Mechanisms of Cardioprotection Against Ischemia Reperfusion injury

摘要

Summary. The high incidence of morbidity and mortality associated with acute myocardial ischemia (AMI) has stimulated substantial research to salvage the dying myocardium. Early restoration of flow to the ischemic myocardium by different interventions has significantly reduced the mortality associated with the acute coronary syndrome but could not improve the morbidity. Accordingly, the possibility of reperfusion injury, and not ischemic injury, as the cause of post ischemic myocardial dysfunction is being considered seriously. Ventricular arrhythmias, myocardial stunning and cell death are the prominent sequels to post ischemic reperfusion. Although thrombolytic and other therapies Eke percutaneous transluminal angio-plasty and coronary artery bypass grafting have "significantly increased the rate of survival of AMI patients, these procedures have also spurred interest in the phenomena of ischemia reperfusion injury. In view of the immense clinical consequences of ischemia reperfusion in humans, a large number of animal studies have been carried out to understand the patho-physiology and therapy. This article elaborates different mechanisms which have been suggested to cause ischemia reperfusion injury'as well as therapeutic modalities that have shown promise in reducing the associated cardiac abnormalities.