Myocardial protection from ischemia-reperfusion injury post coronary revascularization

Expert Rev Cardiovasc Ther. 2015;13(9):1045-57. doi: 10.1586/14779072.2015.1070669. Epub 2015 Jul 22.

Abstract

Effective primary and secondary prevention and advances in cardiac surgery have significantly improved the care and outcomes of patients with myocardial ischemia. While timely reperfusion has proved to be an invaluable tool, ischemia-reperfusion injury represents a mechanism that may limit its effectiveness. Numerous experimental studies have shown effective protection from ischemia-reperfusion injury in animal models, but translation into clinical practice has been less successful. This article summarizes the role of ischemia-reperfusion injury in the pathophysiology of ischemic heart disease and gives an overview of the various modalities that have been developed in order to provide myocardial protection from reperfusion injury in clinical practice.

Keywords: acute myocardial infarction; cardiac surgery; ischemia–reperfusion injury; myocardial protection; percutaneous coronary intervention; postconditioning; preconditioning.

Publication types

  • Review

MeSH terms

  • Cardiotonic Agents / therapeutic use
  • Cell Death / physiology
  • Humans
  • Ischemic Preconditioning, Myocardial
  • Myocardial Ischemia / physiopathology*
  • Myocardial Reperfusion / adverse effects
  • Myocardial Reperfusion Injury / etiology
  • Myocardial Reperfusion Injury / physiopathology
  • Myocardial Reperfusion Injury / prevention & control*

Substances

  • Cardiotonic Agents