HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robert M. Mentzer, Jr Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mentzer, R. M. Search for Related Content PubMed PubMed Citation Articles by Mentzer, R. M., Jr

Ann Thorac Surg 2000;70:356-357
© 2000 The Society of Thoracic Surgeons

---

Editorial

Ischemic preconditioning: how close are we to therapeutic implementation?

^a Department of Surgery, University of Kentucky, Lexington, Kentucky, USA

Address reprint requests to Dr Mentzer, Department of Surgery, University of Kentucky, 800 Rose St, MN264, Lexington, KY 40536-0298
e-mail: mentzer@pop.uky.edu

It is well established experimentally that a brief interval of ischemic stress prior to a period of prolonged ischemia enhances the tolerance of the heart to the insult. This phenomenon, known by the term ischemic preconditioning (IPC), is not confined to the heart and is currently under intense investigation in other organs as well, eg, the brain, skeletal muscle, and the liver. In the heart, this increased tolerance is manifested as a reduction in ventricular arrhythmias and infarct size. Metabolically, it is associated with reduced rates of myocardial adenosine triphosphate (ATP) depletion and interstitial adenosine accumulation.

Despite the fact that classic IPC is one of the most potent methods for lessening infarct size, several aspects of the phenomenon limit direct clinical applicability. The timing of the conditioning event appears to be important, ie, the stimulus must be applied at least 3 minutes prior to the prolonged occlusion. Repeated episodes at short intervals do not enhance the degree of protection; the protection is short-lived and usually disappears within 2 to 3 hours. Ischemic preconditioning can be renewed, but tolerance develops within a short time. Finally, although a decrease in postoperative ventricular arrhythmias and a reduction in infarct size is desirable, a much more . . . [Full Text of this Article]

This article has been cited by other articles:

				S. J. Canyon and G. P. Dobson Pretreatment with an adenosine A1 receptor agonist and lidocaine: A possible alternative to myocardial ischemic preconditioning J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 371 - 377. [Abstract] [Full Text] [PDF]