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Preconditioning induced protection against post-ischaemic contractile dysfunction: Characteristics and mechanisms

1995; Elsevier BV; Volume: 27; Issue: 4 Linguagem: Inglês

10.1016/0022-2828(95)90066-7

1095-8584

Andrew Cave,

Anesthesia and Neurotoxicity Research

Ischaemic preconditioning was first described by Murry and colleagues in 1986. Since this report, many investigators have demonstrated the remarkable protective effect that can be achieved by preceding a prolonged ischaemic episode with either a single short cycle of ischaemia and reperfusion or a number of such cycles (Li et al., 1990; Thornton et al., 1990; Cave and Hearse, 1992). In the initial study of Murry et al. (1986), the protection was manifest as a reduction in infarct size in an openchest anaesthetized dog preparation but protection has since been demonstrated in a variety of species and both in vitro and in vivo (Thornton et al., 1990; Schott et al., 1990; Murry et al., 1986; Cave and Hearse, 1 9 9 2 ) . Preconditioning has also been shown to protect against a variety of indices of ischaemia/reperfusion injury including tissue necrosis (Thornton et al., 1990), ischaemia(Lawson et al., 1993) or reperfusion-induced arrhythmias (Shiki and Hearse, 1987) and contractile dysfunction (Cave and Hearse, 1992). Perhaps the single most important determinant of mortality following infarction is the extent of residual contractile function (Pasternak et al., 1988). The increasingly successful use of revascularization techniques such as coronary artery bypass surgery, thrombolysis and angioplasty make the understanding of the cellular processes underlying post-ischaemic contractile dysfunction essential. The purpose of this article is to review the evidence suggesting that ischaemic preconditioning can provide significant and profound protection against contractile dysfunction and to discuss the possible cellular mechanisms.