Functional Recovery of a Human Neonatal Heart After Severe Myocardial Infarction
Functional Recovery of a Human Neonatal Heart After Severe Myocardial Infarction
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DOI：
10.1161/circresaha.115.307017
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发表时间：
2016-01-22
影响因子：
20.1
通讯作者：
Penninger, Josef M.
中科院分区：
文献类型：
--
作者：
Haubner, Bernhard J.;Schneider, Johanna;Penninger, Josef M.
理由：心肌梗死后心脏重构和随后的心力衰竭仍然是关键问题，尽管改善了治疗和再灌注策略。最近，鱼和新生小鼠在切除心尖或心肌梗死后心脏再生得到证实。将模式生物的发现转化为人类未来的治疗方法还有两个关键问题：机制是什么？新生儿心脏再生是否真的会发生？目的：探讨心肌梗死后新生儿心脏功能能否恢复。方法和结果：在这里，我们报告一个新生儿因冠状动脉闭塞而发生严重心肌梗死的病例。根据心肌细胞死亡、心电图、超声心动图和心脏血管造影的血清标记物，该儿童出现了严重的心脏损伤。值得注意的是，在最初的缺血性损伤后几周内，我们观察到心脏功能恢复，这转化为长期正常的心脏功能。结论：这些数据表明，与新生啮齿动物相似，新生人类可能具有修复心肌损伤和完全恢复心功能的内在能力。
Rationale: Cardiac remodeling and subsequent heart failure remain critical issues after myocardial infarction despite improved treatment and reperfusion strategies. Recently, cardiac regeneration has been demonstrated in fish and newborn mice after apex resection or cardiac infarctions. Two key issues remain to translate findings in model organisms to future therapies in humans: what is the mechanism and can cardiac regeneration indeed occur in newborn humans?Objective: To assess whether human neonatal hearts can functionally recover after myocardial infarction.Methods and Results: Here, we report the case of a newborn child having a severe myocardial infarction due to coronary artery occlusion. The child developed massive cardiac damage as defined by serum markers for cardiomyocyte cell death, electrocardiograms, echocardiography, and cardiac angiography. Remarkably, within weeks after the initial ischemic insult, we observed functional cardiac recovery, which translated into long-term normal heart function.Conclusions: These data indicate that, similar to neonatal rodents, newborn humans might have the intrinsic capacity to repair myocardial damage and completely recover cardiac function.