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Does Reperfusion Cause Any Injury to the Myocardium?

  • Petr Ostadal
  • Irena Zdobnicka
  • Naranjan S. Dhalla
Part of the Progress in Experimental Cardiology book series (PREC, volume 9)

Summary

Enormous effort has been made during the past three decades to explain the pathologic events which occur upon reperfusion of the previously ischemic heart in animals. Experimental studies have described potentially harmful effects of reperfusion, a phenomenon called “reperfusion injury”. It is based on the observations in different animals that some myocardial damage occurs upon reperfusion if it is not instituted within a certain time-period of the ischemic insult. Although reperfusion has been shown as the most efficient treatment strategy for acute myocardial infarction in humans, arrhythmias and myocardial depression (cardiac stunning) have been observed upon reperfusion in patients with acute myocardial infarction; these harmful effects are temporary. In fact, the hard-core evidence that reperfusion causes myocardial injury in human is lacking and this is primarily due to the fact that a host of drugs are administered before inducing reperfusion by angioplasty, thrombolytic therapy or coronary bypass surgery. The purpose of this article is to summarize the current knowledge regarding the relationship between reperfusion and reperfusion injury and their implications in clinical management. De spite abundant information concerning the reperfusion-related injury, it is not clear whether reperfusion causes further injury to the ischemia-damaged cardiomyocytes or it is the delayed effect of ischemia per se. In addition, modifications of the reperfusion conditions have not been shown to improve the long-term damage to the myocardium. Thus, some caution should be exercised in interpreting the data from animal experiments to human until long-term results on ischemia-reperfusion injury are available.

Key words

reperfusion myocardial ischemia acute myocardial infarction cardiac protection 

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Copyright information

© Springer Science+Business Media New York 2003

Authors and Affiliations

  • Petr Ostadal
    • 1
  • Irena Zdobnicka
    • 2
    • 3
  • Naranjan S. Dhalla
    • 2
    • 3
  1. 1.Department of Internal Medicine University Hospital MotolCharles University PragueCzech Republic
  2. 2.Institute of Cardiovascular SciencesSt. Boniface General Hospital Research CentreWinnipegCanada
  3. 3.Department of PhysiologyFaculty of Medicine University of ManitobaWinnipegCanada

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