Effects of diabetes on myocardial infarct size and cardioprotection by preconditioning and postconditioning.

Effects of diabetes on myocardial infarct size and cardioprotection by preconditioning and postconditioning.
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DOI:
10.1186/1475-2840-11-67
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发表时间:
2012-06-13
影响因子:
9.3
通讯作者:
Miura T
Miura T
中科院分区:
医学1区
文献类型:
--
作者:
Miki T;Itoh T;Sunaga D;Miura T

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尽管目前的最佳治疗,缺血性心脏病(IHD)患者的死亡率仍然很高,特别是在糖尿病(DM)作为合并症的情况下。心肌梗死面积是IHD患者预后的主要决定因素,开发新的限制梗死的策略具有重要的临床意义。缺血预处理(PC),后处理(PostC)及其模拟剂已被证明可以减少健康动物的实验中的梗死面积。然而,在临床试验中,各种药理学试剂未能证明梗死面积限制。动物实验和临床试验结果之间存在差异的可能原因之一是,包括DM在内的共病改变了心肌对缺血/再灌注和对心脏保护剂的反应。在这里,我们总结了糖尿病对心肌梗死范围和缺血PC和PostC的影响,并讨论了糖尿病心脏保护的前景。
In spite of the current optimal therapy, the mortality of patients with ischemic heart disease (IHD) remains high, particularly in cases with diabetes mellitus (DM) as a co-morbidity. Myocardial infarct size is a major determinant of prognosis in IHD patients, and development of a novel strategy to limit infarction is of great clinical importance. Ischemic preconditioning (PC), postconditioning (PostC) and their mimetic agents have been shown to reduce infarct size in experiments using healthy animals. However, a variety of pharmacological agents have failed to demonstrate infarct size limitation in clinical trials. One of the possible reasons for the discrepancy between the results of animal experiments and clinical trials is that co-morbidities, including DM, modified myocardial responses to ischemia/reperfusion and to cardioprotective agents. Here we summarize observations of the effects of DM on myocardial infarct size and ischemic PC and PostC and discuss perspectives for protection of DM hearts.
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