Abstract:
Left ventricular remodeling is an adaptive process initially developed in response to acute myocardial infarction (AMI), but it ends up with negative adverse outcomes such as infarcted wall thinning, ventricular dilation, and cardiac dysfunction. A prolonged excessive inflammatory reaction to cardiomyocytes death and necrosis plays the crucial role in the pathophysiological mechanisms. The pharmacological treatment includes nitroglycerine, β-blockers, ACEi/ARBs, SGLT2i, mineralocorticoid receptor antagonists, and some miscellaneous aspects. Stem cells therapy, CD34+ cells transplantation and gene therapy constitute the promissing therapeutic approaches for post AMI cardiac remodeling, thereby enhancing angiogenesis, cardiomyocytes differenciation and left ventricular function on top of inhibiting apoptosis, inflammation, and collagen deposition. All these lead to reduce infarct size, scar formation and myocardial fibrosis.
摘要:
左心室重构是最初针对急性心肌梗死(AMI)而发展的适应性过程。但最终会导致负面的不良后果,例如梗塞壁变薄,心室扩张,和心脏功能障碍。对心肌细胞死亡和坏死的长期过度炎症反应在病理生理机制中起着至关重要的作用。药物治疗包括硝化甘油,β-受体阻滞剂,ACEi/ARB,SGLT2i,盐皮质激素受体拮抗剂,和一些杂项方面。干细胞疗法,CD34+细胞移植和基因治疗构成了AMI后心脏重构的潜在治疗方法,从而增强血管生成,心肌细胞分化和左心室功能在抑制凋亡的顶部,炎症,和胶原蛋白沉积。所有这些都能减少梗死面积,瘢痕形成和心肌纤维化。