[Role of interstitial myocardium in ischemia-reperfusion injury: experimental data and clinical implications].
Myocardial interstitium plays an important role in the regulation of cardiac function compared with myocytes and it is actively involved in ischemia-reperfusion damage and in the acute and chronic remodelling during ischemic heart diseases. Myocardial post-ischemic oedema seems to interfere in this process. Myocardial oedema is able to induce structural alterations, to reduce myocardial function and to activate the renin-angiotensin-aldosterone system. Angiotensin II and aldosterone seem to be the cause of myocardial fibrosis that is detected during ischemic heart disease. Post-ischemic vascular permeability alterations have a similar role. In clinical conditions, ACE-inhibitors have important effects on cardioreparation and are able to improve cardiac function and reduce early and late mortality. The effects of myocardial oedema reduction (i.e. hypertonic reperfusion) on ischemia-reperfusion damage and myocardial fibrosis are still to clarify. A reduction in myocardial fibrosis may improve cardioreparation and prevent congestive heart failure, following ischemic heart disease.
Barsotti
A
A
Istituto di Clinica Cardiovascolare, Università degli Studi Gabriele D'Annunzio, Chieti.
Di Napoli
P
P
Di Girolamo
E
E
Di Muzio
M
M
Vitullo
P
P
Dini
F L
FL
Gallina
S
S
Modesti
A
A
D000208:Acute Disease; D002908:Chronic Disease; D005110:Extracellular Space; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D009203:Myocardial Infarction / Q000473:pathology; D017202:Myocardial Ischemia / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D015427:Reperfusion Injury / Q000473:pathology* / Q000503:physiopathology / Q000517:prevention & control
Ruolo dell'interstizio miocardico nel danno da ischemia-riperfusione: dati sperimentali ed implicazioni cliniche.