Most cardiac surgical procedures require induction and management of myocardial ischemia and reperfusion. Preconditioning by a brief period of unprotected ischemia and reperfusion confers myocardial protection subsequent to a more prolonged insult. The central hypothesis of this application is that understanding the changes in sarcolemmal membrane currents which underlie the ability of the myocyte to maintain excitability consequent to preconditioning may provide an avenue for new approaches to myocardial protection that would improve myocyte function as well as survival. Our novel models use guinea pig myocytes isolated preischemically, prior to metabolic inhibition by NaCN, and rabbit myocytes first exposed to global ischemia, and then isolated during reperfusion. Studies of intracellular calcium and pH, and sarcolemmal current-voltage relations demonstrate an increase in an outward potassium current that appears either during prolonged ischemia, or during reperfusion. This current is not blocked by glybenclamide, indicating an identity other than i(kATP) Ischemic preconditioning shortens the time to appearance of the current during ischemia, and prevents its expression during reperfusion. Using these biological markers, our specific aims are to study, 1.) whether preconditioning triggers intracellular calcium, pH, or potassium conductance changes evident during preischemia, 2.) whether depolarizing (K+ or K+/Mg ++) and/or hyperpolarizing (pinacidil or ACh) cardioplegic ischemia imparts protection by sarcolemmal conductance and intracellular ionic changes similar to preconditioning evident during reperfusion, and 3.) whether maintenance of a specific membrane potential during ischemia limits deleterious biophysical changes, and whether i(kl) or other inward rectifiers may act as mediators of the observed K+ current changes. This translational research effort supports our long-term aim to understand the biophysical mechanisms and triggers that will direct the development of specific methods to enhance the clinical conduct and outcome of cardiac ischemia for patients who must undergo surgical repair.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL070161-01A1
Application #
6573045
Study Section
Surgery and Bioengineering Study Section (SB)
Program Officer
Balshaw, David M
Project Start
2003-04-15
Project End
2007-03-31
Budget Start
2003-04-15
Budget End
2004-03-31
Support Year
1
Fiscal Year
2003
Total Cost
$338,625
Indirect Cost
Name
State University New York Stony Brook
Department
Surgery
Type
Schools of Medicine
DUNS #
804878247
City
Stony Brook
State
NY
Country
United States
Zip Code
11794
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Lu, Zhongju; Jiang, Ya-Ping; Xu, Xin-Hua et al. (2007) Decreased L-type Ca2+ current in cardiac myocytes of type 1 diabetic Akita mice due to reduced phosphatidylinositol 3-kinase signaling. Diabetes 56:2780-9
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