Cardioprotection and ageing

Cardioprotection and ageing
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心脏保护与衰老

DOI:
--
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发表时间:
2010
影响因子:
2.9
通讯作者:
Y. Shim
Y. Shim
中科院分区:
医学3区
文献类型:
--
作者:
Y. Shim

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随着老年人口的增加和年龄相关性心血管疾病患病率的增加,麻醉医生越来越多地面临着围手术期已知或疑似缺血性心脏病的老年患者。尽管早期再灌注仍然是减少缺血损伤的最佳策略,但再灌注可能会损害心肌。因此,血运重建的辅助治疗是必要的。为了开发更好的策略来预防老年患者的缺血再灌注损伤,我们需要了解老年心肌,相对于正常心肌,老年心肌已经经历了结构和功能的变化,导致功能能力降低和易受缺血再灌注损伤。此外,先天或后天的心脏保护随着年龄的增长而恶化。老年心肌的这些变化可能解释了为什么基础研究结果从年轻动物到老年患者的转化率很低。在这篇综述中,我将讨论与心肌老化相关的细胞内信号传导的变化,这些变化对缺血再灌注损伤有影响,我还将讨论缺血和药理学预处理和后处理对老年心肌的心脏保护作用。最后,我概述了策略,以恢复保护老年心肌。
With an increase in the elderly population and an increase in the prevalence of age-related cardiovascular disease, anesthesiologists are increasingly being faced with elderly patients with known or suspected ischemic heart disease in the perioperative period. Although early reperfusion remains the best strategy to reduce ischemic injury, reperfusion may damage the myocardium. Adjuvant therapy to revascularization is therefore necessary. To develop better strategies to prevent ischemia-reperfusion injury in older patients, we need to understand the aged myocardium, which has undergone structural and functional changes relative to the normal myocardium, resulting in reduced functional capacity and vulnerability to ischemia-reperfusion injury. In addition, innate or acquired cardioprotection deteriorates with aging. These changes in the aged myocardium might explain why there is poor translation of basic research findings from young animals to older patients. In this review, I discuss changes in intracellular signaling associated with myocardial ageing that have an effect on ischemia-reperfusion injury, and I discuss the efficacy of cardioprotection afforded by ischemic and pharmacologic pre-and post-conditioning in the aged myocardium. Finally, I outline strategies to restore protection in the aged myocardium.
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DOI: --
发表时间: 1992
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