Remote ischemic conditioning: from experimental observation to clinical application: report from the 8th Biennial Hatter Cardiovascular Institute Workshop

In 1993, Przyklenk and colleagues made the intriguing experimental observation that 'brief ischemiain one vascular bed also protects remote, virgin myocardium from subsequent sustained coronary artery occlusion' and that this effect '…. may be mediated by factor(s) activated, produced, or transported throughout the heart during brief ischemia/reperfusion'. This seminal study laid the foun- dation for the discovery of 'remote ischemic conditioning' ( RIC), a phenomenon in which the heart is protected from the detrimental effects of acute ischemia/reperfusion injury (IRI), by applying cycles of brief ischemiaand reperfusion to an organ or tissue remote from the heart. The concept of RICquickly evolved to extend beyond the heart, encom- passing inter-organ protection against acute IRI. The cru- cial discovery that the protective RICstimulus could be applied non-invasively, by simply inflating and deflating a blood pressure cuff placed on the upper arm to induce cycles of brief ischemiaand reperfusion, has facilitated the translation of RICinto the clinical setting. Despite inten- sive investigation over the last 20 years, the underlying mechanisms continue to elude researchers. In the 8th Biennial Hatter Cardiovascular Institute Workshop, recent