Protection And Mechanism Of Myocardial Postconditioning

With the development of cardiopulmonary bypass, coronary artery bypass grafting, congenital heart disease surgery, valve replacement, percutaneous coronary intervention and vascular surgery, myocardial ischemia / reperfusion injury has become a frequent pathophysiological change in anesthesia and puzzle of effect of heart and vascular surgery. The results indicate that ischemia preconditioning may cause myocardium to produce ischemia toleration and protect myocardium against ischemia-reperfusion injury. But because it is impossible which anticipation the time of myocardial ischemia in advance, ischemic preconditioning has local in clinical application. In 2003, ischemic postconditioning was introduced by professor ZHAO first. Ischemic postconditioning can improve myocardial function obviously, decreasing infarct size attenuating myocardial ischemia/reperfusion injury significantly. Ischemic postconditioning is enforced after myocardium ischemia, it will be bound to have a promising perspective. Pstconditioning can protect myocardium by decreasing infarct size, improving myocardial function and inhibiting reperfusion arrhythmia. Postconditioning can protect myocardium by inhibiting oxygen free radical accumulation, inhibiting intracellular and mitochondrial calcium overload, inhibiting neutrophil activating and inhibiting myocardial cell apoptosis, this is pathophysiolgial mechanism of myocardial protection. The molecular mechanism of myocardial protection induded by postconditioning involving multitudinal endogenous material, intracellular signal transduction mediator, intracellular signal transduction path and effective appararus. In this review, after a brief distruction of the myocardial ischemia / reperfusion injury mechanism, this view will focus on the pathophysiolgial mechanism and Molecular mechanism which postconditioning against myocardial ischemia / reperfusion injury.