Pharmacological therapy for myocardial reperfusion injury.
In the ischemic myocardium, reperfusion is necessary for the salvage of cells and cardiac function. However, reperfusion itself causes 'reperfusion injury', leading to the damage of myocardial cells. This is reduced by several interventions, as measured by the limitation of infarct size or reduction of arrhythmias. Pharmacological agents that protect against injury include Na(+)/H(+) exchanger inhibitors, antioxidants, calcium antagonists, renin-angiotensin system antagonists and adenosine. N-acetylcysteine, diltiazem, verapamil, enalaprilat and adenosine have all showed promising results in patients with acute myocardial infarction when given before reperfusion. Cariporide was beneficial when added to cardioplegia. However, their use in daily practice awaits results from large clinical trials.
Moukarbel
George V
GV
The Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Ayoub
Chakib M
CM
Abchee
Antoine B
AB
D000818:Animals; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000145:classification / Q000627:therapeutic use*; D006801:Humans; D015428:Myocardial Reperfusion Injury / Q000188:drug therapy* / Q000517:prevention & control
D002317:Cardiovascular Agents