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Updated: Jul 10, 2025
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Is Intrinsic Cardioprotection a Laboratory Phenomenon or a Clinically Relevant Tool to Salvage the Failing Heart?
Tanya Ravingerova1, Adriana Adameova1,2, Lubomir Lonek1
1Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 9 Dubravska cesta, 841 04 Bratislava, Slovakia.
Insights
Cardiovascular diseases remain a major health threat, leading to heart failure (HF). Novel preconditioning strategies offer promising avenues for protecting the heart against injury and improving HF treatment.
Area of Science:
- Cardiology
- Molecular Biology
- Pathophysiology
Background:
- Cardiovascular diseases, particularly ischemic heart disease, are leading causes of heart failure (HF) and mortality.
- Despite advances in treatment, HF incidence is rising, especially in the elderly, with worse outcomes in females.
- Ischemic preconditioning (IPC) demonstrates cardioprotective effects by adapting the heart to stress, but clinical translation is challenging.
Purpose of the Study:
- To review the molecular mechanisms underlying heart injury and repair in the context of cardiovascular diseases.
- To explore various preconditioning strategies, including traditional IPC, remote IPC, hypoxia, and exercise-induced preconditioning, as potential interventions for HF.
- To discuss the promise of noninvasive adaptive interventions in combating HF by targeting its complex mechanisms.
Main Methods:
- Review of existing literature on molecular mechanisms of cardiac injury and repair.
- Analysis of studies investigating different forms of preconditioning (IPC, remote IPC, hypoxia, exercise).
- Discussion of the clinical applicability and effectiveness of these interventions.
Main Results:
- Ischemic preconditioning (IPC) shows an infarct-sparing effect, enhancing cardiac resistance to severe insults.
- Novel approaches like remote IPC, hypoxia adaptation, and exercise-induced preconditioning are being explored for clinical application in HF.
- While molecular mechanisms are not fully elucidated, noninvasive preconditioning strategies show potential for HF treatment.
Conclusions:
- Cardiovascular diseases and resultant heart failure pose a significant and growing public health challenge.
- Adaptive interventions, particularly noninvasive preconditioning methods, represent promising strategies for enhancing cardiac tolerance and treating HF.
- Further research into the molecular underpinnings of these interventions is crucial for optimizing their clinical use in managing heart failure.
Abstract:
Cardiovascular diseases, especially ischemic heart disease, as a leading cause of heart failure (HF) and mortality, will not reduce over the coming decades despite the progress in pharmacotherapy, interventional cardiology, and surgery. Although patients surviving acute myocardial infarction live longer, alteration of heart function will later lead to HF. Its rising incidence represents a danger, especially among the elderly, with data showing more unfavorable results among females than among males. Experiments revealed an infarct-sparing effect of ischemic "preconditioning" (IPC) as the most robust form of innate cardioprotection based on the heart's adaptation to moderate stress, increasing its resistance to severe insults. However, translation to clinical practice is limited by technical requirements and limited time. Novel forms of adaptive interventions, such as "remote" IPC, have already been applied in patients, albeit with different effectiveness. Cardiac ischemic tolerance can also be increased by other noninvasive approaches, such as adaptation to hypoxia- or exercise-induced preconditioning. Although their molecular mechanisms are not yet fully understood, some noninvasive modalities appear to be promising novel strategies for fighting HF through targeting its numerous mechanisms. In this review, we will discuss the molecular mechanisms of heart injury and repair, as well as interventions that have potential to be used in the treatment of patients.
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