title: Remote ischemic conditioning.
abstract: In remote ischemic conditioning (RIC), brief, reversible episodes of ischemia with reperfusion in one vascular bed, tissue, or organ confer a global protective phenotype and render remote tissues and organs resistant to ischemia/reperfusion injury. The peripheral stimulus can be chemical, mechanical, or electrical and involves activation of peripheral sensory nerves. The signal transfer to the heart or other organs is through neuronal and humoral communications. Protection can be transferred, even across species, with plasma-derived dialysate and involves nitric oxide, stromal derived factor-1α, microribonucleic acid-144, but also other, not yet identified factors. Intracardiac signal transduction involves: adenosine, bradykinin, cytokines, and chemokines, which activate specific receptors; intracellular kinases; and mitochondrial function. RIC by repeated brief inflation/deflation of a blood pressure cuff protects against endothelial dysfunction and myocardial injury in percutaneous coronary interventions, coronary artery bypass grafting, and reperfused acute myocardial infarction. RIC is safe and effective, noninvasive, easily feasible, and inexpensive.
authors.affiliation: Institute for Pathophysiology, West German Heart and Vascular Centre Essen, University of Essen Medical School, Essen, Germany. Electronic address: gerd.heusch@uk-essen.de.
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
authors.affiliation: Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Bøtker
authors.affiliation: Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Karin
authors.initials: K
authors.lastname: Przyklenk
authors.affiliation: Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Redington
authors.affiliation: The Hatter Cardiovascular Institute, University College London, London, United Kingdom.
authors.forename: Derek
authors.initials: D
authors.lastname: Yellon
mesh_terms: D000818:Animals; D003326:Coronary Circulation / Q000502:physiology*; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control*
keywords: acute myocardial infarction; coronary artery bypass grafting; myocardial ischemia; reperfusion