ISCHEMIC PRECONDITIONING CELLULAR AND MOLECULAR MECHANISMS, PROSPECTS FOR CARDIOLOGICAL APPLICATION. REVIEW
Introduction: Myocardial preconditioning currently has great clinical interest, since its initiation triggers the mechanisms of cardioprotection and metabolic adaptation to non-lethal ischemia, which is very important for patients with reduced coronary reserve. The use of the phenomenon of myocardial preconditioning in rehabilitation programs is pathogenetically substantiated and innovative.
Aim: Analysis of literature sources on the current state of pathogenetic, cellular and molecular mechanisms of ischemic preconditioning, clinical variants, the possibility of pharmacological preconditioning.
Search strategy: The review of scientific publications was carried out in the databases (PubMed, Scopus, Ebscohost, Medine, The Cochrane Library, SpringerLink, Web of Knowledge (ThomsonReuters), (ResearchGate). Inclusion criteria: reports of randomized and cohort studies, meta-analyses and systematic reviews, original articles in English and Russian. Search depth 20 years (2001-2021).
Results: In clinical settings, preconditioning resembles the "going through pain” phenomenon. Patients with stress tests may experience attacks of angina pectoris, but if they continue to exercise, after a while the pain disappears. The evidence for the existence of preconditioning is the fact that patients with exertional angina often develop the phenomenon of warming up, so that raising the threshold of exercise tolerance during repeated exercise.
Conclusions. The results of numerous experimental and clinical studies indicate the high efficiency of preconditioning in the prevention of ischemic myocardial damage. The use of pharmacological drugs to initiate this phenomenon is an alternative for many patients, this will significantly improve not only the treatment, but also the secondary prevention of CHD.
Assel A. Chinybaeva*
* Corporate Foundation "Universyty Medical Center", Republican Clinical and Diagnostic center.
Department of Functional Diagnostics, Nur-Sultan c. Republic of Kazakhstan.
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Chinybaeva A.A. Ischemic preconditioning cellular and molecular mechanisms, prospects for cardiological application. Review // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 6, pp. 140-150. doi:10.34689/SH.2021.23.6.016Related publications:
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