Cardiovascular Research Institute and Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Drugs Aging. 2011 May 1;28(5):331-43. doi: 10.2165/11587190-000000000-00000.
Evidence obtained in multiple experimental models has revealed that cardiac 'conditioning' strategies--including ischaemic preconditioning, postconditioning, remote conditioning and administration of pharmacological conditioning mimetics--are profoundly protective and significantly attenuate myocardial ischaemia-reperfusion injury. As a result, there is considerable interest in translating these cardioprotective paradigms from the laboratory to patients. However, the majority of studies investigating conditioning-induced cardioprotection have utilized healthy adult animals devoid of the risk factors and co-morbidities associated with cardiovascular disease and acute myocardial infarction. The aim of this article is to summarize the growing consensus that two well established risk factors, aging and diabetes mellitus, may render the heart refractory to the favourable effects of myocardial conditioning, and discuss the clinical implications of a loss in efficacy of cardiac conditioning paradigms in these patient populations.
多项实验模型获得的证据表明，心脏“预处理”策略——包括缺血预处理、后处理、远隔预处理和应用药理学预处理模拟物——具有显著的保护作用，可明显减轻心肌缺血再灌注损伤。因此，人们非常有兴趣将这些心脏保护模式从实验室转化为临床应用。然而，大多数研究预处理诱导的心脏保护作用的实验都使用了没有心血管疾病和急性心肌梗死相关风险因素和合并症的健康成年动物。本文旨在总结一个日益得到共识的观点，即两个公认的风险因素——衰老和糖尿病——可能使心脏对心肌预处理的有利作用产生抵抗，并讨论这些患者人群中心脏预处理模式有效性丧失的临床意义。
