How best to control the lack of oxygen
in the ischemic cardiomyocyte? |
Continuous oxygen supply is crucial
to cardiomyocyte function and integrity.
Lack of oxygen leads to
rapid myocardial cell damage. In
the clinical setting, the most frequent
cause of lack of oxygen in myocardial
cells is ischemia. This may
occur because: (i) coronary artery
stenoses impede adequate increase in
oxygen supply to match increased
myocardial consumption; or (ii) a
primary reduction in coronary blood
flow (CBF) occurs resulting from
acute coronary thrombosis or spasm.
Definitive treatment of myocardial
ischemia relies on prompt restoration
of CBF. However, other treatments
aim to increase the resistance of
cardiomyocytes to ischemia and delay
cell death in case of prolonged
ischemia, through: (i) reduction in
myocardial oxygen consumption;
(ii) optimization of cardiomyocyte
metabolism; (iii) preconditioning
and postconditioning; or (iv) prevention
of apoptosis...
|