Abstract
Restoration of blood flow following a prolonged period of ischaemia results in irreversible tissue damage and myocardial dysfunction. Such ischaemic–reperfusion (I/R) injury occurs following myocardial infarction and is a risk in a number of surgical procedures, including coronary bypass and transplant surgery. Numerous studies have shown that ischaemic preconditioning (ip) is a powerful means of protecting the heart against this type of injury. This involves subjecting the heart to brief periods of ischaemia interspersed by periods of normal perfusion prior to prolonged ischaemia, and it has been shown to reduce myocardial cell death as well as having a number of other cardioprotective effects (Murry et al. 1986). Similar beneficial effects are produced by hypothermia, which is used in a number of surgical procedures to protect against an expected ischaemic insult (Riess et al. 2004). In a recent issue of The Journal of Physiology, Khaliulin et al. (2007) described the novel protocol of temperature preconditioning (TP), which combines the principles of ischaemic preconditioning and hypothermia. The study compared the effectiveness of TP with ip and delivery of a single hypothermic perfusion (SHP) in protecting the heart against I/R injury.
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