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2006, Número S4

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Arch Cardiol Mex 2006; 76 (S4)


Remodelación cardíaca e inflamación

Martínez RM

Idioma: Español
Referencias bibliográficas: 70
Paginas: 58-66
Archivo PDF: 118.40 Kb.


RESUMEN

La remodelación cardíaca es una respuesta progresiva del corazón al daño agudo y crónico sin importar su etiología. Este proceso es caracterizado por cambios en el tamaño, en la forma y en la función del corazón y está asociado a un mal pronóstico en pacientes con insuficiencia cardíaca. El infarto agudo del miocardio es la causa más común del proceso de remodelado. En los primeros minutos posteriores al daño en la zona isquémica existe un importante aumento en la síntesis y liberación de citocinas proinflamatorias como el factor de necrosis tumoral-alfa (TNF-α) la interleucina-6 (IL-6), la interleucina-1-beta (IL-1β) y el factor de crecimiento transformante-1-beta (TGF-1β). Esta liberación aguda de citocinas podría regular la sobrevivencia o el proceso de apoptosis de los miocitos en la zona infartada y, sus efectos inotrópicos negativos pudieran representar una respuesta adaptativa para delimitar el daño y para disminuir la demanda de energía del miocardio. Esta significativa regulación a la alta de las citocinas proinflamatorias puede extenderse a la zona no infartada y disparar una segunda fase de niveles elevados de citocinas que promueven la fibrosis intersticial y la deposición de colágena en el miocardio no infartado contralateral llevando a un ventrículo disfuncional. Este artículo revisa los reportes recientes que apoyan la idea de un papel cardioprotector para esta respuesta inflamatoria primaria y un papel deletéreo a largo plazo de la respuesta tardía que media la fibrosis característica del proceso de remodelación.


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