[Endothelial-mesenchymal transition, ventricular remodeling after myocardial infarction, and research progress of Chinese medicine intervention]
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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Yun-Fei Luo1, Zhi-Gang Mei2, Wen-Li Zhang3
1Hunan Key Laboratory of Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of CardioCerebral Diseases, College of Integrated Traditional Chinese Medicine and Western Medicine, Hunan University of Chinese Medicine Changsha 410208, China Department of Cardiovascular Internal Medicine, Chongqing Rongchang District Hospital of Traditional Chinese Medicine Chongqing 402460, China.
Insights
Endothelial-mesenchymal transition (EndMT) drives ventricular remodeling after myocardial infarction (VRAMI) by promoting fibrosis and heart failure. Targeting EndMT offers a novel therapeutic strategy for VRAMI treatment.
Area of Science:
- Cardiovascular Biology
- Pathophysiology
- Regenerative Medicine
Background:
- Ventricular remodeling after myocardial infarction (VRAMI) involves changes in cardiac tissue dimensions and composition, often leading to heart failure.
- Myocardial fibrosis (MF), a key feature of VRAMI, impairs cardiac function and worsens patient prognosis.
- Endothelial-mesenchymal transition (EndMT) is a process where endothelial cells transform into mesenchymal cells, contributing to fibrosis.
Purpose of the Study:
- To review the role and mechanisms of EndMT in VRAMI.
- To explore EndMT as a potential therapeutic target for VRAMI.
- To discuss innovative interventions for VRAMI prevention and treatment.
Main Methods:
- Comprehensive literature review of Chinese and international studies.
- Analysis of pathophysiological mechanisms linking EndMT to VRAMI and MF.
- Evaluation of current and emerging therapeutic strategies.
Main Results:
- EndMT is critically involved in the pathological progression of VRAMI.
- Excessive collagen buildup from EndMT exacerbates VRAMI and MF.
- Targeting EndMT shows promise for impeding VRAMI and preserving cardiac function.
Conclusions:
- EndMT plays a significant role in VRAMI pathogenesis.
- Interventions targeting EndMT could offer novel therapeutic avenues for VRAMI.
- Further research into EndMT mechanisms and targeted therapies is warranted for clinical application.
Abstract:
Ventricular remodeling after myocardial infarction(VRAMI) is a pathological phenomenon triggered by the abrupt occlusion of coronary arteries, leading to myocardial ischemia and hypoxia. This intricate process encompasses alterations in the dimensions, composition, and elasticity of the ventricular tissue and reflects pathophysiological reactions and self-repair after cardiomyocytes are damaged. The characteristic pathological manifestation of VRAMI is the presence of myocardial fibrosis(MF), wherein fibrotic cardiac tissue undergoes a loss of contractile and relaxation capacity, ultimately culminating in heart failure(HF) and significantly impacting the patient's prognosis. Endothelial-mesenchymal transition(EndMT) is a biological process in which endothelial cells, in response to diverse pathological stimuli such as ischemia and hypoxia in the embryonic development period, undergo morphological alterations and functional impairment, progressively acquiring mesenchymal cell properties and ultimately differentiating into mesenchymal cells. The ongoing advancement of the EndMT process will result in an excessive buildup of collagen, thereby inducing structural harm to the myocardium and exacerbating the processes of VRAMI and MF. Recent investigations have demonstrated the pivotal involvement of EndMT in the pathological advancement of VRAMI. Consequently, a targeted intervention aimed at effectively impeding VRAMI, safeguarding cardiac function, and potentially serving as a novel therapeutic target for the prevention and treatment of VRAMI. This article provides a comprehensive review of recent Chinese and international literature, focusing on the role and pathophysiological mechanisms of EndMT in VRAMI. Additionally, it discusses the research progress of innovative targeted interventions using both traditional Chinese and Western medicine, so as to offer new insights and a theoretical foundation for the clinical treatment of the disease.
