Lege Artis Medicinae

[Ischemic preconditioning of the myocardium; The clinical experience]

SIMON Kornél1, SZELIER András2

SEPTEMBER 01, 2000

Lege Artis Medicinae - 2000;10(09)

[The authors give an account of the pathomechanism of ischemic preconditioning. This complex adaptation is achieved by the joint compliance of perfusion, metabolism, function and morphology. The process is triggered by repeated ischemic attacks when transmitter substances are liberated during ischemia, as seen in previous experiments. These modulators are the possible substrates of pharmacologic preconditioning. The principle of parallel treatment of perfusion and metabolism is reviewed with its clinical importance. The clinical manifestations of ischemic preconditioning and the pharmacological approach to mimic preconditioning in the clinical setting are discussed. It is established, that the self-repair mechanisms of the organism can not prevent grave macroangiopathy with its consequences. Persisting ischemia during preconditioning signals the necessity of urgent clinical examinations and effective treatment. By saving time with myocardial adaptation, there will be good chance for the patient to have a successful revascularisation intervention.]

AFFILIATIONS

  1. Siófok Városi Kórház, Belgyógyászati Osztály
  2. Fejér Megyei Szent György Kórház, II. Sz. Belgyógyászati Osztály, Székesfehérvár

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