Wojcik B, Knapp M, Gorski J
Department of Physiology, Medical University of Bialystok, Bialystok, Poland.
Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
J Physiol Pharmacol. 2018 Apr;69(2). doi: 10.26402/jpp.2018.2.03. Epub 2018 Jul 4.
Ischemic heart conditioning has been shown to protect the organ against ischemia/reperfusion injury. Animal studies have revealed that the heart can also be conditioned by non-ischemic procedures, namely physical exercise and tachycardia. Long and short term endurance training, sprint training, resistance or interval training and even one bout of exercise induce cardiac preconditioning, which is manifested by a reduction in post ischemia/reperfusion infarct size, ventricular arrhythmia and improved heart function. Several factors contribute to the exercise-induced heart preconditioning, among which the most important can be: increased activity of the anti-radical defense system, opioids, interleukin-6, nitric oxide, ATP dependent potassium channels, heat shock protein 72 and sphingosine-1-phosphate. A few studies have also shown that one bout of exercise in patients with stable angina increases tolerated workload. According to some data obtained in swine and dogs, stimulated tachycardia before ischemia/reperfusion reduces the infarct size. Future studies are needed to fully clarify the mechanisms responsible for exercise- or tachycardia-induced heart preconditioning against ischemia/reperfusion. It may lead to the development of new treatment modes of the disease.
缺血性心脏预处理已被证明可保护器官免受缺血/再灌注损伤。动物研究表明，心脏也可通过非缺血性程序进行预处理，即体育锻炼和心动过速。长期和短期耐力训练、短跑训练、阻力或间歇训练，甚至单次运动均可诱导心脏预处理，表现为缺血/再灌注后梗死面积减小、室性心律失常减少以及心脏功能改善。运动诱导的心脏预处理有多种因素参与，其中最重要的可能是：抗自由基防御系统、阿片类物质、白细胞介素-6、一氧化氮、ATP依赖性钾通道、热休克蛋白72和鞘氨醇-1-磷酸的活性增加。一些研究还表明，稳定型心绞痛患者进行单次运动可增加耐受工作量。根据在猪和狗身上获得的一些数据，缺血/再灌注前刺激心动过速可减小梗死面积。需要进一步的研究来充分阐明运动或心动过速诱导的心脏预处理对抗缺血/再灌注的机制。这可能会导致该疾病新治疗模式的发展。
