title: 9th Hatter Biannual Meeting: position document on ischaemia/reperfusion injury, conditioning and the ten commandments of cardioprotection.
abstract: In the 30 years since the original description of ischaemic preconditioning, understanding of the pathophysiology of ischaemia/reperfusion injury and concepts of cardioprotection have been revolutionised. In the same period of time, management of patients with coronary artery disease has also been transformed: coronary artery and valve surgery are now deemed routine with generally excellent outcomes, and the management of acute coronary syndromes has seen decade on decade reductions in cardiovascular mortality. Nonetheless, despite these improvements, cardiovascular disease and ischaemic heart disease in particular, remain the leading cause of death and a significant cause of long-term morbidity (with a concomitant increase in the incidence of heart failure) worldwide. The need for effective cardioprotective strategies has never been so pressing. However, despite unequivocal evidence of the existence of ischaemia/reperfusion in animal models providing a robust rationale for study in man, recent phase 3 clinical trials studying a variety of cardioprotective strategies in cardiac surgery and acute ST-elevation myocardial infarction have provided mixed results. The investigators meeting at the Hatter Cardiovascular Institute workshop describe the challenge of translating strong pre-clinical data into effective clinical intervention strategies in patients in whom effective medical therapy is already altering the pathophysiology of ischaemia/reperfusion injury-and lay out a clearly defined framework for future basic and clinical research to improve the chances of successful translation of strong pre-clinical interventions in man.
authors.affiliation: The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, 67 Chenies Mews, London, WC1E 6HX, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Bell
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: H E
authors.initials: HE
authors.lastname: Bøtker
authors.affiliation: The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, 67 Chenies Mews, London, WC1E 6HX, UK.|MSD A/S, Copenhagen V, Denmark.
authors.forename: R D
authors.initials: RD
authors.lastname: Carr
authors.affiliation: The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, 67 Chenies Mews, London, WC1E 6HX, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Davidson
authors.affiliation: Department of Physiology, University of South Alabama College of Medicine, Mobile, AL, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Downey
authors.affiliation: Department of Cardiovascular Medicine, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: D P
authors.initials: DP
authors.lastname: Dutka
authors.affiliation: Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Heusch
authors.affiliation: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Ibanez
authors.affiliation: Centre for Clinical Pharmacology, University College London, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Macallister
authors.affiliation: Department of Anesthesiology, University Hospital Aachen, Aachen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Stoppe
authors.affiliation: Centre de recherche en Cancérologie de Lyon, Université Lyon, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Ovize
authors.affiliation: Department of Pediatric Cardiology, the Heart Institute at Cincinnati Children's Hospital, Cincinnati, OH, USA.
authors.forename: A
authors.initials: A
authors.lastname: Redington
authors.affiliation: The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, 67 Chenies Mews, London, WC1E 6HX, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Walker
authors.affiliation: The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, 67 Chenies Mews, London, WC1E 6HX, UK. d.yellon@ucl.ac.uk.
authors.forename: D M
authors.initials: DM
authors.lastname: Yellon
mesh_terms: D000818:Animals; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods / Q000639:trends; D015428:Myocardial Reperfusion Injury; D057170:Translational Research, Biomedical
keywords: Apoptosis; Asprin; Autophagy; Basic research; Beta blockers; CABG; Cardiac surgery; Clinical trials; Conditioning; Cyclosporine; DNA; Infarction; Injury; Ischaemia; Ischaemic; Metoprolol; Mitochondrial transition pore; Necroptosis; Necrosis; Opiates; Postconditioning; Pre-clinical; Preconditioning; Pyroptosis; RISK pathway; Reperfusion; SAFE pathway; Statins; Valve replacement; p2y12