Cardiovascular Research Advance Access [Accepted Manuscript] published online on May 2, 2008
Cardiovascular Research, doi:10.1093/cvr/cvn114
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Remote ischemic preconditioning: Underlying mechanisms and clinical application
Corresponding author: Dr Derek Hausenloy The Hatter Cardiovascular Institute, University College London Hospital and Medical School, 67 Chenies Mews, London, WC1E 6HX, United Kingdom Fax: 0044-207-388-5095 Tel: 0044-207-380-9776 Email: d.hausenloy{at}ucl.ac.uk
Remote ischemic preconditioning represents a strategy for harnessing the body's endogenous protective capabilities against the injury incurred by ischemia and reperfusion. It describes the intriguing phenomenon in which transient non-lethal ischemia and reperfusion of one organ or tissue confers resistance to a subsequent episode of lethal ischemia 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 ischemia 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 ischemia-reperfusion injury. This article reviews the history and evolution of the phenomenon that is remote ischemic preconditioning, the potential mechanistic pathways underlying its cardioprotective effect, and its emerging application in the clinical setting.
KEYWORDS ischemia; reperfusion; infarction; preconditioning
Time for primary review: 16 days
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