Apoptosis: pathophysiology and therapeutic implications for the cardiac surgeon

The Annals of Thoracic Surgery
Ali KhoynezhadAnthony J Tortolani

Abstract

Cardiomyocyte apoptosis has been associated with the pathogenesis of heart failure as well as ischemic and inflammatory myocardial conditions. The aim of this study is to give a critical synopsis of cardiomyocyte apoptosis and identify methods to prevent or attenuate apoptosis in patients undergoing cardiac surgery. Clinical conditions and agents associated with decreased apoptotic index are early repair or replacement of valvular pathology before deterioration of ventricular function, afterload reduction with medication or intraaortic balloon pulsation in patients with acute increase in afterload or in hemodynamically compromised patients, decreasing catecholamine-induced cardiotoxicity by using beta-blockers, phosphodiesterase inhibitors, or early insertion of intraaortic balloon pulsation or ventricular assist device. Prompt coronary revascularization, which reduces myocardial ischemia time, is the most effective antiapoptotic therapy. Reduction of myocardial apoptosis associated with cardiopulmonary bypass and aortic cross-clamping are other therapeutic targets. Some investigational therapies include ischemic preconditioning and use of antiapoptotic medication such as the caspase inhibitors, antioxidants, calcium-channel bl...Continue Reading

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Jun 19, 2010·Journal of Cardiovascular Translational Research·Husnain Kh Haider, Muhammad Ashraf
Jan 24, 2007·Journal of Cardiothoracic Surgery·Evaristo CastedoJuan Ugarte
Jul 3, 2013·Journal of Cardiothoracic Surgery·Enshi WangZhe Zheng
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Dec 25, 2007·Journal of the American College of Surgeons·Neel R SodhaFrank W Sellke
Jun 28, 2015·Pharmacology & Therapeutics·M ZakkarM S Suleiman
Feb 29, 2016·Apoptosis : an International Journal on Programmed Cell Death·G Kishore KumarH Surekha Rani
Nov 30, 2013·The American Journal of Pathology·Cherng-Shyang ChangYau-Sheng Tsai
Sep 22, 2016·The Journal of Thoracic and Cardiovascular Surgery·Ali Khoynezhad
Feb 23, 2005·Expert Review of Cardiovascular Therapy·Fariya BukhariRoger J Hajjar
Dec 6, 2017·Molecular Medicine Reports·Emmanuel PapadakisDemetrios A Spandidos

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