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Efficacy of Cardioprotective ‘Conditioning’ Strategies in Aging and Diabetic Cohorts

The Co-Morbidity Conundrum

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Abstract

Evidence obtained in multiple experimental models has revealed that cardiac ‘conditioning’ strategies — including ischaemic preconditioning, postconditioning, remote conditioning and administration of pharmacological conditioning mimetics — are profoundly protective and significantly attenuate myocardial ischaemia-reperfusion injury. As a result, there is considerable interest in translating these cardioprotective paradigms from the laboratory to patients. However, the majority of studies investigating conditioning-induced cardioprotection have utilized healthy adult animals devoid of the risk factors and co-morbidities associated with cardiovascular disease and acute myocardial infarction. The aim of this article is to summarize the growing consensus that two well established risk factors, aging and diabetes mellitus, may render the heart refractory to the favourable effects of myocardial conditioning, and discuss the clinical implications of a loss in efficacy of cardiac conditioning paradigms in these patient populations.

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Acknowledgements

No sources of funding were used to assist in the preparation of this article. The author has no conflicts of interest that are directly relevant to the content of this article. The author gratefully acknowledges Peter Whittaker, PhD, for critical discussions during the preparation of this article.

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  1. Cardiovascular Research Institute and Departments of Physiology and Emergency Medicine, Wayne State University School of Medicine, Elliman Building, Room 1107, 421 E Canfield, Detroit, Michigan, 48201, USA

    Karin Przyklenk PhD

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Przyklenk, K. Efficacy of Cardioprotective ‘Conditioning’ Strategies in Aging and Diabetic Cohorts. Drugs Aging 28, 331–343 (2011). https://doi.org/10.2165/11587190-000000000-00000

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