Clinical cardioprotection and the value of conditioning responses

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Title Clinical cardioprotection and the value of conditioning responses
Author Peart, Jason Nigel John; Headrick, John Patrick
Journal Name American Journal of Physiology: Heart and Circulatory Physiology
Year Published 2009
Place of publication United States
Publisher American Physiological Society
Abstract Adjunctive cardioprotective strategies for ameliorating the reversible and irreversible injuries with ischemia-reperfusion (I/R) are highly desirable. However, after decades of research, the promise of clinical cardioprotection from I/R injury remains poorly realized. This may arise from the challenges of trialing and effectively translating experimental findings from laboratory models to patients. One can additionally consider whether features of the more heavily focused upon candidates could limit or preclude therapeutic utility and thus whether we might shift attention to alternate strategies. The phenomena of preconditioning and postconditioning have proven fertile in identification of experimental means of cardioprotection and are the most intensely interrogated responses in the field. However, there is evidence these processes, which share common molecular signaling elements and end effectors, may be poor choices for clinical exploitation. This includes evidence of age dependence, limiting efficacy in target aged or senescent hearts; refractoriness to conditioning stimuli in diseased myocardium; interference from a variety of relevant pharmaceuticals; inadvertent induction of these responses by prior ischemia or commonly used drugs, precluding further benefit; and sex dependence of protective signaling. This review focuses on these features, raising questions about current research strategies, and the suitability of these widely studied phenomena as rational candidates for clinical translation.
Peer Reviewed Yes
Published Yes
Alternative URI
Copyright Statement Self-archiving of the author-manuscript version is not yet supported by this journal. Please refer to the journal link for access to the definitive, published version or contact the authors for more information.
Volume 296
Issue Number 6
Page from H1705
Page to H1720
ISSN 0363-6135
Date Accessioned 2009-06-17
Date Available 2015-04-22T05:40:42Z
Language en_US
Research Centre Menzies Health Institute Qld; Heart Foundation Research Centre
Faculty Griffith Health Faculty
Subject Cardiology (incl Cardiovascular Diseases)
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1a

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