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Published on: May 28, 2019
Pre-conditioning and postconditioning to limit ischemia-reperfusion-induced myocardial injury: what could be the next
Pitchai Balakumar1, Ankur Rohilla, Manjeet Singh
1ISF Institute of Pharmaceutical Sciences and Drug Research, Moga 142001, Punjab, India. pbala2006@gmail.com
Insights
Myocardial ischemia and reperfusion injury can be reduced by pre-conditioning and postconditioning. However, pathological factors like hyperglycemia can suppress these protective effects, impacting heart health.
Area of Science:
- Cardiology
- Physiology
- Pathology
Background:
- Myocardial ischemia reduces coronary blood flow, leading to oxygen and nutrient deficiency.
- Reperfusion following ischemia can cause lethal myocardial injury.
- Pre-conditioning and postconditioning are protective phenomena against ischemia-reperfusion injury.
Purpose of the Study:
- To critically discuss mechanisms of pre- and postconditioning in limiting ischemia-reperfusion injury.
- To delineate clinical relevance and factors affecting cardioprotective potentials.
Main Methods:
- Review of experimental studies on myocardial ischemia and reperfusion.
- Critical discussion of pre-conditioning and postconditioning mechanisms.
- Analysis of factors affecting cardioprotective effects.
Main Results:
- Pre- and postconditioning demonstrate cardioprotective effects against ischemia-reperfusion injury.
- Pathological factors (hyperglycemia, obesity, hypercholesterolemia) can suppress these protective effects.
- Mechanisms underlying cardioprotection and clinical relevance are discussed.
Conclusions:
- Pre- and postconditioning are valuable strategies for protecting the myocardium from injury.
- Understanding and mitigating the impact of pathological factors are crucial for maximizing cardioprotective potential.
Abstract:
Myocardial ischemia is a condition in which the coronary blood flow to the heart is reduced, which results in deficient oxygen and nutrients supply to the heart. Reperfusion to an ischemic myocardium often results in lethal myocardial injury. The brief episodes of ischemia and reperfusion given before prolonged ischemia and reperfusion denote pre-conditioning. On the other hand, brief episodes of ischemia and reperfusion given after prolonged ischemia and at the onset of reperfusion denotes postconditioning. Pre- and postconditioning are anti-jeopardized phenomenons in which both forms have been shown to protect the myocardium from lethal ischemia-reperfusion injury. However, numerous experimental studies reveal that the cardioprotective effects of these phenomenons have been suppressed in presence of some pathological factors such as hyperglycemia, obesity, hypercholesterolemia, etc. In this review, we have critically discussed the mechanisms involved in the cardioprotective effects of pre- and postconditioning to limit ischemia-reperfusion-induced myocardial injury. Moreover, the clinical relevance and factors affecting the cardioprotective potentials of pre- and postconditioning have been delineated.
