25 years of remote ischemic conditioning: from laboratory curiosity to clinical outcome

Excerpt

It is now 25 years ago that Przyklenk et al. first reported the phenomenon of remote ischemic preconditioning [20]. They were intrigued by infarct size reduction through ischemic preconditioning [19] and had hypothesized from a mathematical model that a preconditioning cycle of ischemia/reperfusion might initiate a protective signal/molecule which could diffuse over a certain distance [25]. Indeed, in anesthetized dogs, they demonstrated that four cycles of 5 min left circumflex coronary artery occlusion/5 min reperfusion reduced the infarct size resulting from 60 min left anterior descending coronary artery occlusion/reperfusion [20]. Initially, such ischemic conditioning interaction between two adjacent coronary vascular perfusion territories seemed like a laboratory curiosity. However, then the paradigm of “cardioprotection at a distance” by ischemic conditioning was quickly extended to other organs and tissues and to longer distances from the heart. …