title: Ischemic preconditioning: protection against myocardial necrosis and apoptosis.
abstract: The phenomenon of ischemic preconditioning has been recognized as one of the most potent mechanisms to protect against myocardial ischemic injury. In experimental animals and humans, a brief period of ischemia has been shown to protect the heart from more prolonged episodes of ischemia, reducing infarct size, attenuating the incidence, and severity of reperfusion-induced arrhythmias, and preventing endothelial cell dysfunction. Although the exact mechanism of ischemic preconditioning remains obscure, several reports indicate that this phenomenon may be a form of receptor-mediated cardiac protection and that the underlying intracellular signal transduction pathways involve activation of a number of protein kinases, including protein kinase C, and mitochondrial K(ATP) channels. Apoptosis, a genetically programmed form of cell death, has been associated with cardiomyocyte cell loss in a variety of cardiac pathologies, including cardiac failure and those related to ischemia/reperfusion injury. While ischemic preconditioning significantly reduces DNA fragmentation and apoptotic myocyte death associated with ischemia-reperfusion, the potential mechanisms underlying this effect have not been fully clarified. A comprehensive understanding of these mechanisms and application to clinical scenarios will provide new directions in research and translate this information into new treatment approaches for reducing the extent of ischemia/reperfusion injury.
authors: 2nd University Department of Cardiology, Medical School, University of Athens, Greece.
authors: Efstathios K
authors: EK
authors: Iliodromitis
authors: Antigone
authors: A
authors: Lazou
authors: Dimitrios Th
authors: DT
authors: Kremastinos
mesh_terms: D000818:Animals; D017209:Apoptosis; D006801:Humans; D019194:Ischemic Preconditioning; D017202:Myocardial Ischemia / Q000473:pathology*; D009336:Necrosis / Q000473:pathology