ISCHEMIC PRECONDITIONING CELLULAR AND MOLECULARMECHANISMS, PROSPECTS FOR CARDIOLOGICAL APPLICATION.REVIEW

Abstract

Introduction: Myocardial preconditioning currently has great clinical interest, since its initiation triggers the mechanisms
of cardioprotection and metabolic adaptation to non-lethal ischemia, which is very important for patients with reduced
coronary reserve. The use of the phenomenon of myocardial preconditioning in rehabilitation programs is pathogenetically
substantiated and innovative.
Aim: Analysis of literature sources on the current state of pathogenetic, cellular and molecular mechanisms of ischemic
preconditioning, clinical variants, the possibility of pharmacological preconditioning.
Search strategy: The review of scientific publications was carried out in the databases (PubMed, Scopus, Ebscohost,
Medine, The Cochrane Library, SpringerLink, Web of Knowledge (ThomsonReuters), (ResearchGate). Inclusion criteria:
reports of randomized and cohort studies, meta-analyses and systematic reviews, original articles in English and Russian.
Search depth 20 years (2001-2021). Results: In clinical settings, preconditioning resembles the "going through pain” phenomenon. Patients with stress tests
may experience attacks of angina pectoris, but if they continue to exercise, after a while the pain disappears. The evidence
for the existence of preconditioning is the fact that patients with exertional angina often develop the phenomenon of warming
up, so that raising the threshold of exercise tolerance during repeated exercise.
Conclusions. The results of numerous experimental and clinical studies indicate the high efficiency of preconditioning in
the prevention of ischemic myocardial damage. The use of pharmacological drugs to initiate this phenomenon is an
alternative for many patients, this will significantly improve not only the treatment, but also the secondary prevention of CHD.