Myocardial Ischemia: From Mechanisms to Therapeutic by Dennis V. P. Cokkinos, C. Pantos, Gerd Heusch, H. Taegtmeyer

By Dennis V. P. Cokkinos, C. Pantos, Gerd Heusch, H. Taegtmeyer

Great growth has been made in realizing the pathophysiology of ischemic center disorder. for that reason, new healing ways for safeguarding the center from ischemic damage are in improvement. This quantity will spotlight concerns relating uncomplicated mechanisms of ischemia-reperfusion harm with regards to capability healing recommendations.

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Example text

PKC appears to be involved in the early response. ^^ Acetylcholine is released during ischemia. Acetylcholine can induce cardioprotection by its action on the muscarinic surface receptors with subsequent activation of the PI3K signaling pathway and Src-kinases. Table 1. Figures 10, 11. ^^ See also chapter 3 and figures 3,4. Cardiac tissue angiotensin II is increased in myocardial ischemia and seems to serve an important physiological role. Figure 13. ^^ A beneficial role for angiotensin has been identified in the context of ischemia and reperfusion.

The morphology of hibernating myocardium is characterized by both adaptive and degenerative features. The number of myofibrils is reduced while the number of mitochondria and glycogen deposits are increased after 24 h and these changes are reversed in a week following the release of the coronary stenosis. Other morphological changes include a variable degree of fibrosis and expansion of the interstitium by increased infiltration of macrophages and fibroblasts together with collagen deposition. Extracellular matrix proteins (such as desmin, tubulin and vinculin) are increased, indicating disorganization of the cytoskeleton.

In fact, it has been recently shown that in a swine model of regional reversible ischemia, stunned and normal areas within the same heart corresponded to different gene expression. Interestingly, more than 30% of the genes which were upregulated in the stunned myocardium are known to be involved in different mechanisms of cell survival including resistance to apoptosis, cytoprotection and cell growth. ^^ MYOCARDIAL ISCHEMIA 25 Stunning resolves spontaneously and it can be viewed as a protective mechanism which should be given sufficient time to recover.

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