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铁在心肌梗死后心室重构和动脉瘤中的作用。

Iron in ventricular remodeling and aneurysms post-myocardial infarction.

作者信息

Wang Zuoyan, Ding Xiang, Pan Jingyu, Wang Xueyan, Lin Jieming, Wang Xinzhu

机构信息

Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Haidian District, Beijing, 100038, China.

Department of Clinical Medicine, Capital Medical University, Beijing, China.

出版信息

Open Med (Wars). 2024 Dec 11;19(1):20241109. doi: 10.1515/med-2024-1109. eCollection 2024.

Abstract

BACKGROUND

Post-myocardial infarction (MI) complications, including ventricular remodeling (VR) and left ventricular aneurysm (LVA) formation, significantly affect patient prognosis and quality of life. Both iron overload and deficiency play critical roles in these pathological processes.

OBJECTIVES

This review aims to explore the mechanisms linking abnormal iron metabolism with post-MI VR and LVA formation and to highlight therapeutic strategies that regulate iron levels to mitigate adverse cardiac remodeling.

METHODS

The review analyzes existing clinical and experimental research on the role of iron metabolism in post-MI complications. It focuses on iron overload, oxidative stress, ferroptosis, and the impact of iron deficiency on mitochondrial function, energy metabolism, and cardiomyocyte repair.

RESULTS

Iron overload exacerbates myocardial injury through oxidative stress, ferroptosis, and inflammation, leading to fibrosis and ventricular dilation. In contrast, iron-deficiency impairs mitochondrial function, energy metabolism, and cardiomyocyte repair, further contributing to adverse remodeling outcomes. Therapeutic strategies such as iron chelators, ferroptosis inhibitors, and iron supplementation are potential interventions for mitigating adverse remodeling.

CONCLUSION

Abnormal iron metabolism, both overload and deficiency, plays a critical role in post-MI complications. Therapeutic strategies targeting iron levels hold promise for reducing adverse cardiac remodeling and improving patient outcomes after MI.

摘要

背景

心肌梗死后(MI)的并发症,包括心室重构(VR)和左心室室壁瘤(LVA)形成,显著影响患者的预后和生活质量。铁过载和铁缺乏在这些病理过程中均起关键作用。

目的

本综述旨在探讨异常铁代谢与心肌梗死后心室重构和左心室室壁瘤形成之间的联系机制,并强调调节铁水平以减轻不良心脏重构的治疗策略。

方法

该综述分析了关于铁代谢在心肌梗死后并发症中作用的现有临床和实验研究。它聚焦于铁过载、氧化应激、铁死亡,以及铁缺乏对线粒体功能、能量代谢和心肌细胞修复的影响。

结果

铁过载通过氧化应激、铁死亡和炎症加剧心肌损伤,导致纤维化和心室扩张。相比之下,铁缺乏会损害线粒体功能、能量代谢和心肌细胞修复,进一步促成不良重构结果。铁螯合剂、铁死亡抑制剂和铁补充等治疗策略是减轻不良重构的潜在干预措施。

结论

铁代谢异常,无论是过载还是缺乏,在心肌梗死后并发症中都起着关键作用。针对铁水平的治疗策略有望减少不良心脏重构并改善心肌梗死后患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/233a/11635762/6b9b09903e51/j_med-2024-1109-fig001.jpg

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