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By Li H., Vrancken L.

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9% of the area at risk was infarcted. 9% of the area at risk became infarcted during the 60 minutes in which the 90% coronary blood flow reduction was maintained. In view of the aforementionedresults,it is also of interest that Schulz et al. (1995) showed an increased tolerance to sustained low-flow ischemia when this was preceded by a brief episode of no-flow ischemia without interveningreperfusion. In this study, infarct size produced by 90-minute 90% left anterior descending coronary artery flow reduction in anesthetizedpigs was smaller when 80 minutes of this flow reduction was preceded by a 10-minute episode of no-flow ischemia without intervening reperfusion.

ISCHEMIC PRECONDITIONING BY PARTIAL CORONARY ARTERY OCCLUSION WITHOUT INTERVENING REPERFUSION If stringent conditions, such as abrupt brief total coronary artery occlusion and intervening complete reperfusion, are required to precondition the myocardium, it is very unlikely that ischemic preconditioning has a clinical analog. Ovize and colleagues (1992b) showed that suf- Myocardial Protection by Brief Ischemic and Nonischemic Stress 25 ficiently severe partial coronary artery occlusions alone can also precondition the myocardium but a period of complete reperfusion between the partial occlusion and the subsequent sustained occlusion was a prerequisite to obtain cardioprotection.

Clin. Exper. Pharmacol. Physiol. 1,99-112. R. (1980). The early consequences of myocardial ischaemia and their modification. J. Physiologie (Paris) 76,699-715. A. (1986). Preconditioningwithischaemia: adelay oflethal cell injury in ischaemic myocardium. Circulation 74, 1124-1136. R. (1987). Modification of the thromboxane/prostacyclin balance as an approach to antiarrhythmictherapy during myocardialischaemia and reperfusion;the concept of endogenous antiarrhythmic substances. ), pp. 21-35. Martinus Nijhoff, Boston.

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