Postconditioning the Heart: Analysis of Experimental and Clinical Data

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Experimental atherosclerosis and hypercholesterolemia may reduce or eliminate the infarct-limiting and anti-apoptotic effect of postconditioning (PC). Experiments in rats and mice indicate that the PC may be quite effective in patients with diabetes type 2 or metabolic syndrome. Experimental data suggest that hypertension or the past myocardial infarction is not an obstacle for the implementation of cardioprotective effect of PC. It was established that that aging does not preclude the implementation of PC cardioprotective effect. Inotropic effect of IP can simulate on isolated human atrial trabeculae. The clinical observations suggest that the PC in patients with tetralogy of Fallot and patients with operations on the valves improves the outcome of cardiac surgery. It was established that PC in these patients reduces the intensity of reperfusion necrosis of cardiomyocytes, improves the pumping function of the heart, reduces the inotropic support, shorten the extubation time.

About the authors

L. N. Maslov

Research Institute for Cardiology, Tomsk

Author for correspondence.
MD, PhD, Professor Russian Federation

S. Yu. Tsibul'nikov

Research Institute for Cardiology, Tomsk

MD, PhD Russian Federation

A. V. Mukhomedzyanov

Research Institute for Cardiology, Tomsk

MD Russian Federation

A. S. Semenotsov

Research Institute for Cardiology, Tomsk

MD Russian Federation

A. V. Tsepokina

Research Institute of Complex Problems of Cardiovascular Disease, Kemerovo

PhD-student Russian Federation

M. V. Khutornaya

Research Institute of Complex Problems of Cardiovascular Disease, Kemerovo

PhD-student Russian Federation

A. G. Kutikhin

Research Institute of Complex Problems of Cardiovascular Disease, Kemerovo

PhD-student Russian Federation

I. F. Nam

Tomsk Polytechnic University, Tomsk

PhD, Assistance professor Russian Federation


  1. Zhao ZQ, Corvera JS, Halkos ME, et al. Inhibition of myocardial injury by ischemic postconditioning during reperfusion: comparison with ischemic preconditioning. Am J Physiol Heart Circ Physiol. 2003;285(2):H579–H588. doi: 10.1152/ajpheart.01064.2002.
  2. Шипулин В.М., Козлов Б.Н., Евтушенко А.В., и др. Современные стратегии лечения сердечной недостаточности в кардиохирургии // Сибирский медицинский журнал. – 2010. – Т. 25. – No2. – С. 4–12. [Shipulin VM, Kozlov BN, Evtushenko AV, et al. Modern strategy of heart failure treatment in cardiac surgery. Sibirskii meditsinskii zhurnal. 2010;25(2):4–12. (In Russ).]
  3. Iliodromitis EK, 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. doi: 10.1016/j.atherosclerosis.2005.11.023.
  4. Iliodromitis EK, 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(5):193–203. doi: 10.1007/s00395-0090078-3.
  5. Donato M, D’Annunzio V, Berg G, et al. Ischemic postconditioning reduces infarct size by activation of A receptors and K+ channels 1 ATP in both normal and hypercholesterolemic rabbits. J Cardiovasc Pharmacol. 2007;49(5):287–292. doi: 10.1097/fjc.0b013e31803c55fe.
  6. 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. doi: 10.1007/s11596-012-0090-y.
  7. Zhao JL, Yang YJ, You SJ, et al. Different effects of postconditioning on myocardial no-reflow in the normal and hypercholes-terolemic mini-swines. Microvasc Res. 2007;73(2):137–142. doi: 10.1016/j.mvr.2006.09.002.
  8. Li X, Zhao H, Wu Y, et al. Up-regulation of hypoxia-inducible factor-1α enhanced the cardioprotective effects of ischemic postconditioning in hyperlipidemic rats. Acta Biochim Biophys Sin. (Shanghai). 2014;46(2):112–118. doi: 10.1093/abbs/gmt132.
  9. Wu N, Zhang X, Guan Y, et al. Hypercholesterolemia abrogates the cardioprotection of ischemic postconditioning in isolated rat heart: roles of glycogen synthase kinase-3β and the mitochondrial permeability transition pore. Cell Biochem Biophys. 2014;69(1):123–130. doi: 10.1007/s12013-013-9778-2.
  10. Wu N, Li W, Shu W, et al. Inhibition of Rho-kinase by fasudil restores the cardioprotection of ischemic postconditioning in hypercholesterolemic rat heart. Mol Med Rep. 2014;10(5):2517–2524. doi: 10.3892/mmr.2014.2566.
  11. 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. doi: 10.1016/j.cardiores.2006.06.027.
  12. Fantinelli JC, Mosca SM. 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. doi: 10.1007/s11010-006-9296-2.
  13. 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. doi: 10.1007/s00395-009-0075-6.
  14. González Arbeláez LF, Pérez Núñez IA, et al. Gsk-3β inhibitors mimic the cardioprotection mediated by ischemic preand post-conditioning in hypertensive rats. Biomed Res Int. 2013;2013:317456. doi: 10.1155/2013/317456.
  15. Hausenloy DJ, Tsang A, Yellon DM. Postconditioning does not protect the diabetic heart. J Mol Cell Cardiol. 2006;40(6):958. doi: 10.1016/j.yjmcc.2006.03.119.
  16. Przyklenk K, Maynard M, Greiner DL, et al. Cardioprotection with postconditioning: loss of efficacy in murine models of type-2 and type-1 diabetes. Antioxid Redox Signal. 2011;14(5):781–790. doi: 10.1089/ars.2010.3343.
  17. Ren JY, Song JX, Lu MY, et al. 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):49–57. doi: 10.1016/j.regpep.2011.04.004.
  18. Fan Y, Yang S, Zhang X, et al. Comparison of cardioprotective efficacy resulting from a combination of atorvastatin and ischaemic post-conditioning in diabetic and non-diabetic rats. Clin Exp Pharmacol Physiol. 2012;39(11):938–943. doi: 10.1111/1440-1681.12014.
  19. Najafi M, Farajnia S, Mohammadi M, et al. Inhibition of mitochondrial permeability transition pore restores the cardioprotection by postconditioning in diabetic hearts. J Diabetes Metab Disord. 2014;13(1):106. doi: 10.1186/s40200-014-0106-1.
  20. Kroemer G, Galluzzi L, Brenner C. Mitochondrial membrane permeabilization in cell death. Physiol Rev. 2007;87(1):99–163. doi: 10.1152/physrev.00013.2006.
  21. Oosterlinck W, Dresselaers T, Geldhof V, et al. Diabetes mellitus and the metabolic syndrome do not abolish, but might reduce, the cardioprotective effect of ischemic postconditioning. J Thorac Cardiovasc Surg. 2013;145(6):1595–1602. doi: 10.1016/j. jtcvs.2013.02.016.
  22. Przyklenk K, Maynard M, Darling CE, et al. Aging mouse hearts are refractory to infarct size reduction with postconditioning. J Am Coll Cardiol. 2008;51(14):1393–1398. doi: 10.1016/j.jacc.2007.11.070.
  23. Dow J, Bhandari A, Kloner RA. Ischemic postconditioning’s benefit on reperfusion ventricular arrhythmias is maintained in the senescent heart. J Cardiovasc Pharmacol Ther. 2008;13(2):141–148. doi: 10.1177/1074248408317705.
  24. 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. doi: 10.1161/circresaha.107.164699.
  25. Somers SJ, Lacerda L, Opie L, et al. 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.
  26. Sivaraman V, Mudalagiri NR, Di Salvo C, et al. Postconditioning protects human atrial muscle through the activation of the RISK pathway. Basic Res Cardiol. 2007;102(5):453–459. doi: 10.1007/ s00395-007-0664-1.
  27. Roleder T, Gołba KS, Kunecki M, et al. The co-application of hypoxic preconditioning and postconditioning abolishes their own protective effect on systolic function in human myocardium. Cardiol J. 2013;20(5):472–477. doi: 10.5603/CJ.2013.0131.
  28. Casos K, Perez M, Blasco-Lucas A, et al. P421 Is ischemic postconditioning really effective in protecting the human myocardium? The role of the protocol applied and of clinical conditions. Cardiovasc Res. 2014;103(Suppl.1):S77. doi: 10.1093/cvr/cvu091.101.
  29. Luo W, Li B, Lin G, et al. Postconditioning in cardiac surgery for tetralogy of Fallot. J Thorac Cardiovasc Surg. 2007;133(5):1373– 1374. doi: 10.1016/j.jtcvs.2007.01.028.
  30. 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. doi: 10.1016/j.ejcts.2007.11.010.
  31. Baxter GF. The neutrophil as a mediator of myocardial ischemia-reperfusion injury: time to move on. Basic Res Cardiol. 2002;97(4):268–275. doi: 10.1007/s00395-002-0366-7.
  32. Luo W, Li B, Lin G, et al. Does cardioplegia leave room for postconditioning in paediatric cardiac surgery? Cardiol Young. 2008;18(3):282–287. doi: 10.1017/S1047951108002072.
  33. Li B, Chen R, Huang R, et al. Clinical benefit of cardiac ischemic postconditioning in corrections of tetralogy of Fallot. Interact Cardiovasc Thorac Surg. 2009;8(1):17–21. doi: 10.1510/icvts.2008.189373.
  34. Chen R, Luo WJ, Jiang HH, et al. Cardiopulmonary protection of ischemic postconditioning in cardiac surgery in children with tetralogy of Fallot. Chin J Cotemporary Pediat. 2009;11(4):273–276.
  35. Ji Q, Mei Y, Wang X, et al. Effect of ischemic postconditioning in correction of tetralogy of Fallot. Int Heart J. 2011;52(5):312–317. doi: 10.1536/ihj.52.312.
  36. Zhang R, Shen L, Xie Y, et al. Effect of morphine-induced postconditioning in corrections of tetralogy of Fallot. J Cardiothorac Surg. 2013;8:76. doi: 10.1186/1749-8090-8-76.



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