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Cardioprotection in the Clinical Setting

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Abstract

Reperfusion therapy is the primary treatment of acute myocardial infarction and must be applied as soon as possible to limit the ischemic insult. Unfortunately, reperfusion is responsible for additional myocardial damage likely involving opening of the mitochondrial permeability transition pore. Ischemic postconditioning is a powerful intervention that dramatically reduces lethal reperfusion injury. Several clinical studies using angioplasty postconditioning now support its protective effects in patients with an acute myocardial infarction. Alternatively, pharmacological postconditioning could afford comparable protection and be applied to a much larger number of patients. Indeed, the mitochondrial permeability transition pore inhibitor cyclosporine A has been shown to generate a similar protection in acute myocardial infarction patients. Future large-scale trials are needed to determine whether angioplasty or pharmacological postconditioning may improve clinical outcome in STEMI patients.

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Abbreviations

AMI:

Acute myocardial infarction

CK:

Creatine kinase

ECG:

Electrocardiogram

IPC:

Ischemic preconditioning

IPost:

Ischemic postconditioning

LVEF:

Left ventricular ejection fraction

PTP:

Permeability transition pore

MRI:

Magnetic resonance imaging

PCI:

Percutaneous coronary intervention

ROS:

Reactive oxygen species

SPECT:

Single photon emission computed tomography

WMSI:

Wall motion score index

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Acknowledgments

Fabrice Ivanes is a recipient of a grant from the Fédération Française de Cardiologie (FFC). Nathan Mewton is a recipient from a grant of the Société Française de Cardiologie (SFC).

Author disclosure statement

No competing financial interests exist.

Author information

Authors and Affiliations

  1. Inserm U 886, Lyon, France

    Fabrice Ivanes, Nathan Mewton, Gilles Rioufol & Michel Ovize

  2. CIC de Lyon, Service d’Explorations Fonctionnelles Cardiovasculaires, Hospices Civils de Lyon, Université Claude Bernard Lyon1, Lyon, France

    Fabrice Ivanes, Nathan Mewton, Gilles Rioufol & Michel Ovize

  3. Inserm U661, Montpellier, France

    Christophe Piot

  4. Hopital Arnaud de Villeneuve, Université de Montpellier I and II, Montpellier, France

    Christophe Piot

  5. CREATIS-LRMN, UMR CNRS 5220, U 630 INSERM, Lyon, France

    Didier Revel & Pierre Croisille

  6. Inserm U858, Toulouse, France

    Meyer Elbaz

  7. Hôpital Rangueil, Université Paul Sabatier, Toulouse, France

    Meyer Elbaz

  8. Hôpital Louis Pradel, Hospices Civils de Lyon, 59, Boulevard Pinel, 69394, Lyon Cedex 03, France

    Michel Ovize

Authors
  1. Fabrice Ivanes
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  2. Nathan Mewton
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  3. Gilles Rioufol
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  8. Michel Ovize
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Correspondence to Michel Ovize.

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Ivanes, F., Mewton, N., Rioufol, G. et al. Cardioprotection in the Clinical Setting. Cardiovasc Drugs Ther 24, 281–287 (2010). https://doi.org/10.1007/s10557-010-6243-y

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  • DOI: https://doi.org/10.1007/s10557-010-6243-y

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