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Ischemic conditioning: the challenge of protecting the diabetic heart

Joseph Wider1, Karin Przyklenk1

  • 11 Cardiovascular Research Institute, 2 Department of Physiology, 3 Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI, USA.

Cardiovascular Diagnosis and Therapy
|November 22, 2014
PubMed

Insights

Ischemic conditioning protects the heart from injury, but its effectiveness may be reduced in patients with type-2 diabetes. This review explores the impact of diabetes on this cardioprotective strategy.

Area of Science:

  • Cardiology
  • Diabetology
  • Translational Medicine

Background:

  • Myocardial ischemia-reperfusion injury is a critical clinical challenge, especially in type-2 diabetes patients.
  • Ischemic conditioning (preconditioning, postconditioning, remote conditioning) shows significant preclinical cardioprotection.
  • Clinical trials on ischemic conditioning for myocardial infarction have shown inconsistent results.

Purpose of the Study:

  • To review the effect of type-2 diabetes on ischemic conditioning-induced cardioprotection.
  • To summarize current understanding of compromised infarct-sparing effects in diabetic hearts.
  • To highlight challenges in limiting ischemia-reperfusion injury in diabetic patients.

Main Methods:

  • Literature review of preclinical and clinical studies.
  • Analysis of mechanisms underlying cardioprotection.
  • Examination of diabetes-specific alterations in signaling pathways.

Main Results:

  • Preclinical data suggest ischemic conditioning is cardioprotective.
  • Clinical efficacy of ischemic conditioning is variable, potentially due to diabetes.
  • Type-2 diabetes may attenuate the infarct-sparing effects of ischemic conditioning.

Conclusions:

  • The cardioprotective benefits of ischemic conditioning may be impaired in type-2 diabetes.
  • Further research is needed to overcome diabetes-related limitations in ischemic conditioning.
  • Developing strategies to enhance conditioning efficacy in diabetic hearts is crucial.
Keywords:
Myocardial infarctiondiabetespostconditioningpreconditioningremote conditioning

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