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Controversies in preconditioning

J W de Jong1, R de Jonge, A Marchesani

  • 1Cardiochemical Laboratory, Thorax Center, Erasmus University Rotterdam, The Netherlands.

Cardiovascular Drugs and Therapy
|January 1, 1997
PubMed
Summary
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Cardiac preconditioning protects the heart from ischemia via minor insults. Adenosine and protein kinase C are key, but roles of other factors like noradrenaline and glycolysis remain debated, with species differences noted.

Area of Science:

  • Cardiology
  • Molecular Biology
  • Physiology

Background:

  • Cardiac preconditioning is a protective phenomenon against ischemia.
  • It involves pretreatment with a brief insult to induce tolerance to a subsequent major insult.
  • This review addresses controversies and key molecular players in cardiac preconditioning.

Purpose of the Study:

  • To review current controversies in cardiac preconditioning research.
  • To elucidate the roles of various signaling molecules and pathways.
  • To discuss the potential clinical relevance of preconditioning.

Main Methods:

  • Review of existing literature on cardiac preconditioning.
  • Analysis of experimental data regarding molecular mechanisms.
  • Discussion of species differences and clinical applications.

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Main Results:

  • Adenosine, via protein kinase C activation, is implicated in many preconditioning models.
  • The roles of bradykinin, noradrenaline, 5'-nucleotidase, mitochondrial ATPase, acidosis, and tissue ATP are debated or uncertain.
  • Glycolysis's role is not firmly established, with differing mechanisms in low-flow and stop-flow protocols.

Conclusions:

  • Cardiac preconditioning involves complex signaling pathways with ongoing research debates.
  • Species differences are largely quantitative, not qualitative.
  • Preconditioning may have clinical relevance in procedures like bypass surgery and angioplasty.