Cellular and molecular events in ischemic preconditioning: potential therapeutic applications in cardioprotection

Cardioprotection is a mechanism of guarding the heart from damage secondary to different insults including ischaemia, ischaemia/reperfusion, chemical, metabolic and physical stressors. Ischemic preconditioning, by single or multiple brief periods of ischaemia, protects the heart against a more prolonged ischemic insult (index ischaemia). Understanding the cellular, molecular and biochemical events occurring in cardioprotection will allow the development of new interventions to improve the outcome of patients with myocardial diseases. Most of the present experience with cardioprotection has been obtained from studies in young and middle-aged animals, and cells. In the future, cardioprotection research should be carried out mainly in the aging or senescent heart since this will be most relevant to humans. With aging, the heart has a decreased capacity to tolerate and respond to various forms of stress, and the likelihood of myocardial ischaemia and cardiac dysfunction increases.