Myocardial reperfusion injury—triggered by an inevitable inflammatory response after reperfusion—may undo a considerable part of the myocardial salvage achieved through timely percutaneous coronary intervention in patients with acute myocardial infarction. Because infarct size is strongly correlated to mortality and risk of heart failure, the importance of endeavors for cardioprotective therapies to attenuate myocardial reperfusion injury and decrease infarct size remains undisputed. Myocardial reperfusion injury is the result of several complex nonlinear phenomena, and for a therapy to be effective, it should act on multiple targets involved in this injury. In this regard, hypothermia remains a promising treatment despite a number of negative randomized controlled trials in humans with acute myocardial infarction so far. To turn the tide for hypothermia in patients with acute myocardial infarction, sophisticated solutions for important limitations of systemic hypothermia should continue to be developed. In this review, we provide a comprehensive overview of the pathophysiology and clinical expression of myocardial reperfusion injury and discuss the current status and possible future of hypothermia for cardioprotection in patients with acute myocardial infarction.

中文翻译：

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降低急性心肌梗死心肌再灌注损伤的低温：关闭平移间隙

心肌再灌注损伤——由再灌注后不可避免的炎症反应触发——可能会破坏通过及时经皮冠状动脉介入治疗急性心肌梗死患者获得的相当一部分心肌挽救。由于梗塞面积与死亡率和心力衰竭风险密切相关，努力进行心脏保护治疗以减轻心肌再灌注损伤和减少梗塞面积的重要性仍然无可争议。心肌再灌注损伤是多种复杂非线性现象的结果，为了使治疗有效，它应该作用于与这种损伤有关的多个目标。在这方面，尽管迄今为止在人类急性心肌梗塞中进行了多项阴性随机对照试验，但低温疗法仍然是一种很有前景的治疗方法。为了扭转急性心肌梗死患者体温过低的趋势，应继续开发针对全身性体温过低的重要限制的复杂解决方案。在这篇综述中，我们全面概述了心肌再灌注损伤的病理生理学和临床表现，并讨论了低温对急性心肌梗死患者心脏保护的现状和可能的未来。