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Myocardial Protection from Ischemia and Reperfusion Injury

  • Chapter
Acute Heart Failure

Abstract

Prolonged and unresolved interruption of blood supply to the myocardium without reperfusion ultimately causes myocyte cell death. Early restoration of blood flow to the ischemic myocardium is therefore necessary to prevent myocardial cell death to occur. However, reperfusion itself may lead to additional tissue injury beyond that generated by the ischemic event. This phenomenon is called reperfusion injury and it may manifest as arrhythmias, reversible contractile dysfunction (myocardial stunning), endothelial dysfunction, and ultimately irreversible reperfusion injury with myocardial cell death. Irreversible reperfusion injury is defined as the injury caused by restoration of blood flow after an ischemic episode leading to the death of cells that were only reversibly injured during the preceding ischemic period (Fig. 9.1). This lethal reperfusion injury may result from two mechanisms: necrosis and apoptosis. Therefore, treatment of myocardial ischemia not only should be directed toward a prompt restoration of blood flow to the ischemic area but also should include measures to prevent or minimize the extent of reperfusion injury.

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  1. Department of Anaesthesiology, University of Antwerp, Antwerp University Hospital, Edegem, Belgium

    Stefan G. De Hert MD, PhD

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  1. Stefan G. De Hert MD, PhD
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Editors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France

    Alexandre Mebazaa MD, PhD (Professor of Medicine) (Professor of Medicine)

  2. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Mihai Gheorghiade MD, FACC (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service) (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service)

  3. Department of Cardiology Centre d’Investigation Clinique (CIC), INSERM U-684, Centre Hospitalier Universitaire, University Henri Poincaré, Nancy, France

    Faiez M. Zannad MD, PhD, FESC (Professor of Medicine) (Professor of Medicine)

  4. Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

  5. Cooper Heart Institute, Cooper University Hospital, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

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© 2008 Springer-Verlag London Limited

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De Hert, S.G. (2008). Myocardial Protection from Ischemia and Reperfusion Injury. In: Mebazaa, A., Gheorghiade, M., Zannad, F.M., Parrillo, J.E. (eds) Acute Heart Failure. Springer, London. https://doi.org/10.1007/978-1-84628-782-4_9

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  • DOI: https://doi.org/10.1007/978-1-84628-782-4_9

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-781-7

  • Online ISBN: 978-1-84628-782-4

  • eBook Packages: MedicineMedicine (R0)

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