Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 65, Issue 2, Pages 177-195Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2014.10.031
Keywords
acute myocardial infarction; coronary artery bypass grafting; myocardial ischemia; reperfusion
Categories
Funding
- British Heart Foundation [RG/08/015/26411] Funding Source: Medline
- Medical Research Council [MR/K002066/1] Funding Source: Medline
- NHLBI NIH HHS [R56 HL072684, R01 HL072684, HL072684] Funding Source: Medline
- British Heart Foundation [RG/08/015/26411] Funding Source: researchfish
- Medical Research Council [MR/K002066/1] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0510-10164] Funding Source: researchfish
- Novo Nordisk Fonden [NNF13OC0007447, NNF14OC0013337] Funding Source: researchfish
- Rosetrees Trust [M274] Funding Source: researchfish
- MRC [MR/K002066/1] Funding Source: UKRI
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In remote ischemic conditioning (RIC), brief, reversible episodes of ischemia with reperfusion in one vascular bed, tissue, or organ confer a global protective phenotype and render remote tissues and organs resistant to ischemia/reperfusion injury. The peripheral stimulus can be chemical, mechanical, or electrical and involves activation of peripheral sensory nerves. The signal transfer to the heart or other organs is through neuronal and humoral communications. Protection can be transferred, even across species, with plasma-derived dialysate and involves nitric oxide, stromal derived factor-1 alpha, microribonucleic acid-144, but also other, not yet identified factors. Intracardiac signal transduction involves: adenosine, bradykinin, cytokines, and chemokines, which activate specific receptors; intracellular kinases; and mitochondrial function. RIC by repeated brief inflation/deflation of a blood pressure cuff protects against endothelial dysfunction and myocardial injury in percutaneous coronary interventions, coronary artery bypass grafting, and reperfused acute myocardial infarction. RIC is safe and effective, noninvasive, easily feasible, and inexpensive. (C) 2015 by the American College of Cardiology Foundation.
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