Quindry John C
1 Health and Human Performance, University of Montana, Missoula, MT, USA.
J Cardiovasc Pharmacol Ther. 2017 Sep;22(5):397-403. doi: 10.1177/1074248417715005. Epub 2017 Jun 20.
In the search for innovative solutions to treat ischemic heart disease, recent basic science and clinical approaches have focused on remote ischemic preconditioning (RIPC). Remote ischemic preconditioning involves short intervals of limb blood flow occlusion by the application of a blood pressure cuff inflated to a suprasystolic pressure. The promise of RIPC in the development of new cardioprotective therapies is founded on the premise that it is cost-effective, technically simple, and overcomes many logistical and biochemical hurdles associated with other ischemic preconditioning approaches. However, RIPC as a research subarea is still in its infancy and clinical applications for individuals at high risk of cardiovascular disease remain elusive. The thesis of the current review is that observational and mechanistic similarities between exercise-induced preconditioning and RIPC may reveal novel therapeutic links to cardioprotection. While reductionist understanding of the exercised heart is still in the formative stages, available mechanistic knowledge of exercise-induced cardioprotection is juxtaposed to RIPC and potential implications discussed. In total, additional research is needed in order to fully appreciate the mechanistic and translative connections between exercise and RIPC. Nonetheless, existing rationale are strong and suggest that RIPC approaches may be helpful in the development and application to pharmacologic interventions in those with ischemic heart disease.
在寻找治疗缺血性心脏病的创新解决方案时，最近的基础科学和临床方法都聚焦于远程缺血预处理（RIPC）。远程缺血预处理包括通过将血压袖带充气至收缩压以上来短暂阻断肢体血流。RIPC在开发新的心脏保护疗法方面的前景基于这样一个前提，即它具有成本效益、技术简单，并且克服了与其他缺血预处理方法相关的许多后勤和生化障碍。然而，RIPC作为一个研究领域仍处于起步阶段，心血管疾病高危个体的临床应用仍然难以实现。本综述的论点是，运动诱导的预处理和RIPC之间的观察性和机制性相似性可能揭示与心脏保护的新治疗联系。虽然对运动心脏的还原论理解仍处于形成阶段，但运动诱导的心脏保护的现有机制知识与RIPC并列，并讨论了潜在影响。总的来说，需要更多的研究来充分理解运动与RIPC之间的机制和转化联系。尽管如此，现有理论依据充分，表明RIPC方法可能有助于开发并应用于缺血性心脏病患者的药物干预。
