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Related Experiment Videos

Clinical effects of ischemic preconditioning.

E R Schwarz1, T Reffelmann, R A Kloner

  • 1Heart Institute, Good Samaritan Hospital, Los Angeles, California, USA.

Current Opinion in Cardiology
|August 17, 1999
PubMed
Summary

Brief ischemia protects the heart by reducing infarct size. This cardioprotective effect, known as preconditioning, is observed in experimental studies and shows promise in patients with coronary artery disease.

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Area of Science:

  • Cardiology
  • Experimental Medicine
  • Pharmacology

Background:

  • Myocardial preconditioning, induced by brief ischemia, significantly reduces infarct size in experimental models.
  • Evidence suggests preconditioning occurs in humans with coronary artery disease, indicated by effects from repeated balloon inflations and improved outcomes in patients with angina prior to myocardial infarction.

Purpose of the Study:

  • To review the evidence for myocardial preconditioning in experimental and human studies.
  • To identify potential pharmacological mediators of preconditioning and their therapeutic implications.
  • To discuss the potential use of preconditioning mimetics in clinical settings and consider antipreconditioning effects.

Main Methods:

  • Review of experimental studies on myocardial preconditioning.

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  • Analysis of clinical evidence in patients with coronary artery disease undergoing procedures like coronary angioplasty.
  • Identification and discussion of pharmacological agents (e.g., adenosine, KATP channel openers) and their roles.

    • Main Results:

    • Experimental studies consistently show that brief ischemia confers cardioprotection, reducing infarct size.
    • Clinical observations suggest preconditioning-like effects in humans, with improved outcomes in certain patient groups.
    • Adenosine and adenosine triphosphate-sensitive potassium channel openers are identified as potential mediators of preconditioning.

    Conclusions:

    • Myocardial preconditioning is a potent cardioprotective strategy with evidence supporting its existence in humans.
    • Preconditioning mimetics hold therapeutic potential for protecting myocardial tissue during procedures like angioplasty and surgery.
    • Further research is needed for clinical application in chronic myocardial ischemia, and potential antipreconditioning effects of drugs like sulfonylureas must be considered.