Abstract
The mechanisms of ischemic cell death and reperfusion injury in the myocardium and the ways to limit these have been under extensive research for decades. The discovery of the phenomenon of ischemic preconditioning, i.e. endogenous protection against ischemia-reperfusion injury obtained by one or more brief preceding episodes of ischemia, really boosted this research 15 years ago. Even though extensive research in experimental animals has provided data on the cellular mechanisms of ischemic preconditioning, such as adenosine receptor activation, opening of mitochondrial adenosine triphosphate (ATP)-sensitive potassium channels and production of endogenous protective stress proteins, direct clinical applications are still missing. The purpose of this study is to summarize the latest progress in solving the cellular and molecular mechanisms of the phenomenon, as well as the evidence for the existence of this phenomenon in humans and its clinical relevance.
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