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糖尿病状态下心肌缺血再灌注损伤的机制及治疗策略

Mechanisms and Therapeutic Strategies for Myocardial Ischemia-Reperfusion Injury in Diabetic States.

作者信息

Xue Jing, Zhuang Jialu, Wang Xinyue, Meng Tao, Wu Jin, Zhang Xiaoqian, Zhang Guiyang

机构信息

Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, China.

Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei 230031, China.

出版信息

ACS Pharmacol Transl Sci. 2024 Nov 1;7(12):3691-3717. doi: 10.1021/acsptsci.4c00272. eCollection 2024 Dec 13.

Abstract

In patients with myocardial infarction, one of the complications that may occur after revascularization is myocardial ischemia-reperfusion injury (IRI), characterized by a depleted myocardial oxygen supply and absence of blood flow recovery after reperfusion, leading to expansion of myocardial infarction, poor healing of myocardial infarction and reversal of left ventricular remodeling, and an increase in the risk for major adverse cardiovascular events such as heart failure, arrhythmia, and cardiac cell death. As a risk factor for cardiovascular disease, diabetes mellitus increases myocardial susceptibility to myocardial IRI through various mechanisms, increases acute myocardial infarction and myocardial IRI incidence, decreases myocardial responsiveness to protective strategies and efficacy of myocardial IRI protective methods, and increases diabetes mellitus mortality through myocardial infarction. This Review summarizes the mechanisms, existing therapeutic strategies, and potential therapeutic targets of myocardial IRI in diabetic states, which has very compelling clinical significance.

摘要

在心肌梗死患者中,血运重建后可能发生的并发症之一是心肌缺血再灌注损伤(IRI),其特征是心肌氧供应耗尽且再灌注后血流未恢复,导致心肌梗死范围扩大、心肌梗死愈合不良和左心室重构逆转,并增加心力衰竭、心律失常和心肌细胞死亡等主要不良心血管事件的风险。作为心血管疾病的一个危险因素,糖尿病通过多种机制增加心肌对心肌IRI的易感性,增加急性心肌梗死和心肌IRI的发生率,降低心肌对保护策略的反应性以及心肌IRI保护方法的疗效,并通过心肌梗死增加糖尿病死亡率。本综述总结了糖尿病状态下心肌IRI的机制、现有治疗策略和潜在治疗靶点,具有非常重要的临床意义。

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