Mechanisms of cardiac preconditioning: ten years after the discovery of ischemic preconditioning.

Cardiac preconditioning describes the phenomenon by which transient ischemia induces myocardial protection against subsequent ischemia and reperfusion injury. Ten years have passed since the original description of this potent cardiac protective strategy and within this period tremendous progress has been made elucidating the mechanisms of preconditioning. Mechanistic understanding may allow safe clinical application. This review (1) recalls the history of preconditioning and how it relates to the history of the investigation of endogenous adaptation; (2) summarizes the current mechanistic understanding of early preconditioning; (3) compares and contrasts the mechanisms of early versus delayed preconditioning; (4) suggests potential anti-inflammatory aspects of preconditioning; (5) examines limitations in laboratory models of preconditioning; and (6) explores the potential of using preconditioning clinically. Copyright 1997 Academic Press.