The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK; The National Institute of Health Research University College London Hospitals Biomedical Research Centre, 149 Tottenham Court Road London, W1T 7DN, UK; Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, 8 College Road, Singapore 169857; National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, Singapore 169609, Singapore; Yong Loo Lin School of Medicine, National University Singapore, Singapore; Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Department of Cardiology, Vall d Hebron University Hospital and Research Institute. Universitat Autònoma, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
Cardiovasc Res. 2017 May 1;113(6):564-585. doi: 10.1093/cvr/cvx049.
Ischaemic heart disease and the heart failure that often results, remain the leading causes of death and disability in Europe and worldwide. As such, in order to prevent heart failure and improve clinical outcomes in patients presenting with an acute ST-segment elevation myocardial infarction and patients undergoing coronary artery bypass graft surgery, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury (IRI). During the last three decades, a wide variety of ischaemic conditioning strategies and pharmacological treatments have been tested in the clinic-however, their translation from experimental to clinical studies for improving patient outcomes has been both challenging and disappointing. Therefore, in this Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart, we critically analyse the current state of ischaemic conditioning in both the experimental and clinical settings, provide recommendations for improving its translation into the clinical setting, and highlight novel therapeutic targets and new treatment strategies for reducing acute myocardial IRI.
缺血性心脏病和由此导致的心力衰竭仍然是欧洲和全球死亡和残疾的主要原因。因此，为了预防心力衰竭并改善急性 ST 段抬高型心肌梗死患者和接受冠状动脉旁路移植术患者的临床结局，需要新型疗法来保护心脏免受急性缺血/再灌注损伤（IRI）的有害影响。在过去的三十年中，已经在临床上测试了多种缺血预处理策略和药物治疗方法-然而，将其从实验研究转化为改善患者结局的临床研究既具有挑战性，又令人失望。因此，在这份欧洲心脏病学会工作组关于心脏细胞生物学的立场文件中，我们批判性地分析了缺血预处理在实验和临床环境中的现状，为改善其向临床环境的转化提供了建议，并强调了减少急性心肌 IRI 的新的治疗靶点和新的治疗策略。
