{"id":"https://openalex.org/W4230837149","doi":"https://doi.org/10.1161/hc5001.100039","title":"Consequences of Brief Ischemia: Stunning, Preconditioning, and Their Clinical Implications","display_name":"Consequences of Brief Ischemia: Stunning, Preconditioning, and Their Clinical Implications","publication_year":2001,"publication_date":"2001-12-17","ids":{"openalex":"https://openalex.org/W4230837149","doi":"https://doi.org/10.1161/hc5001.100039"},"language":"en","primary_location":{"id":"doi:10.1161/hc5001.100039","doi":"https://doi.org/10.1161/hc5001.100039","is_oa":false,"landing_page_url":"https://doi.org/10.1161/hc5001.100039","pdf_url":null,"source":{"id":"https://openalex.org/S116251202","display_name":"Circulation","issn_l":"0009-7322","issn":["0009-7322","1524-4539"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Circulation","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5015839705","display_name":"Robert Alan Kloner","orcid":"https://orcid.org/0000-0002-6258-0544","observed_orcids":["https://orcid.org/0000-0002-6258-0544"]},"institutions":[{"id":"https://openalex.org/I1174212","display_name":"University of Southern California","ror":"https://ror.org/03taz7m60","country_code":"US","type":"education","lineage":["https://openalex.org/I1174212"]},{"id":"https://openalex.org/I170897317","display_name":"Duke University","ror":"https://ror.org/00py81415","country_code":"US","type":"education","lineage":["https://openalex.org/I170897317"]},{"id":"https://openalex.org/I4210126298","display_name":"Duke Medical Center","ror":"https://ror.org/03njmea73","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210126298","https://openalex.org/I4210144876"]},{"id":"https://openalex.org/I4210164417","display_name":"Good Samaritan Hospital","ror":"https://ror.org/05hm6ny55","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210164417"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Robert A. Kloner","raw_affiliation_strings":["From the Heart Institute, Good Samaritan Hospital, Keck School of Medicine, University of Southern California, Los Angeles (R.A.K.), and the Pathology Department, Duke University Medical Center, Durham, NC (R.B.J.)","Robert A. Kloner From the Heart Institute, Good Samaritan Hospital, Keck School of Medicine, University of Southern California, Los Angeles (R.A.K.), and the Pathology Department, Duke University Medical Center, Durham, NC (R.B.J.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From the Heart Institute, Good Samaritan Hospital, Keck School of Medicine, University of Southern California, Los Angeles (R.A.K.), and the Pathology Department, Duke University Medical Center, Durham, NC (R.B.J.)","institution_ids":["https://openalex.org/I1174212","https://openalex.org/I170897317","https://openalex.org/I4210126298","https://openalex.org/I4210164417"]},{"raw_affiliation_string":"Robert A. Kloner From the Heart Institute, Good Samaritan Hospital, Keck School of Medicine, University of Southern California, Los Angeles (R.A.K.), and the Pathology Department, Duke University Medical Center, Durham, NC (R.B.J.)","institution_ids":["https://openalex.org/I1174212","https://openalex.org/I170897317","https://openalex.org/I4210126298","https://openalex.org/I4210164417"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5042739051","display_name":"Robert B. Jennings","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1174212","display_name":"University of Southern California","ror":"https://ror.org/03taz7m60","country_code":"US","type":"education","lineage":["https://openalex.org/I1174212"]},{"id":"https://openalex.org/I170897317","display_name":"Duke University","ror":"https://ror.org/00py81415","country_code":"US","type":"education","lineage":["https://openalex.org/I170897317"]},{"id":"https://openalex.org/I4210126298","display_name":"Duke Medical Center","ror":"https://ror.org/03njmea73","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210126298","https://openalex.org/I4210144876"]},{"id":"https://openalex.org/I4210164417","display_name":"Good Samaritan Hospital","ror":"https://ror.org/05hm6ny55","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210164417"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Robert B. Jennings","raw_affiliation_strings":["From the Heart Institute, Good Samaritan Hospital, Keck School of Medicine, University of Southern California, Los Angeles (R.A.K.), and the Pathology Department, Duke University Medical Center, Durham, NC (R.B.J.)","Robert B. Jennings From the Heart Institute, Good Samaritan Hospital, Keck School of Medicine, University of Southern California, Los Angeles (R.A.K.), and the Pathology Department, Duke University Medical Center, Durham, NC (R.B.J.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From the Heart Institute, Good Samaritan Hospital, Keck School of Medicine, University of Southern California, Los Angeles (R.A.K.), and the Pathology Department, Duke University Medical Center, Durham, NC (R.B.J.)","institution_ids":["https://openalex.org/I1174212","https://openalex.org/I170897317","https://openalex.org/I4210126298","https://openalex.org/I4210164417"]},{"raw_affiliation_string":"Robert B. Jennings From the Heart Institute, Good Samaritan Hospital, Keck School of Medicine, University of Southern California, Los Angeles (R.A.K.), and the Pathology Department, Duke University Medical Center, Durham, NC (R.B.J.)","institution_ids":["https://openalex.org/I1174212","https://openalex.org/I170897317","https://openalex.org/I4210126298","https://openalex.org/I4210164417"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":2.8869,"has_fulltext":false,"cited_by_count":291,"citation_normalized_percentile":{"value":0.93258427,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":95,"max":100},"biblio":{"volume":"104","issue":"25","first_page":"3158","last_page":"3167"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11057","display_name":"Cardiac Ischemia and Reperfusion","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11057","display_name":"Cardiac Ischemia and Reperfusion","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10372","display_name":"Cardiac Imaging and Diagnostics","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10292","display_name":"Acute Myocardial Infarction Research","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/myocardial-stunning","display_name":"myocardial stunning","score":0.9330000281333923},{"id":"https://openalex.org/keywords/ischemic-preconditioning","display_name":"ischemic preconditioning","score":0.9679999947547913},{"id":"https://openalex.org/keywords/myocardial-ischemia","display_name":"myocardial ischemia","score":0.8130000233650208},{"id":"https://openalex.org/keywords/ischemia-reperfusion-injury","display_name":"ischemia-reperfusion injury","score":0.8019999861717224},{"id":"https://openalex.org/keywords/cardioprotection","display_name":"cardioprotection","score":0.9010000228881836},{"id":"https://openalex.org/keywords/oxygen-free-radicals","display_name":"oxygen free radicals","score":0.8259999752044678},{"id":"https://openalex.org/keywords/calcium-homeostasis","display_name":"calcium homeostasis","score":0.9779999852180481},{"id":"https://openalex.org/keywords/pkc-epsilon","display_name":"protein kinase C epsilon","score":0.6579999923706055},{"id":"https://openalex.org/keywords/adenosine-receptors","display_name":"adenosine receptors","score":0.7829999923706055},{"id":"https://openalex.org/keywords/atp-sensitive-potassium-channels","display_name":"ATP-sensitive potassium channels","score":0.9150000214576721},{"id":"https://openalex.org/keywords/second-messenger-pathways","display_name":"second messenger pathways","score":0.847000002861023},{"id":"https://openalex.org/keywords/coronary-artery-occlusion","display_name":"coronary artery occlusion","score":0.7699999809265137},{"id":"https://openalex.org/keywords/myocardial-necrosis","display_name":"myocardial necrosis","score":0.6380000114440918},{"id":"https://openalex.org/keywords/left-ventricular-dysfunction","display_name":"left ventricular dysfunction","score":0.718999981880188},{"id":"https://openalex.org/keywords/heart-failure","display_name":"heart failure","score":0.6439999938011169},{"id":"https://openalex.org/keywords/percutaneous-transluminal-coronary-angioplasty","display_name":"percutaneous transluminal coronary angioplasty","score":0.8769999742507935}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9394127130508423},{"id":"https://openalex.org/C2778492669","wikidata":"https://www.wikidata.org/wiki/Q7628762","display_name":"Stunning","level":3,"score":0.799056887626648},{"id":"https://openalex.org/C541997718","wikidata":"https://www.wikidata.org/wiki/Q188151","display_name":"Ischemia","level":2,"score":0.6579336524009705},{"id":"https://openalex.org/C2775992611","wikidata":"https://www.wikidata.org/wiki/Q2075261","display_name":"Myocardial stunning","level":3,"score":0.6164134740829468},{"id":"https://openalex.org/C2779311647","wikidata":"https://www.wikidata.org/wiki/Q17148404","display_name":"Ischemic preconditioning","level":3,"score":0.5460784435272217},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.45242276787757874},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.34331613779067993}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1161/hc5001.100039","doi":"https://doi.org/10.1161/hc5001.100039","is_oa":false,"landing_page_url":"https://doi.org/10.1161/hc5001.100039","pdf_url":null,"source":{"id":"https://openalex.org/S116251202","display_name":"Circulation","issn_l":"0009-7322","issn":["0009-7322","1524-4539"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Circulation","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9391000270843506}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":74,"referenced_works":["https://openalex.org/W2970711","https://openalex.org/W53005362","https://openalex.org/W161733890","https://openalex.org/W169179504","https://openalex.org/W198847974","https://openalex.org/W313032012","https://openalex.org/W1493556752","https://openalex.org/W1965101612","https://openalex.org/W1972499472","https://openalex.org/W1974486977","https://openalex.org/W1978221784","https://openalex.org/W1978698182","https://openalex.org/W1979250205","https://openalex.org/W1983537876","https://openalex.org/W1987664769","https://openalex.org/W1998482069","https://openalex.org/W1999220821","https://openalex.org/W2003182429","https://openalex.org/W2007525497","https://openalex.org/W2010496965","https://openalex.org/W2020971669","https://openalex.org/W2021612538","https://openalex.org/W2026717727","https://openalex.org/W2026826353","https://openalex.org/W2030855199","https://openalex.org/W2030986775","https://openalex.org/W2031492659","https://openalex.org/W2036076671","https://openalex.org/W2036847572","https://openalex.org/W2037381400","https://openalex.org/W2041934112","https://openalex.org/W2049931137","https://openalex.org/W2051035231","https://openalex.org/W2054220851","https://openalex.org/W2054526264","https://openalex.org/W2056117281","https://openalex.org/W2062401160","https://openalex.org/W2067991743","https://openalex.org/W2070951720","https://openalex.org/W2071487519","https://openalex.org/W2079380240","https://openalex.org/W2080761805","https://openalex.org/W2084719078","https://openalex.org/W2085583127","https://openalex.org/W2088043482","https://openalex.org/W2091146995","https://openalex.org/W2092094831","https://openalex.org/W2093233851","https://openalex.org/W2094216675","https://openalex.org/W2109277649","https://openalex.org/W2122272732","https://openalex.org/W2126311981","https://openalex.org/W2133339324","https://openalex.org/W2136545895","https://openalex.org/W2144782341","https://openalex.org/W2146217294","https://openalex.org/W2151575949","https://openalex.org/W2169806115","https://openalex.org/W2171775479","https://openalex.org/W2183243513","https://openalex.org/W2200178908","https://openalex.org/W2210244945","https://openalex.org/W2274304870","https://openalex.org/W2274658894","https://openalex.org/W2278230456","https://openalex.org/W2300605281","https://openalex.org/W2324371576","https://openalex.org/W2354920372","https://openalex.org/W2405287729","https://openalex.org/W2408228088","https://openalex.org/W2409597019","https://openalex.org/W2415255407","https://openalex.org/W2725968691","https://openalex.org/W4236900551"],"related_works":["https://openalex.org/W2054475515","https://openalex.org/W2201768294","https://openalex.org/W169179504","https://openalex.org/W2037580457","https://openalex.org/W2217812117","https://openalex.org/W2301569663","https://openalex.org/W2090846185","https://openalex.org/W2058015324","https://openalex.org/W1981807915","https://openalex.org/W117203086"],"abstract_inverted_index":{"In":[0],"experimental":[1,135],"studies":[2,345],"in":[3,17,36,84,90,98,134,138,218,222,308,319,370,378,427],"the":[4,22,37,43,186,198,205,260,267,296,313,320,334,340,398,403,419,424],"dog,":[5],"total":[6],"proximal":[7],"coronary":[8,106,192,321],"artery":[9,193,322],"occlusions":[10],"of":[11,30,46,54,66,73,77,131,155,175,200,208,236,263,280,290,337,358,390],"up":[12],"to":[13,42,128,149,159,252,367,381,417],"15":[14,28],"minutes":[15,29],"result":[16,377],"reversible":[18],"injury,":[19],"meaning":[20],"that":[21,48,202,250,315,351,361],"myocytes":[23],"survive":[24],"this":[25],"insult.":[26],"The":[27,71,234,412],"ischemia,":[31,111,375],"however,":[32],"induce":[33],"numerous":[34],"changes":[35],"myocardium,":[38,59],"including":[39,102,275],"certain":[40],"monuments":[41,56],"brief":[44,153,388],"episode":[45,207],"ischemia":[47,156,176,391],"may":[49,306],"persist":[50],"for":[51],"days.":[52],"One":[53],"these":[55],"is":[57,229,310,415],"stunned":[58,132],"which":[60,223],"represents":[61],"\u201cprolonged":[62],"postischemic":[63],"contractile":[64,91],"dysfunction":[65,163],"myocardium":[67,133],"salvaged":[68],"by":[69,183,195,312],"reperfusion.\u201d":[70],"mechanism":[72,235],"stunning":[74,420],"involves":[75,239,245],"generation":[76],"oxygen":[78,281],"radicals":[79],"as":[80,82,177,179,256,271,273],"well":[81,272],"alteration":[83,89],"calcium":[85,122,143],"homeostasis":[86],"and":[87,114,121,137,164,228,242,244,286,295,344,401,422],"possibly":[88],"protein":[92,264],"structure.":[93],"Stunning":[94],"has":[95,215,225],"been":[96,126,147,216,226,293],"observed":[97,217],"several":[99],"clinical":[100,141,428],"scenarios,":[101],"after":[103,112,115],"percutaneous":[104],"transluminal":[105],"angioplasty,":[107],"unstable":[108],"angina,":[109,339],"stress-induced":[110],"thrombolysis,":[113],"cardiopulmonary":[116],"bypass.":[117],"Oxygen":[118],"radical":[119],"scavengers":[120],"channel":[123,144],"blockers":[124,145],"have":[125,146,292,393,407],"shown":[127,148],"enhance":[129],"function":[130],"studies,":[136,142],"a":[139,171,189,230,276,287,394,408],"few":[140],"ameliorate":[150],"stunning.":[151],"Although":[152],"periods":[154],"can":[157,392],"contribute":[158],"prolonged":[160],"left":[161],"ventricular":[162],"even":[165],"heart":[166,187],"failure,":[167],"they":[168,406],"paradoxically":[169],"play":[170],"cardioprotective":[172,232],"role.":[173],"Episodes":[174],"short":[178],"5":[180],"minutes,":[181],"followed":[182],"reperfusion,":[184],"protect":[185],"from":[188,204],"subsequent":[190],"longer":[191],"occlusion":[194],"markedly":[196],"reducing":[197],"amount":[199],"necrosis":[201],"results":[203],"test":[206],"ischemia.":[209,383],"This":[210],"phenomenon,":[211],"called":[212],"ischemic":[213,237],"preconditioning,":[214,371],"virtually":[219],"every":[220],"species":[221],"it":[224],"studied":[227],"powerful":[231],"effect.":[233],"preconditioning":[238,291,305,425],"both":[240],"triggers":[241],"mediators":[243],"complex":[246],"second":[247,363],"messenger":[248,364],"pathways":[249,365],"appear":[251],"involve":[253],"such":[254],"components":[255],"adenosine,":[257],"adenosine":[258],"receptors,":[259],"epsilon":[261],"isoform":[262],"kinase":[265],"C,":[266],"ATP-dependent":[268],"potassium":[269],"channels,":[270],"others,":[274],"paradoxical":[277],"protective":[278,335,409],"role":[279],"radicals.":[282],"Both":[283],"an":[284],"early":[285],"late":[288],"phase":[289],"described,":[294],"mechanisms":[297],"underlying":[298],"their":[299],"induction":[300],"are":[301,323],"under":[302],"investigation.":[303],"That":[304],"occur":[307],"humans":[309],"suggested":[311],"observations":[314],"repetitive":[316],"balloon":[317],"inflations":[318],"associated":[324],"with":[325],"progressively":[326],"less":[327],"chest":[328],"pain,":[329],"ST-segment":[330],"elevation,":[331],"lactate":[332],"production,":[333],"effects":[336],"preinfarction":[338],"anginal":[341],"\u201cwarm-up":[342],"phenomenon,\u201d":[343],"performed":[346],"on":[347,385,397,402],"human":[348],"cardiac":[349],"biopsies":[350],"show":[352],"metabolic":[353],"properties":[354],"suggesting":[355],"preconditioning.":[356,411],"Development":[357],"pharmacological":[359],"agents":[360],"stimulate":[362],"thought":[366],"be":[368],"involved":[369],"but":[372],"without":[373],"causing":[374],"could":[376],"novel":[379],"approaches":[380],"treating":[382],"Hence,":[384],"one":[386],"hand,":[387,405],"episodes":[389],"negative":[395],"effect":[396],"heart:":[399],"stunning;":[400],"other":[404],"effect:":[410],"future":[413],"challenge":[414],"how":[416],"minimize":[418],"phenomenon":[421,426],"maximize":[423],"practice.":[429]},"counts_by_year":[{"year":2026,"cited_by_count":4},{"year":2025,"cited_by_count":5},{"year":2024,"cited_by_count":7},{"year":2023,"cited_by_count":3},{"year":2022,"cited_by_count":6},{"year":2021,"cited_by_count":6},{"year":2020,"cited_by_count":8},{"year":2019,"cited_by_count":12},{"year":2018,"cited_by_count":8},{"year":2017,"cited_by_count":9},{"year":2016,"cited_by_count":9},{"year":2015,"cited_by_count":12},{"year":2014,"cited_by_count":10},{"year":2013,"cited_by_count":8},{"year":2012,"cited_by_count":15}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2022-05-11T00:00:00"}