Dialogues in Cardiovascular Medicine - Vol 14. N°4. 2009





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...






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