[The basis of ischemia-reperfusion and myocardial protection]

Abstract

The myocardial infarction represents a major cause of mortality. The deleterious phenomena arising during the ischaemia and the reperfusion of the myocardium are studied for more than 40 years. We thought for a long time that the ischaemia was the harmful stage, at the origin of the decrease of the energy stores, the dysregulation of the ionic homeostasis and the metabolic deregulation. We know now that the reperfusion itself is also a source of noxious effects (calcium overload, free radicals production, mitochondrion alteration). To combat these deleterious processes, two maneuvers demonstrated their efficiency by protecting the ischemic myocardium : it is the preconditioning and the postconditionning.