The levels reached are sometimes considerable (increases 10-20 fold). The second piece of evidence comes from dogs subjected to a preconditioning stimulus (2 x 5 min periods of ischemia), followed 20 min later by occlusion of the same artery for a 25-min period. This preconditioning procedure markedly reduces ischemia-induced ventricular arrhythmias and, although under resting conditions there was little difference between arterial and coronary sinus bradykinin levels (125 ± 22 and 157 ± 41 pg/mL, respectively), there was a marked increase in coronary sinus levels in preconditioned dogs before the prolonged occlusion (637 ± 293 pg/mL compared with 114 ± 18 pg/mL in nonpreconditioned dogs); levels at the end of the prolonged occlusion in the preconditioned dogs were also higher (577 ± 305 pg/mL compared with 162 ± 34 pg/mL in control dogs). Other evidence for the involvement of bradykinin and nitric oxide comes from studies in which the generation, or effects, of these mediators have been suppressed (e.g., with the bradykinin B2 receptor blocking agent icatibant, with inhibitors of the L-arginine-nitric oxide pathway, and by methylene blue). The conclusion is that early bradykinin release is protective under conditions of ischemia, is presumably enhanced during therapy with angiotensin-converting enzyme (ACE) inhibitors and is suppressed under conditions of endothelial dysfunction.

Original languageEnglish
JournalThe American journal of cardiology
Volume80
Issue number3 A
DOIs
Publication statusPublished - Aug 4 1997

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Ischemic Preconditioning
Bradykinin
Cardiac Myocytes
Dogs
Coronary Sinus
Nitric Oxide
Ischemia
Bradykinin B2 Receptors
Cohort Effect
Kinins
Methylene Blue
Economic Inflation
Angioplasty
Angiotensin-Converting Enzyme Inhibitors
Reperfusion
Myocardial Ischemia
Arginine
Cardiac Arrhythmias
Endothelial Cells
Arteries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bradykinin and endothelial-cardiac myocyte interactions in ischemic preconditioning. / Parratt, J.; Végh, A.; Zeitlin, I. Jack; Ahmad, Maqsood; Oldroyd, Keith; Kaszala, Karoly; Papp, J.

In: The American journal of cardiology, Vol. 80, No. 3 A, 04.08.1997.

Research output: Contribution to journalArticle

Parratt, J. ; Végh, A. ; Zeitlin, I. Jack ; Ahmad, Maqsood ; Oldroyd, Keith ; Kaszala, Karoly ; Papp, J. / Bradykinin and endothelial-cardiac myocyte interactions in ischemic preconditioning. In: The American journal of cardiology. 1997 ; Vol. 80, No. 3 A.
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