Sun Bingbing, Wang Long, Guo Wenmin, Chen Shixuan, Ma Yujie, Wang Dongwei
Department of Critical Care Medicine, The Air Force Characteristic Medical Center, Air Force Medical University, Beijing, China.
Department of General Internal Medicine, Beijing Dawanglu Emergency Hospital, Beijing, China.
Front Cardiovasc Med. 2023 Sep 28;10:1251669. doi: 10.3389/fcvm.2023.1251669. eCollection 2023.
For a long time, cardiovascular clinicians have focused their research on coronary atherosclerotic cardiovascular disease and acute myocardial infarction due to their high morbidity, high mortality, high disability rate, and limited treatment options. Despite the continuous optimization of the therapeutic methods and pharmacological therapies for myocardial ischemia-reperfusion, the incidence rate of heart failure continues to increase year by year. This situation is speculated to be caused by the current therapies, such as reperfusion therapy after ischemic injury, drugs, rehabilitation, and other traditional treatments, that do not directly target the infarcted myocardium. Consequently, these therapies cannot fundamentally solve the problems of myocardial pathological remodeling and the reduction of cardiac function after myocardial infarction, allowing for the progression of heart failure after myocardial infarction. Coupled with the decline in mortality caused by acute myocardial infarction in recent years, this combination leads to an increase in the incidence of heart failure. As a new promising therapy rising at the beginning of the twenty-first century, cardiac regenerative medicine provides a new choice and hope for the recovery of cardiac function and the prevention and treatment of heart failure after myocardial infarction. In the past two decades, regeneration engineering researchers have explored and summarized the elements, such as cells, scaffolds, and cytokines, required for myocardial regeneration from all aspects and various levels day and night, paving the way for our later scholars to carry out relevant research and also putting forward the current problems and directions for us. Here, we describe the advantages and challenges of cardiac tissue engineering, a contemporary innovative therapy after myocardial infarction, to provide a reference for clinical treatment.
长期以来,心血管临床医生一直将研究重点放在冠状动脉粥样硬化性心血管疾病和急性心肌梗死上,因为它们具有高发病率、高死亡率、高致残率以及有限的治疗选择。尽管心肌缺血再灌注的治疗方法和药物治疗在不断优化,但心力衰竭的发病率仍逐年上升。据推测,这种情况是由目前的治疗方法,如缺血性损伤后的再灌注治疗、药物、康复治疗以及其他传统治疗方法,未直接针对梗死心肌所导致的。因此,这些治疗方法无法从根本上解决心肌梗死心肌病理重塑和心功能降低的问题,从而使心肌梗死后心力衰竭病情进展。再加上近年来急性心肌梗死导致的死亡率下降,这使得心力衰竭的发病率上升。作为21世纪初兴起的一种有前景的新疗法,心脏再生医学为心肌梗死后心功能恢复及心力衰竭的防治提供了新的选择和希望。在过去的二十年里,再生工程研究人员夜以继日地从各个方面和不同层面探索并总结了心肌再生所需的细胞、支架和细胞因子等要素,为我们后来的学者开展相关研究铺平了道路,也为我们提出了当前存在的问题和方向。在此,我们阐述心肌梗死后当代创新疗法——心脏组织工程的优势与挑战,为临床治疗提供参考。