[Adaptation to hypoxia and ischemic preconditioning: from basic research to clinical practice]

Experimental and clinical studies of the last ten years gave evidence of successful application of the protective effect of hypoxia in clinical practice. The view of hypoxia as an exclusively injurious factor has undergone significant changes. A promising approach to solving the problem of heart adaptation to ischemic injury is the use of cellular mechanisms realized through myocardial ischemic preconditioning (IP). Modern understanding of the mechanisms of IP protective effect takes into consideration the processes underlying the development of adaptation to hypoxia related to the changes in intracellular metabolism and accompanied by a stronger activation of the systems responsible for adaptation. All this provides a real opportunity for studying intracellular functional and metabolic mechanisms of adaptation to hypoxia and ischemia, formation of adaptive syndromes in clinical practice, development and implementation of new evidence-based medical technologies for diagnostics, prevention, and rehabilitative treatment of heart pathology.