Reperfusion injury risk factors: Difference between revisions

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{{Reperfusion injury}}
 
'''Editors-In-Chief:''' {{AC}}; [[C. Michael Gibson]], M.S., M.D. [mailto:Mgibson@perfuse.org]; [[User:Shivam Singla|Dr. Shivam Singla M.D. [2]]] ;'''Associate Editors-In-Chief: '''[[User:Kashish Goel|Kashish Goel, M.D.,]]
{{CMG}} {{AE}}{{AC}}{{Shivam Singla}}  [[User:Kashish Goel|Kashish Goel, M.D.]]
 
==Overview==
 
[[Ischemia reperfusion injury]] is a complex disorder associated with various [[cardiovascular]] and other risk factors mainly including [[Hypertension]], [[hyperlipidemia]], [[Diabetes]], [[Insulin resistance]], [[aging]], and defects with [[coronary artery]] [[circulation]]. Although the exact mechanism about how these causes injuries are still not clear but studies have done so far best explains their role in mediating [[oxidative stress]] and [[endothelial cell]] dysfunctions, the two most important pathophysiological processes involved in the mediation of [[injury]].


==Risk Factors==
==Risk Factors==
Risk factors for reperfusion injury include
[[File: Risk Factors Ischemia Reperfusion Injury.png|thumb|441x441px|Risk Factors Ischemia Reperfusion Injury. Various cardiovascular and non-cardiovascular risk factors involved in the potentiation and aggravation of Ischemia-reperfusion injury. [https://www.bing.com/images/search?view=detailV2&ccid=SMNDI8wB&id=88E5186EC294A45270065565B8FC83F15822A364&thid=OIP.SMNDI8wB1Qp8QhRksM_bYgHaD2&mediaurl=http%3A%2F%2Fwww.conditionmed.org%2FAssets%2Fuserfiles%2Fsys_eb538c1c-65ff-4e82-8e6a-a1ef01127fed%2Ffiles%2Fv3i2-5.png&exph=399&expw=767&q=hypertension+diabetes+risk+factors+for+ischemia+reperfusion+injury&simid=608041019840660694&ck=62210F121E709512C734DEC36E75C9C2&selectedindex=61&form=EX0023&adlt=demote&shtp=GetUrl&shid=6beb27f7-26af-4fa1-99d0-5c2c9309f343&shtk=SG9tZSAtIENvbmRpdGlvbmluZyBNZWRpY2luZQ%3D%3D&shdk=Rm91bmQgb24gQmluZyBmcm9tIHd3dy5jb25kaXRpb25tZWQub3Jn&shhk=pWrs1LEJSOMbSgZ8IIsm639FRC%2BXJzwXFgrwUoDj500%3D&shth=OSH.Xtu%252BEgGwuMG2lvY9nt1r%252FA]]]
Risk factors for reperfusion injury include<ref name="urlIschemia‐Reperfusion: Mechanisms of Microvascular Dysfunction and the Influence of Risk Factors for Cardiovascular Disease - GRANGER - 1999 - Microcirculation - Wiley Online Library">{{cite web |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1549-8719.1999.tb00099.x |title=Ischemia‐Reperfusion: Mechanisms of Microvascular Dysfunction and the Influence of Risk Factors for Cardiovascular Disease - GRANGER - 1999 - Microcirculation - Wiley Online Library |format= |work= |accessdate=}}</ref>


* [[Hypertension]] with [[left ventricular hypertrophy]],
* [[Hypertension]] with [[left ventricular hypertrophy]],
* [[Congestive heart failure]],
* [[Congestive heart failure]]
* Increased age,
* Increased age<ref name="urlFundamentals of Reperfusion Injury for the Clinical Cardiologist | Circulation">{{cite web |url=https://www.ahajournals.org/doi/full/10.1161/01.cir.0000016602.96363.36 |title=Fundamentals of Reperfusion Injury for the Clinical Cardiologist &#124; Circulation |format= |work= |accessdate=}}</ref>,
* [[Diabetes]], and
* [[Diabetes]], and
* [[Hyperlipidemia]]
* [[Hyperlipidemia]]


It is important to identify the risk factors associated with worse [[reperfusion injury]] in [[STEMI]] patients. This may help in early risk stratification and develop therapy targets to reduce the infarct size associated with [[reperfusion injury]]. These risk factors also increase the risk of first cardiac event and emphasizes the importance of secondary prevention. Most of these associations are based on animal studies and includes:
It is important to identify the risk factors associated with worse [[reperfusion injury]] in [[STEMI]] patients. This may help in early risk stratification and develop therapeutic targets to reduce the infarct size associated with [[reperfusion injury]]. These risk factors also increase the risk of a first cardiac event and emphasize the importance of secondary prevention. Most of these associations are based on animal studies and includes:


* [[Left Ventricular hypertrophy]]: Long-standing hypertension leads to pressure overload [[hypertrophy]]. This is associated with metabolic and biochemical changes, predisposing the [[myocardium]] to severe [[reperfusion injury]]<ref name="urlFundamentals of Reperfusion Injury for the Clinical Cardiologist | Circulation">{{cite web |url=https://www.ahajournals.org/doi/full/10.1161/01.cir.0000016602.96363.36#:~:text=Cardiovascular%20risk%20factors%2C%20including%20hypercholesterolemia%2C%20diabetes%2C%20and%20hypertension%2C,underlie%20risk%20factor%E2%80%93mediated%20exacerbation%20of%20reperfusion%20injury.%209 |title=Fundamentals of Reperfusion Injury for the Clinical Cardiologist &#124; Circulation |format= |work= |accessdate=}}</ref>. Moreover, increase in [[lactate dehydrogenase]] and [[creatine kinase]] release after reperfusion increases the susceptibility of the hypertrophied heart to [[Ischemia|ischemia/reperfusion injury]].
* [[Left Ventricular hypertrophy]]:  
**Long-standing hypertension leads to pressure overload [[hypertrophy]]. This is associated with metabolic and biochemical changes, predisposing the [[myocardium]] to severe [[reperfusion injury]].
**Moreover, an increase in [[lactate dehydrogenase]] and [[creatine kinase]] release after reperfusion increases the susceptibility of the hypertrophied heart to [[Ischemia|ischemia/reperfusion injury]].
* [[Heart failure]]: Left ventricular dysfunction may predispose the heart to [[reperfusion injury]].
* [[Heart failure]]: Left ventricular dysfunction may predispose the heart to [[reperfusion injury]].
* [[Age]]: Aging is associated with [[oxidative stress]] as well as impaired [[systolic]] and [[diastolic]] function, increasing the risk related to [[reperfusion injury]].
* [[Age]]: Aging is associated with<ref name="urlIschemia Reperfusion Injury - Pipeline Review, H2 2020">{{cite web |url=https://www.researchandmarkets.com/reports/5137289/ischemia-reperfusion-injury-pipeline-review-h2?utm_source=dynamic&utm_medium=BW&utm_code=8r6vpt&utm_campaign=1345421+-+Ischemia+Reperfusion+Injury%2c+Pipeline+Review%2c+H1+2020+-++Risk+Factors+Include+Hypertension%2c+Hyperlipidemia%2c+Diabetes%2c+Insulin+Resistance%2c+Heart+Failure%2c+Altered+Coronary+Circulation+%26+Aging&utm_exec=anwr281bwd |title=Ischemia Reperfusion Injury - Pipeline Review, H2 2020 |format= |work= |accessdate=}}</ref>
* [[Diabetes]]: The data from preclinical studies in diabetic patients is not clear, however there is clearly increased susceptibility of the heart to ischemic stress and possibly [[reperfusion]].
**[[Oxidative stress]] as well as
* [[Hyperlipidemia]]: [[Hyperlipidemia]] is a known risk factor for [[ischemic heart disease]]. Animal and human studies have shown that presence of [[hyperlipidemia]] increases the risk of [[reperfusion injury]] and may also attenuate the protective effect of [[ischemic]] preconditioning.
**Impaired [[systolic]] and [[diastolic]] function,Both the mech. increases the risk related to [[reperfusion injury]].
 
*[[Diabetes]]: The data from preclinical studies in diabetic patients is not clear, however, there is clearly increased susceptibility of the heart to ischemic stress and possibly [[reperfusion]].
*[[Hyperlipidemia]]: [[Hyperlipidemia]] is a known risk factor for [[ischemic heart disease]].  
**Animal and human studies have shown that the presence of [[hyperlipidemia]] increases the risk of [[reperfusion injury]] and may also attenuate the protective effect of [[ischemic]] preconditioning.


==References==
==References==
{{Reflist|2}}
[[Category:Physiology]]
[[Category:Physiology]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date cardiology]]
<references />

Latest revision as of 19:19, 21 August 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Anjan K. Chakrabarti, M.D. [3]Shivam Singla, M.D.[4] Kashish Goel, M.D.

Overview

Ischemia reperfusion injury is a complex disorder associated with various cardiovascular and other risk factors mainly including Hypertension, hyperlipidemia, Diabetes, Insulin resistance, aging, and defects with coronary artery circulation. Although the exact mechanism about how these causes injuries are still not clear but studies have done so far best explains their role in mediating oxidative stress and endothelial cell dysfunctions, the two most important pathophysiological processes involved in the mediation of injury.

Risk Factors

Risk Factors Ischemia Reperfusion Injury. Various cardiovascular and non-cardiovascular risk factors involved in the potentiation and aggravation of Ischemia-reperfusion injury. [1]

Risk factors for reperfusion injury include[1]

It is important to identify the risk factors associated with worse reperfusion injury in STEMI patients. This may help in early risk stratification and develop therapeutic targets to reduce the infarct size associated with reperfusion injury. These risk factors also increase the risk of a first cardiac event and emphasize the importance of secondary prevention. Most of these associations are based on animal studies and includes:

References

  1. ↑ "Ischemia‐Reperfusion: Mechanisms of Microvascular Dysfunction and the Influence of Risk Factors for Cardiovascular Disease - GRANGER - 1999 - Microcirculation - Wiley Online Library".
  2. ↑ "Fundamentals of Reperfusion Injury for the Clinical Cardiologist | Circulation".
  3. ↑ "Ischemia Reperfusion Injury - Pipeline Review, H2 2020".
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