New Targets to Treat the Structural Remodeling of the Myocardium
New Targets to Treat the Structural Remodeling of the Myocardium
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DOI：
10.1016/j.jacc.2011.06.058
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发表时间：
2011-10-25
影响因子：
24
通讯作者：
Diez, Javier
中科院分区：
文献类型：
--
作者：
Gonzalez, Arantxa;Ravassa, Susana;Diez, Javier
心力衰竭的经典治疗是基于其诱发/触发因素和继发于心脏功能恶化的神经体液激活的治疗。一种新的观点正在出现，提出直接干预心肌的病理性结构重塑作为心力衰竭治疗的一部分。事实上，在慢性损伤的情况下，心肌的心肌细胞和非心肌细胞组分经历一系列结构损伤（即，心肌细胞生长和死亡、炎症、胶原基质的改变和微血管稀疏），其由复杂的机制相互作用控制。我们对这些机制在重塑中的作用的了解越来越多，这不仅使我们能够更好地了解我们更成功的疗法是如何工作的，而且还能探索未来的新疗法。在本文中，我们将研究实验和试点临床研究的最新见解，这些研究为预防或逆转炎症，胶原基质改变和心肌细胞死亡的干预提供了新的靶点。（J Am科尔心脏病学杂志2011; 58：1833 - 43）（C）2011年美国心脏病学会基金会
Classical therapy of heart failure is based on treatment of its pre-disposing/triggering factors and of the neurohumoral activation secondary to the deterioration of cardiac function. A new view is emerging that proposes the direct intervention on the pathological structural remodeling of the myocardium as part of heart failure therapy. In fact, in conditions of chronic injury, the cardiomyocytic and the noncardiomyocytic components of the myocardium undergo a series of structural lesions (i.e., cardiomyocyte growth and death, inflammation, alterations of collagen matrix, and microvascular rarefaction) that are governed by a complex interplay of mechanisms. Our increasing knowledge of the role of these mechanisms in remodeling enables us not only to better understand how our more successful therapies work but also to explore novel therapies for the future. In this paper, we will examine recent insights from experimental and pilot clinical studies that have provided new targets for interventions to prevent or reverse inflammation, alterations of collagen matrix, and cardiomyocyte death. (J Am Coll Cardiol 2011;58:1833-43) (C) 2011 by the American College of Cardiology Foundation