Myocardial reperfusion and reperfusion injury: current views

Salvage of the ischaemic/infarcting myocardium has been the goal of both experimental and clinical cardiologists for many years. Of the various approaches, including the array of pharmacological methods that have been tried to date, the restoration of myocardial blood flow must now be accepted as the undisputed means of achieving this goal. Thus while reperfusion appears to be the prerequisite for tissue salvage, as in many positive arenas, there tends to be a negative aspect. Not only does reperfusion salvage tissue but there appears to be evidence that the process of reperfusion itself also carries with it a component of injury which can prove deleterious to the ischemic myocardium. This article therefore addresses the concept of reperfusion and the important consequences, both positive and negative, which are associated with it. In turn we also address the importance and relevance of the various methods of evaluation of experimental procedures of reperfusion as well as discuss some of the pharmacological means that have been employed to protect the ischaemic and reperfused myocardium.