Cardioprotection 'outside the box'--the evolving paradigm of remote preconditioning.
Conventional ischemic preconditioning is the phenomenon whereby brief episodes of myocardial ischemia render the ischemic territory resistant to a subsequent, sustained ischemic insult. A growing body of evidence further indicates that brief ischemia applied in distant organs and tissues can also protect naïve, virgin myocardium from ischemic injury. In this review, we describe the initial observations that provided the impetus for the study of 'remote preconditioning', and summarize our current knowledge of the three facets of 'preconditioning at a distance' --intra-cardiac, inter-organ and transferred inter-cardiac preconditioning.
Przyklenk
Karin
K
Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA. Karin.Przyklenk@umessmed.edu
Darling
Chad E
CE
Dickson
Eric W
EW
Whittaker
Peter
P
D001921:Brain / Q000502:physiology; D006321:Heart / Q000502:physiology; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D007668:Kidney / Q000502:physiology; D017202:Myocardial Ischemia / Q000503:physiopathology*