Aida Kinderytė, Edmundas Širvinskas, Andrius Macas
Coronary artery blood flow restoration is necessary in order to preserve the myocardial viability. Often reperfusion of ischemic area can cause cardiomyocytes dysfunction and the phenomenon known as reperfusion injury. Reperfusion can induced myocardial stunning, microvascular and endothelial injury, and cell death of apoptosis and necrosis. Ischemia/reperfusion injury is a complex of molecular and cellular processes in which interlaced different biological mechanisms. Number of studies published that after ischemia/reperfusion period are significantly elevated myocardial damage markers, impaired myocardial contractility, worse clinical parameters. In animal studies, there is increasing evidence, that during ischemia/reperfusion injury the dysfunction of heart mitochondria plays a critical role. Cardioplegia during surgery is one of the prevention methods of ischemic injury. Cardioplegia reduces myocardial metabolic activity and oxygen demand during ischemia. Another way of determining a lower ischemic / reperfusion injury is ischemic preconditioning. It is noted that cardiac function from ischemic damage can preserve not only ischemic preconditioning, but also pharmacologic agents. The studies showed that volatile anesthetics may exert profound cardioprotection against myocardial ischemia and reperfusion injury.
Keyword(s): ischemia/reperfusion injury; ischemic preconditioning; cardioprotection
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