Cardiac surgical implications of calcium dyshomeostasis in the heart.

Cardiac surgical implications of calcium dyshomeostasis in the heart.
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心脏钙稳态失调对心脏手术的影响。

DOI:
10.1016/0003-4975(95)00952-3
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发表时间:
1996
期刊:
The Annals of thoracic surgery
影响因子:
--
通讯作者:
A. Harken
A. Harken
中科院分区:
--
文献类型:
--
作者:
D. Meldrum;J. Cleveland;B. Sheridan;R. T. Rowland;A. Banerjee;A. Harken

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冠状动脉疾病的流行使心肌缺血成为发病率和死亡率的主要原因。心脏搭桥手术和心脏移植都会造成心肌缺血再灌注损伤。细胞内钙的运输和调节在正常和病理心肌状态中都是至关重要的。钙调节是不可或缺的,几乎每一个肌细胞的功能,从早期发育到衰老。正常的细胞内钙介导的兴奋-收缩耦合和钙调节的异常模式导致收缩/舒张功能障碍,现在心脏外科医生可以治疗。此外,Ca2+转运蛋白基因表达的改变是心肌功能障碍的一个机制。治疗策略包括受体介导的信号转导到细胞内代谢位点。证据暗示蛋白激酶C以及Ca2+的潜在治疗作用。潜在的药理学进入这种保护状态具有丰富的临床吸引力。这种保护状态(心脏“预处理”)是短暂的,但可用于治疗与手术相关的缺血事件。
The prevalence of coronary artery disease renders myocardial ischemia a leading cause of morbidity and mortality. Both cardiac bypass operations and cardiac transplantation cause myocardial ischemia and reperfusion injury. Intracellular calcium transport and regulation are of paramount importance in both normal and pathologic myocardial states. Calcium regulation is integral to nearly every myocyte function, from early development to senescence. Normal intracellular calcium-mediated excitation-contraction coupling and abnormal patterns of calcium regulation leading to systolic/diastolic dysfunction are now therapeutically accessible to the cardiac surgeon. Additionally, altered Ca2+transport protein gene expression is a mechanism of myocardial dysfunction. Therapeutic strategies involve receptor-mediated transduction of signals to intracellular metabolic sites. Evidence implicates protein kinase C as well as a potential therapeutic role for Ca2+. The potential for pharmacologic access to this protective state has abundant clinical appeal. The protective state (cardiac “preconditioning”) is transient but is amenable as therapy against operation-related ischemic events.
细胞内钙调节异常是心脏收缩功能障碍的主要原因。
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