Cardiovascular Research Advance Access first published online on May 2, 2008
This version [Corrected Proof] published online on May 20, 2008
Cardiovascular Research, doi:10.1093/cvr/cvn114
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Remote ischaemic preconditioning: underlying mechanisms and clinical application
The Hatter Cardiovascular Institute, University College London Hospital and Medical School, 67 Chenies Mews, London WC1E 6HX, UK
* Corresponding author. Tel: +44 207 380 9888; fax: +44 207 380 9505. E-mail address: d.hausenloy{at}ucl.ac.uk
Remote ischaemic preconditioning (RIPC) represents a strategy for harnessing the body’s endogenous protective capabilities against the injury incurred by ischaemia and reperfusion. It describes the intriguing phenomenon in which transient non-lethal ischaemia and reperfusion of one organ or tissue confers resistance to a subsequent episode of lethal ischaemia reperfusion injury in a remote organ or tissue. In its original conception, it described intramyocardial protection, which could be relayed from the myocardium served by one coronary artery to another. It soon became apparent that myocardial infarct size could be dramatically reduced by applying brief ischaemia and reperfusion to an organ or tissue remote from the heart before the onset of myocardial infarction. The concept of remote organ protection has now been extended beyond that of solely protecting the heart to providing a general form of inter-organ protection against ischaemia-reperfusion injury. This article reviews the history and evolution of the phenomenon that is RIPC, the potential mechanistic pathways underlying its cardioprotective effect, and its emerging application in the clinical setting.
KEYWORDS Ischaemia; Reperfusion; Infarction; Preconditioning
Time for primary review: 16 days
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