Yamada Kelly P, Kariya Taro, Aikawa Tadao, Ishikawa Kiyotake
Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Front Cardiovasc Med. 2021 Feb 15;8:642843. doi: 10.3389/fcvm.2021.642843. eCollection 2021.
Therapeutic hypothermia has been used for treating brain injury after out-of-hospital cardiac arrest. Its potential benefit on minimizing myocardial ischemic injury has been explored, but clinical evidence has yet to confirm positive results in preclinical studies. Importantly, therapeutic hypothermia for myocardial infarction is unique in that it can be initiated prior to reperfusion, in contrast to its application for brain injury in resuscitated cardiac arrest patients. Recent advance in cooling technology allows more rapid cooling of the heart than ever and new clinical trials are designed to examine the efficacy of rapid therapeutic hypothermia for myocardial infarction. In this review, we summarize current knowledge regarding the effect of hypothermia on normal and ischemic hearts and discuss issues to be solved in order to realize its clinical application for treating acute myocardial infarction.
治疗性低温已被用于治疗院外心脏骤停后的脑损伤。其对最小化心肌缺血性损伤的潜在益处已得到探索,但临床性证据证据尚未证实临床前研究中的积极结果。重要的是,用于心肌梗死的治疗性低温的独特之处在于,与在复苏的心脏骤停患者中用于脑损伤的应用相反,它可以在再灌注之前启动。冷却技术的最新进展使心脏能够比以往任何时候都更快地冷却,并且新的临床试验旨在检验快速治疗性低温对心肌梗死的疗效。在这篇综述中,我们总结了关于低温对正常和缺血心脏影响的当前知识,并讨论了为实现其在治疗急性心肌梗死中的临床应用而需要解决的问题。