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  • Title: [Preconditioning--endogenous defence mechanisms of the heart during ischemia].
    Author: Sommerschild HT.
    Journal: Tidsskr Nor Laegeforen; 2000 Nov 10; 120(27):3269-73. PubMed ID: 11187167.
    Abstract:
    BACKGROUND: The term "preconditioning" refers to the paradoxical phenomenon that pretreatment with a potential noxious stress-stimulus can increase cellular tolerance to subsequent noxious stress-stimuli. This was first described in an experimental model in dog hearts in which short-lasting periods of myocardial ischaemia resulted in reduced infarction during a subsequent long-lasting ischaemic period. Similar observations are made in other organs and species. Preconditioning is also used to describe pretreatment with other physical stress-stimuli or pharmacological agents that can increase resistance against cellular damage. This phenomenon probably represents a general adaptive response to cellular stress. MATERIAL AND METHODS: This review focuses on preconditioning in the heart and the possible endogenous mechanisms involved. The potential clinical role of preconditioning is also discussed. RESULTS: It is shown that preconditioning can reduce myocardial infarction in patients. However, protection against reduced contractility without infarction ("stunning") and arrhythmia is more uncertain. Several mechanisms might be involved; these are not fully clarified. INTERPRETATION: Preconditioning is of great interest because its effect is vigorous and reproducible, with a potential for use in patients with coronary heart disease. Preconditioning also illustrates how activation of endogenous defence mechanisms can increase cellular tolerance to ischaemia or other stress stimuli.
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