Nitric oxide and cardioprotection during ischemia-reperfusion

被引：130

作者：

Jugdutt B.I. ^{[1
]}

机构：

[1] Division of Cardiology, Department of Medicine, University of Alberta, Edmonton

来源：

Heart Failure Reviews | 2002年 / 7卷 / 4期

基金：

加拿大健康研究院;

关键词：

Angiotensin; Ischemia-reperfusion; Nitric oxide; Nitroglycerin; Peroxynitrite;

D O I：

10.1023/A:1020718619155

中图分类号：

学科分类号：

摘要：

Coronary artery reperfusion is widely used to restore blood flow in acute myocardial infarction and limit its progression. However, reperfusion of ischemic myocardium results in reperfusion injury and persistent ventricular dysfunction even when achieved after brief periods of ischemia. Normally, small amounts of nitric oxide (NO) generated by endothelial NO synthase (eNOS) regulates vascular tone. Ischemia-reperfusion triggers the release of oxygen free radicals (OFRs) and a cascade involving endothelial dysfunction, decreased eNOS and NO, neutrophil activation, increased cytokines and more OFRs, increased inducible NO synthase (iNOS) and marked increase in NO, excess peroxynitrite formation, and myocardial injury. Low doses of NO appear to be beneficial and high doses harmful in ischemia-reperfusion. eNOs knock-out mice confirm that eNOS-derived NO is cardioprotective in ischemia-reperfusion. iNOS overexpression increases peroxynitrite but did not cause severe dysfunction. Increased angiotensin II (AngII) after ischemia-reperfusion inactivates NO, forms peroxynitrite and produces cardiotoxic effects. Beneficial effects of angiotensin-converting-enzyme inhibition and AngII type 1 (AT1) receptor blockade after ischemia-reperfusion are partly mediated through AngII type 2 (AT2) receptors stimulation, increased bradykinin and NO. Interventions that enhance NO availability by increasing eNOS might be beneficial after ischemia-reperfusion.

引用

页码：391 / 405

页数：14

共 163 条

[1]

Ryan T.J., Antman E.M., Brooks N.H., Et al., Update: ACC/AHA guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on management of acute myocardial infarction), J Am Coll Cardiol, 34, pp. 890-911, (1999)

[2]

Hearse D.J., Reperfusion of the ischemic myocardium, J Mol Cell Cardiol, 9, pp. 605-616, (1997)

[3]

Braunwald E., Kloner R.A., The stunned myocardium: Prolonged, post-ischemic ventricular dysfunction, Circulation, 66, pp. 1146-1149, (1982)

[4]

Braunwald E., Kloner R.A., Myocardial reperfusion: A double-edged sword?, J Clin Invest, 76, pp. 1713-1719, (1985)

[5]

Topol E.J., Early myocardial reperfusion: An assessment of current strategies in acute myocardial infarction, Eur Heart J, 17, SUPPL. E, pp. 42-48, (1996)

[6]

Kloner R.A., Jennings R.B., Consequences of brief ischemia: Stunning, preconditioning, and their clinical implications. Part 1, Circulation, 104, pp. 2981-2989, (2001)

[7]

Kloner R.A., Jennings R.B., Consequences of brief ischemia: Stunning, preconditioning, and their clinical implications. Part 2, Circulation, 104, pp. 3158-3167, (2001)

[8]

Przyklenk K., Kloner R.A., Superoxide dismutase plus catalase improve contractile function in the canine model of the "stunned myocardium, Circ Res, 58, pp. 148-156, (1986)

[9]

Bolli R., Jeroudi M.O., Patel B.S., Et al., Marked reduction of free radical generation and contractile dysfunction by antioxidant therapy begun at the time of reperfusion: Evidence that myocardial "stunning" is a manifestation of reperfusion injury, Circ Res, 65, pp. 607-622, (1989)

[10]

Bolli R., Mechanisms of myocardial "stunning, Circulation, 82, pp. 723-738, (1990)

← 1 2 3 4 5 6 7 8 9 10 →