Exercise Induced Cardioprotection: An Overview of a Unique Form of Preconditioning

Experimental models for the study of an ischemia reperfusion (IR) resistant myocardium include exercise, ischemia, and pharmacologic stimuli. While research utilizing all three of these models consistently demonstrates a cardioprotected phenotype, presently only exercise represents a viable intervention for humans. Nonetheless, knowledge gleaned from ischemic preconditioning research has contributed greatly to the progress in identifying mechanisms of exercise induced cardioprotection. Similarly, ongoing pharmacologic preconditioning investigations are a direct byproduct of ischemic preconditioning research. In this review we present a critical analysis of commonalities and differences between exercise, pharmacologic, and ischemic models of myocardial preconditioning. Specifically, we identify keys points that illustrate why exercise research may be valuable for translating ischemic preconditioning research into a viable intervention against IR injury. As part of this discussion, we first provide a brief introduction of the mechanisms responsible for IR mediated injury followed by a thorough discussion of exercise induced cardioprotection against IR injury.