Myocardial Cell Injury : Acute Myocardial Infarction(Topics in internal medicine of cardiopulmonary system,Symposium)

Acute myocardial infarction (AMI) is one of the representative, life-threatening cardiovascular disease. Due to the introduction of Western culture and dietary habits, the number of patients with coronary heart disease is gradually increasing in this country. In this report, a new interventional therapeutic strategy in the management of AMI: reperfusion therapy is discussed. In these days, patients who could reach to hospital with a coronary care unit in the early stage of AMI receive specific treatments: Intracoronay thrombolysis and primary PTCA (percutaneous transluminal coronary angioplasty) to restore the coronary flow. Despite the high percentage of coronary recanalization, absence of improvement (or sometimes worsening) of cardiac function is observed in the considerable number of patients, and it has become very important to recognize the development of myocardial cell injury after the reperfusion: reperfusion injury. Calcium overload and free radical production in the myocardial cells have been proposed to be one of the main mechanisms of reperfusin injury, however the adherence of activated leukocytes to the damaged endothelial cells and production of vasoconstrictor such as endothelin-1 also play an important role in the development of reperfusion injury