| A multidisciplinary overview of cardiogenic shock. | |
| | |
MedLine Citation:
|
PMID: 16721262 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Cardiogenic shock complicating acute myocardial infarction (AMI) is reviewed from multidisciplinary viewpoints encompassing both basic and clinical aspects. Insights into the absolute obligate aerobic nature of the heart which possesses neither facultative capability nor functional collateral channels, together with O2 diffusion gradients, mitochondrial O2 sensing and anaerobic ATP deficiencies, are described in some detail. Myocardial adaptive responses against energy crisis, termed the Pasteur Effect, and hypoxia inducible factor (HIF)-1 alpha are implicated for cardiomyocyte viability. Oncosis and/or lysosomal autophagy cause such overwhelming numbers (several billions) of cardiomyocyte death, virtually simultaneously following coronary thrombotic occlusion. Apoptosis is briefly described and cardiogenic shock is discussed in terms of the diagnostic criteria by MIRU, unique hemodynamic manifestations, infarct sizes and border zone extension, and potentially jeopardized myocardium in the remote areas. Reperfusion injury, i.e., reactive oxygen species (ROS), is noted as a double-edged sword. The importance of early revascularization by means of PCI, CABG, and IABP support is emphasized according to current guidelines. For innovative promise in the future, de novo development of collateral channels by growth factors and trials of stem cell implantation aimed at myocardial regeneration are introduced. |
| | |
Authors:
|
Minoru Okuda |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Shock (Augusta, Ga.) Volume: 25 ISSN: 1073-2322 ISO Abbreviation: Shock Publication Date: 2006 Jun |
Date Detail:
|
Created Date: 2006-05-24 Completed Date: 2006-07-07 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9421564 Medline TA: Shock Country: United States |
Other Details:
|
Languages: eng Pagination: 557-70 Citation Subset: IM |
Affiliation:
|
Department of Medicine, Keio University School of Medicine, Tokyo, Japan. minoru_okuda@mqb.biglobe.ne.jp |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adenosine Triphosphate
/
deficiency,
metabolism Animals Apoptosis Autophagy Cell Survival Diagnosis, Differential Energy Metabolism Humans Hypoxia-Inducible Factor 1, alpha Subunit / biosynthesis Lysosomes / metabolism, pathology Myocardial Reperfusion Injury / etiology, metabolism, pathology, therapy Myocardial Revascularization Myocardium / metabolism, ultrastructure Myocytes, Cardiac / metabolism, ultrastructure Oxygen / metabolism* Regeneration Shock, Cardiogenic* Stem Cell Transplantation |
| Chemical | |
Reg. No./Substance:
|
0/HIF1A protein, human; 0/Hypoxia-Inducible Factor 1, alpha Subunit; 56-65-5/Adenosine Triphosphate; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Hypertrophic osteoarthropathy secondary to vascular prosthesis infection: report of 3 cases and revi...
Next Document: Elevated high-mobility group box 1 levels in patients with cerebral and myocardial ischemia.