Combined morphine and limb remote ischaemia postconditioning may produce an enhanced cardioprotection

The limb remote ischaemia postconditioning (RIPOC), a newly conceived idea of applying brief limb ischaemic stimulus after onset of the myocardial ischaemia but prior to the reperfusion, can offer the possibility of applying this cardioprotective strategy to the patients with acute myocardial infraction. Although increasing numbers of circles and duration of limb ischaemia may augment the protective effect of the limb RIPOC, these ways are not feasible in a clinical setting. Morphine, a classic opioid drug, has been proven to enhance the cardioprotection obtained by the other interventions. Because both the RPIOC and opioid drugs produce the cardioprotection by multiple pathways, and there may be overlaps and cross talk in their mechanisms, we hypothesize that a combination of morphine and the limb RIPOC may produce an enhanced cardioprotection.