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Ischemic preconditioning

E R Schwarz1, W S Whyte, R A Kloner

  • 1Heart Institute Research, Good Samaritan Hospital, Los Angeles, CA 90017-2395, USA.

Current Opinion in Cardiology
|November 14, 1997
PubMed
Summary
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Repeated brief ischemia, known as ischemic preconditioning, makes the heart resistant to prolonged ischemia, limiting infarct size. This cardioprotective effect offers potential for future therapeutic applications.

Area of Science:

  • Cardiovascular Physiology
  • Ischemic Heart Disease Research

Background:

  • Repeated brief coronary occlusions enhance myocardial resistance to prolonged ischemia.
  • This phenomenon, termed ischemic preconditioning, limits infarct size and protects against post-ischemic dysfunction and arrhythmias.
  • A 'second window of protection' reappears at 24 hours after initial preconditioning.

Purpose of the Study:

  • To review the phenomenon of ischemic preconditioning.
  • To discuss the mechanisms underlying acute and late preconditioning.
  • To explore the potential clinical relevance in human hearts.

Main Methods:

  • Review of experimental and clinical evidence on ischemic preconditioning.
  • Discussion of molecular mechanisms including adenosine receptors, ATP-sensitive potassium channels, and stress proteins.

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Main Results:

  • Ischemic preconditioning confers tolerance to ischemia, reducing infarct size.
  • Adenosine receptors and ATP-sensitive potassium channels are implicated in acute protection.
  • Stress protein synthesis may mediate late preconditioning.

Conclusions:

  • Ischemic preconditioning demonstrates significant cardioprotective effects.
  • Evidence suggests preconditioning may exist in the human heart.
  • Understanding these mechanisms could lead to novel therapeutic strategies for ischemic heart disease.