tailieunhanh - Mechanisms of Disease Myocardial Reperfusion Injury

Coronary heart disease is the leading cause of death worldwide, and million men and million women die of the disease each year. After an acute myocardial infarction, early and successful myocardial reperfusion with the use of thrombolytic therapy or primary percutaneous coronary intervention (PCI) is the most effective strategy for reducing the size of a myocardial infarct and improving the clinical outcome. The process of restoring blood flow to the ischemic myocardium, however, can induce injury. This phenomenon, termed myocardial reperfusion injury, can paradoxically reduce the beneficial effects of myocardial reperfusion | Mechanisms of Disease Myocardial Reperfusion Injury mechanisms of disease Myocardial Reperfusion Injury Derek M. Yellon . and Derek J. Hausenloy . Coronary heart disease is the leading cause of death worldwide and million men and million women die of the disease each year. After an acute myocardial infarction early and successful myocardial reperfusion with the use of thrombolytic therapy or primary percutaneous coronary intervention PCI is the most effective strategy for reducing the size of a myocardial infarct and improving the clinical outcome. The process of restoring blood flow to the ischemic myocardium however can induce injury. This phenomenon termed myocardial reperfusion injury can paradoxically reduce the beneficial effects of myocardial reperfusion. The potentially detrimental aspect of myocardial reperfusion injury termed lethal reperfusion injury is defined as myocardial injury caused by the restoration of coronary blood flow after an ischemic episode. The injury culminates in the death of cardiac myocytes that were viable immediately before myocardial This form of myocardial injury which by itself can induce cardiomyocyte death and increase infarct size Fig. 1 may in part explain why despite optimal myocardial reperfusion the rate of death after an acute myocardial infarction approaches 10 2 and the incidence of cardiac failure after an acute myocardial infarction is almost 25 . Studies in animal models of acute myocardial infarction suggest that lethal reperfusion injury accounts for up to 50 of the final size of a myocardial infarct and in these models a number of strategies have been shown to ameliorate lethal reperfusion injury. Yet the translation of these beneficial effects into the clinical setting has been Nevertheless recent demonstrations of the benefit of ischemic postconditioning 4 in which myocardial reperfusion in patients with acute myocardial infarction who are undergoing PCI is .