[Preconditioning and preservation of myocardial viability]

Preservation of myocardial viability is a major objective of modern cardiology. Many patients develop large infarcts with major functional consequences in the short and long term. Too many still develop progressive left ventricular dysfunction for which cardiac transplantation, with all its limitations, is the only therapeutic possibility. It is therefore essential to prevent or delay the extension of necrosis. Preconditioning is a natural form of protection which delays the development of myocardial necrosis. A great deal of research is under way to understand this complex process of cardiac protection with the objective to develop pharmacological agents able of simulate or to reproduce its effects in the clinical setting.