Preconditioning and postconditioning: underlying mechanisms and clinical application.

摘要: Coronary heart disease (CHD) is the leading cause of death world-wide. Its major pathophysiological manifestation acute myocardial ischaemia-reperfusion injury. Innovative treatment strategies for protecting myocardium against detrimental effects this form injury are required in order to improve clinical outcomes patients with CHD. In regard, harnessing endogenous protection elicited by heart's ability 'condition' itself, has recently emerged as a powerful new strategy limiting injury, preserving left ventricular systolic function and potentially improving morbidity mortality 'Conditioning' tolerate can be initiated through application several different mechanical pharmacological strategies. Inducing brief non-lethal episodes ischaemia reperfusion either prior to, during, or even after an episode sustained lethal capacity dramatically reduce injury--a phenomenon termed ischaemic preconditioning (IPC), postconditioning, respectively. Intriguingly, similar levels cardioprotection achieved applying organ tissue remote from heart, thereby obviating need directly. This been 'conditioning', it offer widespread systemic other organs which susceptible such brain, liver, intestine kidney. Furthermore, identification signalling pathways underlie provided novel targets agents allowing one recapitulate benefits these cardioprotective phenomena--so-termed postconditioning. Initial studies, reporting beneficial 'conditioning' have encouraging. Larger multi-centred randomised studies now determine whether able impact on outcomes. article, we provide overview all its various forms, describe underlying mechanisms review recent emerging strategy.