Cover Page

Cite item


Analysis of experimental data indicates that aging, metabolic syndrome may be serious obstacle against realization of cardioprotective effect of postconditioning. The moderate hypercholesterolemia, postinfarction cardiosclerosis and cardiac hypertrophy do not abolish protective effect of postconditioning in experimental animals. The issue whether diabetes mellitus and arterial hypertension affect an efficacy of postconditioning is a subject of discussion. Clinical investigations testify on cardioprotective impact of postconditioning in patients with acute myocardial infarction and cardiosurgery patients. At the same time, it is remained unclear when after coronary artery occlusion postconditioning exhibits cardioprotective effect. It is remained unknown how do affect aging, diabetes mellitus, metabolic syndrome, arterial hypertension, myocardial hypertrophy, cardiac postinfarction remodeling and efficacy postconditioning in clinical praxis. It is required a further clinical investigations turning the development pharmacological approaches to prophylaxis of reperfusion injury of the heart.

About the authors

L. N. Maslov

Federal State Budgetary Institution «Research Institute for Cardiology» of Siberian Branch under the Russian Academy
of Medical Sciences, Tomsk, Russian Federation

Author for correspondence.

PhD, Professor, Head of the laboratory of experimental Cardiology «Research Institute of Cardiology» Siberian Branch of the Russian Academy of Medical Sciences
Address: 634012, Tomsk, Kiev St. 111; tel.: (3822) 26-21-74

Russian Federation

A. G. Mrochek

Republic Scientific-Practical Center “Cardiology”, Minsk, Belarus


PhD, Professor, Academician of the National Academy of Sciences of Belarus, Director of Republican Scientific Practical Center «Сardiology» Address: 220036, Minsk, Rosa Luxemburg St. 110


I. Khaliulin

University of Bristol, Bristol, UK


PhD, Research Worker Biochemistry Department University of Bristol
Address: University Walk, Bristol, BS8 1TD UK; tel.: +44 (0)117-331-21-20

United Kingdom

L. Hanuš

Institute for Drug Research, Faculty of Medicine, Hebrew University of Jerusalem, Israel

Professor, Hebrew University’s School of Pharmacy
Address: Jerusalem, Israel, The Hebrew University of Jerusalem Israel

J.-M. Pei

Fourth Military Medical University, Xi'an, Shaanxi Province, China


Professor, Department of Physiology, Fourth Military Medical University
Address: 710032, Shaanxi Province, China, West Changle Road, Xi’an


Y. Zhang

Hebei Medical University, Shijiazhuang, China


Professor, Department of Physiology, Hebei Medical University
Address: Shijiazhuang 050017, China, 361, East Zhongshan Road



  1. Zhao Z.Q., Corvera J.S., Halkos M.E. et al. Inhibition of myocardial injury by ischemic postconditioning during reperfusion: comparison with ischemic preconditioning. Am. J. Physiol. Heart Circ. Physiol. 2003; 285 (2): 579–H588.
  2. Lishmanov Yu.B., Maslov L.N. Kardiologiya = Cardiology. 2010; 50 (6): 68–74.
  3. Maslov L.N. Sib. med. zhurn. = Siberian Medical Journal. Tomsk; 2010; 25 (2): 17–24.
  4. Maslov L.N., Krig T., Daivan V. Pat. fiziol. eksper. terapiya = Pathological Physiology and Experimental Therapy 2009; 3: 2–6.
  5. Shlyakhto E.V., Galagudza M.M. Syrenskii A.V., Nifontov E.M. Kardiologiya = Cardiology. 2005; 45 (7): 44–48.
  6. Galagudza M.M., Blokhin I.O., Shmonin A.A., Mischenko K.A. Reduction of myocardial ischemia-reperfusion injury with pre- and postconditioning: molecular mechanisms and therapeutic targets. Cardiovasc. Hematol. Disord. Drug Targets. 2008; 8 (1): 47–65.
  7. Rohilla A., Rohilla S., Kushnoor A. Myocardial postconditioning: Next step to cardioprotection. Arch. Pharm. Res. 2011; 34 (9): 1409–1415.
  8. Shi W., Vinten-Johansen J. Endogenous cardioprotection by ischaemic postconditioning and remote conditioning. Cardiovasc. Res. 2012; 94 (2): 206–216.
  9. Mahaffey K.W., Puma J.A., Barbagelata N.A. et al. Adenosine as an adjunct to thrombolytic therapy for acute myocardial infarction: results of a multicenter, randomized, placebo-controlled trial: the Acute Myocardial Infarction Study of Adenosine (AMISTAD) trial. J. Am. Coll. Cardiol. 1999; 34 (6): 1711–1720.
  10. Ross A.M., Gibbons R.J., Stone G.W. et al. AMISTAD-II Investigators. A randomized, double-blinded, placebo-controlled multicenter trial of adenosine as an adjunct to reperfusion in the treatment of acute myocardial infarction (AMISTAD-II). J. Am. Coll. Cardiol. 2005; 45 (11): 1775–1780.
  11. Przyklenk K., Maynard M., Darling C.E., Whittaker P. Aging mouse hearts are refractory to infarct size reduction with post-conditioning. J. Am. Coll. Cardiol. 2008; 51 (14): 1393–1398.
  12. Dow J., Bhandari A., Kloner R.A. Ischemic postconditioning's benefit on reperfusion ventricular arrhythmias is maintained in the senescent heart. J. Cardiovasc. Pharmacol. Ther. 2008; 13 (2): 141–148.
  13. Boengler K., Buechert A., Heinen Y. et al. Cardioprotection by ischemic postconditioning is lost in aged and STAT3-deficient mice. Circ. Res. 2008; 102 (1): 131–135.
  14. Boengler K., Hilfiker-Kleiner D., Heusch G., Schulz R. Inhibition of permeability transition pore opening by mitochondrial STAT3 and its role in myocardial ischemia/reperfusion. Basic Res. Cardiol. 2010; 105 (6): 771–785.
  15. Halestrap A.P. A pore way to die: the role of mitochondria in reperfusion injury and cardioprotection. Biochem. Soc. Trans. 2010; 38 (4): 841–860.
  16. Somers S.J., Lacerda L., Opie L., Lecour S. Age, genetic characteristics and number of cycles are critical factors to consider for successful protection of the murine heart with postconditioning. Physiol. Res. 2011; 60 (6): 971–974.
  17. Iliodromitis E.K., Zoga A., Vrettou A. et al. The effectiveness of postconditioning and preconditioning on infarct size in hypercholesterolemic and normal anesthetized rabbits. Atherosclerosis. 2006; 188 (2): 356–362.
  18. Iliodromitis E.K., Andreadou I., Prokovas E. et al. Simvastatin in contrast to postconditioning reduces infarct size in hyperlipidemic rabbits: possible role of oxidative/nitrosative stress attenuation. Basic Res. Cardiol. 2010; 105 (2): 193–203.
  19. Donato M., D'Annunzio V., Berg G. et al. Ischemic postconditioning reduces infarct size by activation of A1 receptors and K+ATP channels in both normal and hypercholesterolemic rabbits. J. Cardiovasc. Pharmacol. 2007; 49 (5): 287–292.
  20. Zhao J.L., Yang Y.J., You S.J. et al. Different effects of postconditioning on myocardial no-reflow in the normal and hypercholesterolemic mini-swines. Microvasc. Res. 2007; 73 (2): 137–142.
  21. Huang C., Li R., Zeng Q. et al. Effect of minocycline postconditioning and ischemic postconditioning on myocardial ischemia-reperfusion injury in atherosclerosis rabbits. J. Huazhong Univ. Sci. Technolog. Med. Sci. 2012; 32 (4): 524–529.
  22. Miller C.D., Thomas M.J., Hiestand B. et al. Cholesteryl esters associated with acyl-CoA: cholesterol acyltransferase predict coronary artery disease in patients with symptoms of acute coronary syndrome. Acad. Emerg. Med. 2012; 19 (6): 673–682.
  23. Rhew S.H., Ahn Y., Kim M.C. et al. Is myocardial infarction in patients without significant stenosis on a coronary fngiogram as benign as believed? Chonnam. Med. J. 2012; 48 (1): 39–46.
  24. Bonaca M.P., Scirica B.M., Sabatine M.S. et al. Prospective evaluation of pregnancy-associated plasma protein-a and outcomes in patients with acute coronary syndromes. J. Am. Coll. Cardiol. 2012; 60 (4): 332–338.
  25. Mazurek M., Kowalczyk J., Lenarczyk R. et al. The prognostic value of different glucose abnormalities in patients with acute myocardial infarction treated invasively. Cardiovasc. Diabetol. 2012; 11 (1): 78.
  26. O'Donoghue M.L., Vaidya A., Afsal R. et al. An invasive or conservative strategy in patients with diabetes mellitus and non-ST-segment elevation acute coronary syndromes: a collaborative meta-analysis of randomized trials. J. Am. Coll. Cardiol. 2012; 60 (2): 106–111.
  27. Yin X., Zheng Y., Zhai X., Zhao X., Cai L. Diabetic inhibition of preconditioning- and postconditioning-mediated myocardial protection against ischemia/reperfusion injury. Exp. Diabetes Res. 2012; 2012: 198048.
  28. Cai W., Fang J., Chen Z.Y. et al. Rosuvastatin enhances the protective effects of ischemic postconditioning on myocardial ischaemia-reperfusion injury in type 2 diabetic rat. Chin. J. Cardiol. 2010; 38 (9): 814–818.
  29. Ren J.Y., Song J.X., Lu M.Y., Chen H. Cardioprotection by ischemic postconditioning is lost in isolated perfused heart from diabetic rats: Involvement of transient receptor potential vanilloid 1, calcitonin gene-related peptide and substance P. Regul Pept. 2011; 169 (1–3): 4–957.
  30. Wagner C., Kloeting I., Strasser R.H., Weinbrenner C. Cardioprotection by postconditioning is lost in WOKW rats with metabolic syndrome: role of glycogen synthase kinase 3β. J. Cardiovasc. Pharmacol. 2008; 52 (5): 430–437.
  31. Zhu M., Feng J., Lucchinetti E. et al. Ischemic postconditioning protects remodeled myocardium via the PI3K-PKB/Akt reperfusion injury salvage kinase pathway. Cardiovasc. Res. 2006; 72 (1): 152–162.
  32. Teppermen Dzh., Teppermen Kh. Fiziologiya obmena veshchestv i endokrinnoi sistemy [Physiology of metabolism and endocrine system]. Moscow, Mir. 1989. 653 p.
  33. Ahmed E., El-Menyar A., Singh R. et al. Effect of age on clinical Presentation and outcome of patients hospitalized with acute coronary syndrome: a 20-year registry in a Middle Eastern country. Open Cardiovasc. Med. J. 2012; 6: 60–67.
  34. Milani R.V., Lavie C.J., Dornelles A.C. The impact of achieving perfect care in acute coronary syndrome: The role of computer assisted decision support. Am. Heart J. 2012; 164 (1): 29–34.
  35. Fantinelli J.C., Mosca S.M. Comparative effects of ischemic pre and postconditioning on ischemia-reperfusion injury in spontaneously hypertensive rats (SHR). Mol. Cell. Biochem. 2007; 296 (1–2): 45–51.
  36. Penna C., Tullio F., Moro F. et al. Effects of a protocol of ischemic postconditioning and/or captopril in hearts of normotensive and hypertensive rats. Basic Res. Cardiol. 2010; 105 (2): 181–192.
  37. Choi W.S., Lee J.H., Park S.H. et al. Prognostic value of standard electrocardiographic parameters for predicting major adverse cardiac events after acute myocardial infarction. Ann. Noninvasive Electrocardiol. 2011; 16 (1): 56–63.
  38. Ledakowicz-Polak A., Polak L., Zielińska M. Ventricular septal defect complicating acute myocardial infarction-still an unsolved problem in the invasive treatment era. Cardiovasc. Pathol.2011; 20 (2): 93–98.
  39. Kiselev A.R., Gridnev V.I., Prokhorov M.D. et al. Evaluation of 5-year risk of cardiovascular events in patients after acute myocardial infarction using synchronization of 0.1-Hz rhythms in cardiovascular system. Ann. Noninvasive Electrocardiol. 2012; 17 (3): 204–213.
  40. Li X.M., Ma Y.T., Yang Y.N. et al. Ischemic postconditioning protects hypertrophic myocardium by ERK1/2 signaling pathway: experiment with mice. Zhonghua Yi Xue Za Zhi. 2009; 89 (12): 846–850.
  41. Staat P., Rioufol G., Piot C. et al. Postconditioning the human heart. Circulation. 2005; 112 (14): 2143–2148.
  42. Ma X., Zhang X., Li C., Luo M. Effect of postconditioning on coronary blood flow velocity and endothelial function and LV recovery after myocardial infarction. J. Interv. Cardiol. 2006; 19 (5): 367–375.
  43. Darling C.E., Solari P.B. et al. «Postconditioning» the human heart: multiple balloon inflations during primary angioplasty may confer cardioprotection. Basic Res. Cardiol. 2007; 102 (3): 274–278.
  44. Dzhennings R.B., Reimer K.A. Metabolizm miokarda. Mat-ly 2-go sovetsko-amerikanskogo simpoziuma [Myocardial metabolism. Paper of 2nd Soviet-American Symposium]. May 28–30, 1975; Sochi. Pod red. E.I. Chazova, Kh.E. Morgana [Chazova E.I., Morgan H.E. (editors)]. Moscow. Meditsina. 1977. 90–108 p.
  45. Yang X.C., Liu Y., Wang L.F. et al. Reduction in myocardial infarct size by postconditioning in patients after percutaneous coronary intervention. J. Invasive. Cardiol. 2007; 19 (10): 424–430.
  46. Lishmanov Yu.B., Chernov V.I. Radionuklidnaya diagnostika dlya prakticheskikh vrachei Pod red. Lishmanova Yu.B., Chernova V.I. [Radionuclide diagnostics for practicing physicians. Lishmanova Y.B., Chernov V.I. (editors)]. Tomsk, STT, 2004. 55–137 p.
  47. Horwitz L. D., Kaufman D., Keller M. W., Kong Y. Time course of coronary endothelial healing after injury due to ischemia and reperfusion. Circulation. 1994; 90 (5): 2439–2447.
  48. Thibault H., Piot C., Staat P. et al. Long-term benefit of postconditioning. Circulation. 2008; 117 (8): 1037–1044.
  49. Laskey W.K., Yoon S., Calzada N., Ricciardi M.J. Concordant improvements in coronary flow reserve and ST-segment resolution during percutaneous coronary intervention for acute myocardial infarction: a benefit of postconditioning. Catheter. Cardiovasc. Interv. 2008; 72 (2): 212–220.
  50. Zhao W.S., Xu L., Wang L.F. et al. A 60-s postconditioning protocol by percutaneous coronary intervention inhibits myocardial apoptosis in patients with acute myocardial infarction. Apoptosis. 2009; 14 (10): 1204–1211.
  51. Yarilin A.A. Aktual'nye problemy patofiziologii [Actual problems of the pathophysiology] Pod red. Moroza B.B. [ Moroz B.B. (editors)]. Moscow, Meditsina, 2001. 13–56 p.
  52. Wang G., Zhang S., Joggerst S.J. et al. Effects of the number and interval of balloon inflations during primary PCI on the extent of myocardial injury in patients with STEMI: does postconditioning exist in real-world practice? J. Invasive Cardiol. 2009; 21 (9): 451–455.
  53. Lonborg J., Kelbaek H., Vejlstrup N. et al. Cardioprotective effects of ischemic postconditioning in patients treated with primary percutaneous coronary intervention, evaluated by magnetic resonance. Circ. Cardiovasc. Interv. 2010; 3 (1): 34–41.
  54. Fan Q., Yang X.C., Liu Y. et al. Postconditioning attenuates myocardial injury by reducing nitro-oxidative stress in vivo in rats and in humans. Clin. Sci. (Lond). 2010; 120 (6): 251–261.
  55. Xue F., Yang X., Zhang B. et al. Postconditioning the human heart in percutaneous coronary intervention. Clin. Cardiol. 2010; 33 (7): 439–444.
  56. Lin X.M., Zhang Z.Y., Wang L.F. et al. Attenuation of tumor necrosis factor-α elevation and improved heart function by postconditioning for 60 seconds in patients with acute myocardial infarction. Chin. Med. J. 2010; 123 (14): 1833–1839.
  57. Sörensson P., Saleh N., Bouvier F. et al. Effect of postconditioning on infarct size in patients with ST elevation myocardial infarction. Heart. 2010; 96 (21): 1710–1715.
  58. Garcia S., Henry T.D., Wang Y.L. et al. Long-term follow-up of patients undergoing postconditioning during ST-elevation myocardial infarction. J. Cardiovasc. Transl. Res. 2011; 4 (1): 92–98.
  59. Liu T.K., Mishra A.K., Ding F.X. Protective effect of ischemia postconditioning on reperfusion injury in patients with ST-segment elevation acute myocardial infarction. Chin. J. Cardiol. 2011; 39 (1): 35 – 39.
  60. Thuny F., Lairez O., Roubille F. et al. Post-conditioning reduces infarct size and edema in patients with ST-segment elevation myocardial infarction. J. Am. Coll. Cardiol. 2012; 59 (24): 2175–2181.
  61. Luo W., Li B., Lin G., Huang R. Postconditioning in cardiac surgery for tetralogy of Fallot. J. Thorac. Cardiovasc. Surg. 2007; 133 (5): 1373–1374.
  62. Li B., Chen R., Huang R., Luo W. Clinical benefit of cardiac ischemic postconditioning in corrections of tetralogy of Fallot. Interact. Cardiovasc. Thorac. Surg. 2009; 8 (1): 17–21.
  63. Ji Q., Mei Y., Wang X., Feng J. et al. Effect of ischemic postconditioning in correction of tetralogy of Fallot. Int. Heart J. 2011; 52 (5): 312–317.
  64. Luo W., Li B., Lin G., Chen R., Huang R. Does cardioplegia leave room for postconditioning in paediatric cardiac surgery? Cardiol. Young. 2008; 18 (3): 282–287.
  65. Luo W., Li B., Chen R. et al. Effect of ischemic postconditioning in adult valve replacement. Eur. J. Cardiothorac. Surg. 2008; 33 (2): 203–208.
  66. Garratt K.N., Holmes D.R., Molina-Viamonte V. et al. Intravenous adenosine and lidocaine in patients with acute myocardial infarction. Am. Heart J. 1998; 136 (2): 196–204.
  67. Marzilli M., Orsini E., Marraccini P., Testa R. Beneficial effects of intracoronary adenosine as an adjunct to primary angioplasty in acute myocardial infarction. Circulation. 2000; 101 (18): 2154–2159.
  68. Claeys M.J., Bosmans J., De Ceuninck M. et al. Effect of intracoronary adenosine infusion during coronary intervention on myocardial reperfusion injury in patients with acute myocardial infarction. Am. J. Cardiol. 2004; 94 (1): 9–13.
  69. Lim S.Y., Bae E.H., Jeong M.H. et al. Effect of combined intracoronary adenosine and nicorandil on no-reflow phenomenon during percutaneous coronary intervention. Circ. J. 2004; 68 (10): 928–932.
  70. Quintana M., Hjemdahl P., Sollevi A. et al. ATTACC investigators. Left ventricular function and cardiovascular events following adjuvant therapy with adenosine in acute myocardial infarction treated with thrombolysis, results of the ATTenuation by Adenosine of Cardiac Complications (ATTACC) study. Eur. J. Clin. Pharmacol. 2003; 59 (1): 1–9.
  71. Argaud L., Gateau-Roesch O., Raisky O. et al. Postconditioning inhibits mitochondrial permeability transition. Circulation. 2005; 111 (2): 194–197.
  72. Hausenloy D.J., Maddock H.L., Baxter G.F., Yellon D.M. Inhibiting mitochondrial permeability transition pore opening: a new paradigm for myocardial preconditioning? Cardiovasc. Res. 2002; 55 (3): 534–543.
  73. Piot C., Croisille P., Staat P. et al. Effect of cyclosporine on reperfusion injury in acute myocardial infarction. N. Engl. J. Med. 2008; 359 (5): 473–481.
  74. Mewton N., Croisille P., Gahide G. et al. Effect of cyclosporine on left ventricular remodeling after reperfused myocardial infarction. J. Am. Coll. Cardiol. 2010; 55 (12): 1200–1205.

Comments on this article

View all comments

Copyright (c) 1970 "Paediatrician" Publishers LLC

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies