Ischemic cell injury and the uptake mechanism of 99mTc-PYP (Pyrophosphate) were studied with preconditioning and calcium antagonist.
Method: The coronary artery of an adult mongrel dog was clamped for 1 hour, followed by reperfusion and 99mTc-PYP injection. A control group (group C, n = 8), a group in which continuous drip infusion of diltiazem (10 mg/kg) (group D, n = 7), and a group preconditioned by six 5-minute clampings and perfusions before occlusion (group P, n = 6) were compared.
Results: Wall motion was fully recovered in group D but not in group P after 2 hours of reperfusion. The 99mTc-PYP uptake ratio showed a significant (p < 0.05) reduction in group D (11.5 : 3.6 compared with group C), but not in group P (11.5 : 9.1, p = 0.25). The infarct area was 1.2 +/- 0.6% of the left ventricle in group D, 1.3 +/- 0.4 in group P, and 6.4 +/- 1.0 in group C (p < 0.01 in groups D and P vs. group C).
Conclusions: These findings suggest that preconditioning does not alleviate stunning, but it improves cell injury in spite of high uptake of 99mTc-PYP. Diltiazem protects from both stunning and cell injury, suggesting a different mechanism of myocardial protection from that of preconditioning.