The Journal of Physiological Sciences

, Volume 65, Issue 3, pp 201–215 | Cite as

Contribution of apoptosis in myocardial reperfusion injury and loss of cardioprotection in diabetes mellitus

  • Reza BadalzadehEmail author
  • Behnaz MokhtariEmail author
  • Raana Yavari


Ischemic heart disease is one of the major causes of death worldwide. Ischemia is a condition in which blood flow of the myocardium declines, leading to cardiomyocyte death. However, reperfusion of ischemic regions decreases the rate of mortality, but it can also cause later complications. In a clinical setting, ischemic heart disease is always coincident with other co-morbidities such as diabetes. The risk of heart disease increases 2–3 times in diabetic patients. Apoptosis is considered to be one of the main pathophysiological mechanisms of myocardial ischemia–reperfusion injury. Diabetes can disrupt the anti-apoptotic intracellular signaling cascades involved in myocardial protection. Therefore, targeting these changes may be an effective cardioprotective approach in the diabetic myocardium against ischemia–reperfusion injury. In this article, we review the interaction of diabetes with the pathophysiology of myocardial ischemia–reperfusion injury, focusing on the contribution of apoptosis in this context, and then discuss the alterations of pro-apoptotic or anti-apoptotic pathways probably responsible for the loss of cardioprotection in diabetes.


Myocardial reperfusion injury Apoptosis Diabetes Preconditioning Postconditioning 


Conflict of interest



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Copyright information

© The Physiological Society of Japan and Springer Japan 2015

Authors and Affiliations

  1. 1.Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
  2. 2.Drug Applied Research CenterTabriz University of Medical SciencesTabrizIran
  3. 3.Department of Physiology, Faculty of MedicineTabriz University of Medical SciencesTabrizIran

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