BMJ 1994;308:1 (1 January)

Editorials

Ischaemic preconditioning

Is myocardial ischaemia always harmful? Research is proving that it is not. Traditionally it was thought that myocardium sublethally injured by a brief period of ischaemia would become more sensitive to subsequent ischaemia and that repeated brief ischaemic insults might cumulatively cause infarction. This is not the case. In 1986 Murry and colleagues described the results of a series of experiments on canine hearts, which examined the metabolic consequences of repeated brief episodes of ischaemia with intervening reperfusion (reviewed by Reimer and Jennings1). Although myocardial ATP concentrations fell during the first brief coronary artery occlusion, these concentrations were preserved during further identical occlusions and no necrosis occurred. Murry and colleagues then found that pretreatment with similar repeated brief periods of ischaemia also triggered adaptive changes that protected the myocardium from the effects of a subsequent, prolonged ischaemic insult.1 Compared with that in controls the size of myocardial infarction fell . . . [Full text of this article]


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Relevant Article

Ischaemic preconditioning
M Hargreaves
BMJ 1994 308: 414. [Extract] [Full Text]

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