8611 - Eugene Yevstratov MD Institute of Cardiology and...

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Eugene Yevstratov, MD Institute of Cardiology and Cardiovascular Surgery, Favaloro Foundation Buenos Aires, Argentina                                                               October/2002
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1. Protect against ischemic injury 2. Provide a motionless, bloodless field 3. Allow effective post-ischemic  myocardial resuscitation Goals of Myocardial protection
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Spectrum of myocardial ischemic injury Acute ischemic disfunction Preconditioning Stunning Hibernation Necrosis vs. Apoptosis
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Acute ischemic disfunction Reversible contractile failure Perfusion pressure O2 supply Inmediate recovery
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Preconditioning Reversible Slowed energy utilization Reduction in myocardial necrosis Increase protective abilities of myocardium Presented as a normal proper protective reaction of the ischemic myocardium Recovery Hs,Ds
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Stunning Parcialy Reversible May be accompained by endothelial disfunction (NO) causing reduced coronary blood flow Result of ischemia-reperfusion insult Mediated by increased intracellular Ca accumulation Recovery in Hs,Wks
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Hibernation Parcialy Reversible Related to poor myocardial blood flow Chronic Recovery Wks,Mo
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