title: Editor's Choice- Inside the cold heart: A review of therapeutic hypothermia cardioprotection.
abstract: Targeted temperature management has been originally used to reduce neurological injury and improve outcome in patients after out-of-hospital cardiac arrest. Myocardial infarction remains a major cause of death in the world and several investigators are studying the effect of mild therapeutic hypothermia during an acute cardiac ischemic injury. A search on MEDLINE, Scopus and EMBASE databases was conducted to obtain data regarding the cardioprotective properties of therapeutic hypothermia. Preclinical studies have shown that therapeutic hypothermia provides a cardioprotective effect in animals. The proposed pathways for the cardioprotective effects of therapeutic hypothermia include stabilization of mitochondrial permeability, production of nitric oxide, equilibration of reactive oxygen species, and calcium channels homeostasis. Clinical trials in humans have yielded controversial results. Current trials are therefore seeking to combine therapeutic hypothermia with other treatment modalities in order to improve the outcomes of patients with acute ischemic injury. This article provides a review of the hypothermia effects on the cardiovascular system, from the basic science of physiological changes in the human body and molecular mechanisms of cardioprotection to the bench of clinical trials with therapeutic hypothermia in patients with acute ischemic injury.
authors.affiliation: 1 University General Hospital, Houston, USA.|2 Universidad Autonoma de Baja California, Facultad de Medicina y Psicología, Tijuana, Mexico.
authors.forename: Luis O
authors.initials: LO
authors.lastname: Chavez
authors.affiliation: 1 University General Hospital, Houston, USA.|3 Universidad Popular Autonoma del Estado de Puebla, Facultad de Medicina Puebla, Mexico.
authors.forename: Monica
authors.initials: M
authors.lastname: Leon
authors.affiliation: 4 Shaare Zedek Medical Center and Hadassah-Hebrew University Faculty of Medicine, Jerusalem, Israel.
authors.forename: Sharon
authors.initials: S
authors.lastname: Einav
authors.affiliation: 1 University General Hospital, Houston, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Varon
mesh_terms: D000818:Animals; D015220:Calcium Channels / Q000378:metabolism; D002986:Clinical Trials as Topic; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D009203:Myocardial Infarction / Q000378:metabolism / Q000628:therapy*; D017382:Reactive Oxygen Species / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D015220:Calcium Channels; D017382:Reactive Oxygen Species
keywords: Acute myocardial infarction; cardiac arrest; dysrhythmias; hypothermia