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Cardioprotective interventions and increased myocardial tolerance to ischemia

Publication at Second Faculty of Medicine |
2017

Abstract

Ischemic heart disease is the most frequent cause of death in developed countries. It is caused by disproportion between myocardial oxygen demands and flow of oxygenized blood through coronary vessels.

The final scope of ischemic damage however depends not only on duration and intensity of ischemia but on the myocardial resistance to ischemia as well. Lots of research groups therefore tasks themselves with increasing this resistance.

Over time, several cardiprotective mechanisms were described (adaptation to chronic hypoxia, ischemic preconditioning, ischemic postconditioning, remote ischemic conditioning and pharmacological protections). Apart from that, two naturally occurring states of high myocardial resistance to ischemia exist (neonatal heart and premenopausal female heart).

Mechanisms of these cardioprotective interventions and states of high myocardial resistance to ischemia are complicated, but they contain many common elements. The aim of this review is to summarize current knowledge regarding cardioprotective interventions with particular attention being paid to intracellular mechanisms of myocardial resistance to ischemia.