Remote ischaemic preconditioning: underlying mechanisms and clinical application

Cardiovasc Res. 2008 Aug 1;79(3):377-86. doi: 10.1093/cvr/cvn114. Epub 2008 May 2.


Remote ischaemic preconditioning (RIPC) represents a strategy for harnessing the body's endogenous protective capabilities against the injury incurred by ischaemia and reperfusion. It describes the intriguing phenomenon in which transient non-lethal ischaemia and reperfusion of one organ or tissue confers resistance to a subsequent episode of lethal ischaemia reperfusion injury in a remote organ or tissue. In its original conception, it described intramyocardial protection, which could be relayed from the myocardium served by one coronary artery to another. It soon became apparent that myocardial infarct size could be dramatically reduced by applying brief ischaemia and reperfusion to an organ or tissue remote from the heart before the onset of myocardial infarction. The concept of remote organ protection has now been extended beyond that of solely protecting the heart to providing a general form of inter-organ protection against ischaemia-reperfusion injury. This article reviews the history and evolution of the phenomenon that is RIPC, the potential mechanistic pathways underlying its cardioprotective effect, and its emerging application in the clinical setting.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Humans
  • Ischemic Preconditioning*
  • Ischemic Preconditioning, Myocardial
  • Myocardial Infarction / metabolism
  • Myocardial Infarction / prevention & control*
  • Myocardial Reperfusion Injury / metabolism
  • Myocardial Reperfusion Injury / prevention & control
  • Myocardium / metabolism*
  • Reperfusion Injury / metabolism
  • Reperfusion Injury / prevention & control*
  • Signal Transduction*
  • Treatment Outcome