心脏保护:将其转化为临床的机会和挑战
1Institut für Pathophysiologie, Universitätsklinikum Essen, Essen, Germany. gerd.heusch@uk-essen.de
Lancet (London, England)
|October 26, 2012
概括
缺血条件,使用短暂的冠状动脉封闭或远程器官缺血,有效地减少心肌梗塞的大小. 这些方法激活保护信号通路,在心脏病发作患者的临床环境中显示出前景.
科学领域:
- 心血管科学 心血管科学
- 缺血性心脏病研究 缺血性心脏病研究
- 细胞心脏保护机制
背景情况:
- 心肌梗塞的大小显著影响心脏病发作后的患者预后.
- 现有的调节方案,如预调和后调,显示了限制心脏病发作大小的潜力.
- 远程缺血预调提供了一种新的方法,通过诱导远处器官的保护.
研究的目的:
- 审查缺血调节在减少心肌梗塞大小中的机制和临床应用.
- 评估各种调节协议的有效性,包括预调节,后调节和远程预调节.
- 探索参与心脏保护的信号级联及其治疗潜力.
主要方法:
- 对缺血性预调 (冠状动脉和远程) 和后调技术的审查.
- 分析潜在的分子和细胞信号通路 (受体激活,酶级联,线粒体稳定).
- 检查在接受冠状动脉再血管化和急性心肌梗塞治疗的患者中的临床应用.
主要成果:
- 缺血性调节方案 (预调,后调,远程预调) 有效地减少心肌梗塞的大小.
- 这些协议激活复杂的细胞内信号级联,导致线粒体稳定和抑制细胞死亡.
- 调节策略在接受冠状动脉复血管化和心肌梗塞再输疗法等手术的患者中取得了成功.
结论:
- 缺血调节是一种可行的策略,可以限制心脏病发作的大小并改善心肌梗塞的结果.
- 针对类似途径的药理学方法尚未证明预后益处.
- 临床结果受到患者特定因素 (年龄,性别,并发病症,药物) 和程序技术因素的影响.
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