[Induction of increased cardiac tolerance against damage--a new therapeutic principle?]

In animal experiments, brief periods of myocardial ischemia have shown to improve cardiac tolerance against a subsequent ischemic exposure. We argue that ischemic preconditioning may be only one example of a general protective biological adaption to harmful stimuli. We refer to several studies indicating that ischemic preconditioning may occur in patients, e.g. during episodes of angina pectoris, or during percutaneous transluminal coronary angioplasty or cardiac surgery. The phenomenon has also been demonstrated in cultured human myocytes after anoxic periods. In the future, therefore, it may be possible to use suitable drugs to induce higher ischemic tolerance in patients with cardiac disorders. It may also be possible to induce protection against other harmful stimuli. Extensive research is necessary, however, to reveal the underlying mechanisms and choose the most suitable procedures.