Holmes Jeffrey W, Borg Thomas K, Covell James W
Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA.
Annu Rev Biomed Eng. 2005;7:223-53. doi: 10.1146/annurev.bioeng.7.060804.100453.
Therapies for myocardial infarction have historically been developed by trial and error, rather than from an understanding of the structure and function of the healing infarct. With exciting new bioengineering therapies for myocardial infarction on the horizon, we have reviewed the time course of structural and mechanical changes in the healing infarct in an attempt to identify key structural determinants of mechanics at several stages of healing. Based on temporal correlation, we hypothesize that normal passive material properties dominate the mechanics during acute ischemia, edema during the subsequent necrotic phase, large collagen fiber structure during the fibrotic phase, and cross-linking of collagen during the long-term remodeling phase. We hope these hypotheses will stimulate further research on infarct mechanics, particularly studies that integrate material testing, in vivo mechanics, and quantitative structural analysis.
心肌梗死的治疗方法历来是通过反复试验来开发的，而不是基于对愈合梗死灶结构和功能的理解。随着激动人心的新型心肌梗死生物工程疗法即将出现，我们回顾了愈合梗死灶结构和力学变化的时间进程，试图确定愈合几个阶段力学的关键结构决定因素。基于时间相关性，我们假设正常的被动材料特性在急性缺血期间主导力学，随后坏死期出现水肿，纤维化期出现大的胶原纤维结构，长期重塑期出现胶原交联。我们希望这些假设将激发对梗死力学的进一步研究，特别是整合材料测试、体内力学和定量结构分析的研究。
