The pathobiology of acute coronary syndromes: clinical implications and central role of the mitochondria

Tex Heart Inst J. 2013;40(3):221-8.

Abstract

Ongoing investigation has provided new insights into the pathobiology of myocardial ischemic injury. These include an improved understanding of the roles of the major modes of cell injury and death, including oncosis, apoptosis, and unregulated autophagy, as well as the central role of the mitochondria in the progression of myocardial ischemic injury, reperfusion injury, and myocardial conditioning. This understanding is providing insights for developing new pathophysiologic, pharmacologic, and cell-based therapies, alone or in combination with percutaneous coronary interventions, for better preservation of myocardium and reduction of morbidity and mortality rates from ischemic heart disease.

Keywords: Apoptosis; autophagy; cardioprotection; inflammation mediators; ischemic preconditioning, myocardial; mitochondria; myocardial ischemia/physiopathology; myocardial reperfusion injury; myocardial reperfusion injury/physiopathology; myocardial stunning/physiopathology; myocardium/cytology/ultrastructure; myocytes, cardiac/pathology; necrosis/prevention & control; oncosis; regeneration/physiology; reperfusion injury; signal transduction; stem cell transplantation.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / metabolism*
  • Acute Coronary Syndrome / mortality
  • Acute Coronary Syndrome / pathology
  • Acute Coronary Syndrome / physiopathology
  • Acute Coronary Syndrome / therapy
  • Animals
  • Cell Death
  • Disease Progression
  • Humans
  • Mitochondria, Heart / metabolism*
  • Mitochondria, Heart / pathology
  • Myocardium / metabolism*
  • Myocardium / pathology
  • Prognosis