Myocardial remote ischemic preconditioning: from pathophysiology to clinical application.

摘要: Abstract Short periods of myocardial ischemia followed by reperfusion induce a cardioprotective mechanism when the myocardium is subsequently subjected to prolonged period ischemia, phenomenon known as ischemic preconditioning. As well its application in myocardium, preconditioning can also be induced brief interruptions blood flow other organs, particularly skeletal muscle. Transient noninvasively inflating cuff on limb, reperfusion, helps reduce damage caused interruption coronary circulation. Remote involves activation humoral and/or neural pathways that open mitochondrial ATP-sensitive potassium channels and close permeability transition pores, making cardiomyocytes less vulnerable ischemia-induced cell death. This now being translated into clinical practice, with positive results several trials artery bypass surgery, surgical repair abdominal aortic aneurysms, valve replacement surgery percutaneous intervention. However, certain factors weaken subcellular mechanisms – age, comorbidities, medication, anesthetic protocol appear explain heterogeneity some studies. Detailed understanding involved cardioprotection expected lead development new drugs consequences ischemia.