心室负荷卸载防治心肌缺血再灌注损伤的应用及机制

Application and mechanism of ventricular unloading in prevention and treatment of myocardial ischemia-reperfusion injury

目前临床上针对心肌缺血再灌注(myocardial ischemia-reperfusion,MI/R)损伤仍缺乏有效的防治策略。一些临床及动物实验发现,在再灌注之前经皮植入心室辅助装置(percutaneous ventricular assistance device,pVAD)可以减少心室收缩-舒张负荷并减少心室做功与耗氧量,实现心室负荷有效卸载。这种操作可以减少MI/R损伤相关的心肌梗死面积扩大并限制纤维疤痕的形成。因此,pVAD植入有望成为防治MI/R损伤、改善心肌梗死患者预后的重要治疗手段。本文就心室负荷卸载防治MI/R损伤的应用及机制进行综述。

There is no effective strategy for preventing or treating myocardial ischemia-reperfusion(MI/R) injury.A recent set of basic and clinical research indicates that implanting a percutaneous ventricular assistance device(pVAD) prior to reperfusion unloads the ventricle and decreases myocardial oxygen consumption.The ventricular unloading induced by pVAD implantation prevents the infarction enlargement and minimizes fibrotic scar formation.The implantation of pVAD before reperfusion is recognized as a promising therapeutic approach for ameliorating MI/R injury.We summarize the application and mechanism of pVAD-induced ventricular unloading in the prevention and treatment of MI/R injury.