Myocardium reperfusion injury

The phenomenon of ischemia/reperfusion injury is described in the experimental models of acute myocardial infarction(AMI),causing additional functional and structural damage to the acute reperfused myocardium,and ischemic preconditioning refers to the myocardial ischemia after a long period of reperfusion before one or several shortoccasional duplication of myocardial ischemia /reperfusion1,which can increase myocardial ischemic tolerance.The therapeutic strategies for AMI have focused on myocardial ischemia /reperfusion injury,which accounts for a significant part of the final infarct size.Although experiments in the last 20 years have reported that pharmacological interventions at reperfusion might reduce myocardial reperfusion injury,this could not be confirmed in human studies.An alternative to chemical modifiers,postconditioning(brief repeated periods of ischemia applied at the onset of reperfusion) is another method proven to be efficient in animal models and to be confirmed in recent human studies.This simple method,applied in the first minute of reperfusion,reduces the final infarct size by 30%-50%.This review will focus on the mechanisms,pharmacological preconditioning,postconditioning technique,which is easily applicable in human patients in the setting of AMI.