Postconditioning: from experimental proof to clinical concept
Postconditioning: from experimental proof to clinical concept
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DOI：
10.1242/dmm.004309
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发表时间：
2010-01-01
影响因子：
4.3
通讯作者：
Ovize, Michel
中科院分区：
文献类型：
--
作者：
Mewton, Nathan;Ivanes, Fabrice;Ovize, Michel
在过去的十年中，急性心肌梗死的治疗策略主要集中在心肌再灌注损伤上，心肌再灌注损伤占最终心肌梗死面积的很大一部分。尽管在过去20年中的几个实验报告了在再灌流时的药物干预可能会减少心肌再灌注损伤，但这在动物模型或人类研究中并不能得到一致的证实。作为化学修饰剂的替代品，后处理(在再灌流开始时应用短暂重复的缺血期)是第一种在不同动物模型中被证明有效的方法，并在最近的一项人类研究中得到证实。这种简单的方法，在再灌注的第一分钟内应用，可以将最终的梗塞面积减少30-50%。这篇综述将集中于后处理技术，并展示来自不同动物模型和实验环境的数据如何促进我们对急性心肌梗死的机制和准确方案的定义的理解，该方案容易适用于人类患者的急性心肌梗死。
The therapeutic strategies for acute myocardial infarction in the last decade have, among other therapeutic targets, focused on myocardial reperfusion injury, which accounts for a significant part of the final infarct size. Although several experiments in the last 20 years have reported that pharmacological interventions at reperfusion might reduce myocardial reperfusion injury, this could not be consistently confirmed in animal models or human studies. An alternative to chemical modifiers, postconditioning (brief repeated periods of ischemia applied at the onset of reperfusion) is the first method proven to be efficient in different animal models and to be confirmed in a recent human study. This simple method, applied in the first minute of reperfusion, reduces the final infarct size by 30-50%. This review will focus on the postconditioning technique and show how the data from different animal models and experimental settings have advanced our understanding of both the mechanisms and the definition of an accurate protocol that is easily applicable in human patients in the setting of acute myocardial infarction.