Open AccessOntogenetic development of cardiac tolerance to oxygen deprivation – possible mechanisms
Author(s) -
B Ošťádal,
I Ošťádalová,
František Kolář,
Zuzana Charvátová,
Ivan Netuka
Publication year - 2009
Publication title -
physiological research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 70
eISSN - 1802-9973
pISSN - 0862-8408
DOI - 10.33549/physiolres.931920
Subject(s) - hypoxia (environmental) , disease , heart disease , medicine , ontogeny , pathogenesis , cardiology , cardiac function curve , physiology , oxygen , heart failure , chemistry , organic chemistry
Our present focus on the hypoxic immature heart is driven byclinical urgency: cyanotic congenital cardiac malformationsremain the single largest cause of mortality from congenitaldefects and ischemic heart disease is no more the disease of thefifth and older decades but its origin as well as risk factors arepresent already during early ontogeny. Moreover, the number ofadult patients operated for cyanotic congenital heart diseaseduring infancy steadily increases. This group approaches the ageof the rising risk of serious cardiovascular diseases, particularlyischemic heart disease. Experimental results have clearly shownthat the immature heart is significantly more tolerant to oxygendeficiency than the adult myocardium. However, the mechanismsof this difference have not yet been satisfactorily clarified; theyare likely the result of developmental changes in cardiac energymetabolism, including mitochondrial function. The high resistanceof the newborn heart cannot be further increased by ischemicpreconditioning or adaptation to chronic hypoxia; theseprotective mechanisms appear only with decreasing toleranceduring development. Resistance of the adult myocardium toacute oxygen deprivation may be significantly influenced byperinatal hypoxia. These results suggest that the developmentalapproach offers new possibilities in the studies of pathogenesis,prevention and therapy of critical cardiovascular diseases.