Reducing myocardial infarct size: challenges and future opportunities.
Reducing myocardial infarct size: challenges and future opportunities.
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DOI：
10.1136/heartjnl-2015-307855
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发表时间：
2016-03
期刊：
影响因子：
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通讯作者：
Hausenloy DJ
中科院分区：
文献类型：
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作者：
Bulluck H;Yellon DM;Hausenloy DJ
尽管通过直接经皮冠状动脉介入治疗（PPCI）进行了及时再灌注，但急性ST段抬高型心肌梗死（STEMI）患者的死亡率和发病率仍然很高，1年时死亡率为9%，心力衰竭率为10%。 在这些患者中，一个重要的被忽视的治疗目标是“心肌再灌注损伤”，这是一个术语，指缺血心肌再灌注时发生的心肌细胞死亡和微血管功能障碍。许多已知靶向心肌再灌注损伤的心脏保护疗法（机械和药理学）已在小型概念验证临床研究中显示可减少心肌梗死（MI）面积-然而，能够证明改善临床结局一直难以捉摸。在这篇文章中，我们回顾了临床心脏保护研究面临的挑战，并强调了未来的治疗方法，以减少心肌梗死的大小和预防心力衰竭的患者提出的STEMI心肌再灌注损伤的风险。
Despite prompt reperfusion by primary percutaneous coronary intervention (PPCI), the mortality and morbidity of patients presenting with an acute ST-segment elevation myocardial infarction (STEMI) remain significant with 9% death and 10% heart failure at 1 year. In these patients, one important neglected therapeutic target is ‘myocardial reperfusion injury’, a term given to the cardiomyocyte death and microvascular dysfunction which occurs on reperfusing ischaemic myocardium. A number of cardioprotective therapies (both mechanical and pharmacological), which are known to target myocardial reperfusion injury, have been shown to reduce myocardial infarct (MI) size in small proof-of-concept clinical studies—however, being able to demonstrate improved clinical outcomes has been elusive. In this article, we review the challenges facing clinical cardioprotection research, and highlight future therapies for reducing MI size and preventing heart failure in patients presenting with STEMI at risk of myocardial reperfusion injury.