Exercise-Induced Ischemic Preconditioning and the Potential Application to Cardiac Rehabilitation

Abstract

Exercise-induced ischemic preconditioning (IPC) can be assessed by the results of the second of sequential exercise tests. Exercise-induced IPC is quantified by using the time to 1-mm ST-segment depression, the rate-pressure product at 1-mm ST-segment depression, the maximal ST-segment depression, and the rate-pressure product at the peak of exercise. Few studies reported whether exercise-induced IPC could be used in cardiovascular rehabilitation. A systematic review of the literature limited to human studies was performed using electronic databases, and the main key words were ischemic preconditioning, warm-up phenomenon, and exercise. After careful review, 38 articles were included in the systematic review. This review summarizes the molecular pathways of IPC and describes the first window of protection induced by sequential exercise tests, as well as the effect of medication on exercise-induced IPC. A section on the exercise protocol, mode of exercise, and intensity provides understanding as to what is needed for clinicians to induce IPC with sequential stress tests. The final section of the review is a discussion of the potential use of exercise-induced IPC in a cardiovascular rehabilitation setting. Even if exercise-induced IPC is a well-documented phenomenon, additional studies are needed in order to more fully understand its use in rehabilitation.

Serum concentration of cobalt, molybdenum and zinc in aerobic, anaerobic and aerobic-anaerobic sportsmen

“…In relation to Mo, data obtained in the present research could indicate a higher production of free radicals by exercise-induced ischemia-reperfusion in the muscles. This physiological phenomenon can be induced by high intensity muscle contractions [ 24 ], a typical situation among anaerobic physical efforts and, with minor magnitude, by long-duration aerobic exercise, this hypothesis is reinforced by the obtained data, being higher the Mo values among all sportsmen (of all modalities) than among CG.…”

“…Bergeret al [ 23 ], found similar results among marathon runners, but, in their case, without the reference of a control group. Augmented Mo concentrations would ease the formation of uric acid as well as decrease the damage caused by superoxide anions generated by xanthine oxidase in the ischemia-reperfusion processes, situation induced by high intensity muscular activities [ 24 ].…”

Ischemic Preconditioning Attenuates Rating of Perceived Exertion But Does Not Improve Maximal Oxygen Consumption or Maximal Power Output

“…A review by Marocolo et al (32) shows the majority of studies demonstrating beneficial effects of IPC did not include a sham condition. Although true blinding in IPC studies is difficult because the pressures typically used for IPC and sham feel very different (12,27), the perception of whether the discomfort that may accompany IPC is detrimental or beneficial is unknown (21). Nonetheless, it is important that the subjects are unaffected by the researchers potential bias, which can be done by blinding the researchers (24).…”

Combining Chronic Ischemic Preconditioning and Inspiratory Muscle Warm-Up to Enhance On-Ice Time-Trial Performance in Elite Speed Skaters

“…In the current investigation, all athletes reported having integrated intense priming exercises to their warm-up routine ( Table 1 ). Therefore, since physical activity may elicit a similar preconditioning response to RIPC/IPC ( Lalonde et al, 2015 ; Salvador et al, 2015 ), it is plausible that the effect of RIPC on performance and local metabolism are limited in field studies that investigate elite athletes who typically perform complete warm-up routines ( McGowan et al, 2015 ; Richard and Billaut, 2018 ).…”