Pharmacological modulation, preclinical studies, and new clinical features of myocardial ischemic preconditioning.
The term "ischemic preconditioning (PC)" was first applied to canine myocardium subjected to brief episodes of ischemia and reperfusion that tolerated a more prolonged episode of ischemia better than myocardium not previously exposed to ischemia. Protective effect of myocardial ischemic PC was demonstrated in several animal species, resulting in the strongest endogenous form of protection against myocardial injury, jeopardized myocardium, infarct size, and arrhythmias other than early reperfusion. New onset angina before acute myocardial infarction, episodes of myocardial ischemia during coronary angioplasty or bypass surgery, and the "warm-up" phenomenon may represent clinical counterparts of the PC phenomenon in humans. Here, we have attempted to summarize pharmacological modulation, preclinical studies, and new clinical features of ischemic PC. To date, the pathophysiological basis of the "chemical PC" is still not well established, and "putting PC in a bottle" for clinical applications still remains a new pharmacological venture.
Napoli
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Department of Medicine, Federico II University of Naples, P.O. Box, Naples 80131, Italy. claunap@tin.it cnapoli@ucsd.edu
Pinto
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Cirino
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D000368:Aged; D000375:Aging; D000787:Angina Pectoris / Q000503:physiopathology; D017130:Angioplasty; D000818:Animals; D001786:Blood Glucose; D001026:Coronary Artery Bypass; D004195:Disease Models, Animal; D004285:Dogs; D004358:Drug Therapy / Q000639:trends; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000503:physiopathology*; D011957:Receptors, Opioid / Q000502:physiology; D018047:Receptors, Purinergic P1 / Q000502:physiology
D001786:Blood Glucose; D011957:Receptors, Opioid; D018047:Receptors, Purinergic P1