Engelsk titel: Preconditioning - endogenous defence mechanisms of the heart during ischemia
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Författare:
Sommerschild HT
Språk: Nor
Antal referenser: 48
Dokumenttyp:
Översikt
UI-nummer: 00112307
Sammanfattning
BACKGROUND : The term "preconditioning" refers to the paradoxical phenomenon that pretreatment with a potential noxious stress-stimulus can increase cellular tolerance to subsequent noxious stress-stimuli. This was first described in an experimental model in dog hearts in which short-lasting periods of myocardial ischaemia resulted in reduced infarction during a subsequent long-lasting ischaemic period. Similar observations are made in other organs and species. Preconditioning is also used to describe pretreatment with other physical stress-stimuli or pharmacological agents that can increase resistance against cellular damage. This phenomenon probably represents a general adaptive response to cellular stress.
INTERPRETATION : Preconditioning is of great interest because its effect is vigorous and reproducible, with a potential for use in patients with coronary heart disease. Preconditioning also illustrates how activation of endogenous defence mechanisms can increase cellular tolerance to ischaemia or other stress stimuli.
RESULTS : It is shown that preconditioning can reduce myocardial infarction in patients. However, protection against reduced contractility without infarction ("stunning") and arrhythmia is more uncertain. Several mechanisms might be involved; these are not fully clarified.
MATERIAL AND METHODS : This review focuses on preconditioning in the heart and the possible endogenous mechanisms involved. The potential clinical role of preconditioning is also discussed.