Posts Tagged ‘ischemic post condtionining’

One popular definition of Intelligence goes something like this  “It’s a global capacity  of a living organism  to deal effectively with environment and live peacefully”

When myocytes are confronted with acute ischemia , they  don’t always  jitter . It expresses many behavioral pattern.The damage inflicted is variable as  the molecular mechanism of ischemic tolerance appears to be a virtue ! This might make  much revered time window of myocyte ischemia irrelevant .Each cell has got a unique capacity to survive or die . In chronic ischemia this myocyte intelligence and intention to survive is glaringly evident. How about this phenomenon in ACS ?

myocardial intelligence myocyte memory

Art of  survival 

Why some cells die instantly , some fully recover and few go for hibernation  and others  are just stunned . While apoptosis is programmed cell death with intact cell membrane , hibernation can be termed as programmed cell survival .We don’t know how many intermediate forms of cell surviving mechanisms exists.

One of the famous questions is does the myocyte need blood or fuel for survival* ?

It is a fine balance of various cell  surviving (Anti ) mechanism.How energy is utilised with available ATP molecules is a different  science altogether .It’s  possible like brain,  heart too has  myocardial intelligence  , which does  some independent thinking aided by  fuzzy logic and problem solving algorithms  built within.

Ignorance based ACS care 

While we slog with metals inside the large coronary arteries , the response of the micro vascular territory is at the mercy of God . mRNA instructed DNA codes determine acute mitochondrial  respiratory sensitization.Finally ,the successful reversal of ischemic injury depends upon the cell repair molecule’s crisis management skills !

How else one can explain , some broken hearts recover so well from a major ischemic injury others sink with first insult !

The concepts of pre and post ischemic conditioning  are related phenomenon which can be pharmacologically  mimicked .They  are the major areas of research in myocyte  revascularisation.

Final message 

What is written above  is pure non academic fantasy . Now, read the following article by Dr Kloner which describe the molecular mechanism of  ischemia modification and its impact on clinical cardiology.


1.Robert A. Kloner, Shereif H. Rezkalla; Preconditioning, postconditioning and their application to clinical cardiology, Cardiovascular Research, Volume 70, Issue 2, 1 May 2006, Pages 297–307,

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