Kologrivova Irina, Kercheva Maria, Panteleev Oleg, Ryabov Vyacheslav
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 111A Kievskaya, Tomsk 634012, Russia.
Cardiology Division, Siberian State Medical University, 2 Moscovsky Trakt, Tomsk 634055, Russia.
Biomedicines. 2024 Sep 11;12(9):2073. doi: 10.3390/biomedicines12092073.
Cardiogenic shock (CS) is one of the most serious complications of myocardial infarction (MI) with a high mortality rate. The timely and effective prevention and early suppression of this adverse event may influence the prognosis and outcome in patients with MI complicated by CS (MI CS). Despite the use of existing pharmaco-invasive options for maintaining an optimal pumping function of the heart in patients with MI CS, its mortality remains high, prompting the search for new approaches to pathogenetic therapy. This review considers the role of the systemic inflammatory response in the pathogenesis of MI CS. The primary processes involved in its initiation are described, including the progression from the onset of MI to the generalization of the inflammatory response and the development of multiple organ dysfunction. The approaches to anti-inflammatory therapy in patients with CS are discussed, and further promising research directions are outlined. In this review, we updated and summarized information on the inflammatory component of MI CS pathogenesis with a particular focus on its foundational aspects. This will facilitate the identification of specific inflammatory phenotypes and endotypes in MI CS and the development of targeted therapeutic strategies for this MI complication.
心源性休克(CS)是心肌梗死(MI)最严重的并发症之一,死亡率很高。及时有效地预防和早期抑制这一不良事件可能会影响合并CS的MI(MI CS)患者的预后和结局。尽管使用了现有的药物介入方法来维持MI CS患者心脏的最佳泵血功能,但其死亡率仍然很高,这促使人们寻找新的致病治疗方法。本综述探讨了全身炎症反应在MI CS发病机制中的作用。描述了其启动过程中涉及的主要过程,包括从MI发作到炎症反应泛化以及多器官功能障碍发展的过程。讨论了CS患者的抗炎治疗方法,并概述了进一步有前景的研究方向。在本综述中,我们更新并总结了关于MI CS发病机制炎症成分的信息,特别关注其基础方面。这将有助于识别MI CS中的特定炎症表型和内型,并为这种MI并发症制定靶向治疗策略。