Remote ischemic conditioning

Gerd Heusch, Hans Erik Bøtker, Karin Przyklenk, Andrew Redington, Derek Yellon

Research output: Contribution to journalReview articlepeer-review

483 Scopus citations


In remote ischemic conditioning (RIC), brief, reversible episodes of ischemia with reperfusion in one vascular bed, tissue, or organ confer a global protective phenotype and render remote tissues and organs resistant to ischemia/reperfusion injury. The peripheral stimulus can be chemical, mechanical, or electrical and involves activation of peripheral sensory nerves. The signal transfer to the heart or other organs is through neuronal and humoral communications. Protection canbe transferred, even across species, with plasma-derived dialysate and involves nitric oxide, stromal derived factor-1a, microribonucleic acid-144, but also other, not yet identified factors. Intracardiac signal transduction involves: adenosine, bradykinin, cytokines, and chemokines, which activate specific receptors; intracellular kinases; and mitochondrial function. RIC by repeated brief inflation/deflation of a blood pressure cuff protects against endothelial dysfunction and myocardial injury in percutaneous coronary interventions, coronary artery bypass grafting, and reperfused acute myocardial infarction. RIC is safe and effective, noninvasive, easily feasible, and inexpensive.

Original languageEnglish
Pages (from-to)177-195
Number of pages19
JournalJournal of the American College of Cardiology
Issue number2
StatePublished - 2015


  • Acute myocardial infarction
  • Coronary artery bypass grafting
  • Myocardial ischemia
  • Reperfusion


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