Amelioration of ischemic cardiomyopathy in patients using physiological ischemic training
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Weihai Chen1 · Jun Shen1 · Rongrong Chen2 · Hua You1 · Fulong Ye1 · Ju Zheng1 · Lijuan Lu3 · Xiao Lu4 · Jun Ni5 · Yanming Wu1 · Zhenguo Qiao6 1
Department of Cardiology, Suzhou Ninth People’s Hospital, Affiliated Wujiang Hospital of Nantong University, Suzhou, China 2 Department of Geriatric Medicine, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China 3 Department of Gynecology and Obstetrics, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, China 4
Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China Department of Rehabilitation, Affiliated Hospital of Nantong University, Nantong, China 6 Department of Gastroenterology, Suzhou Ninth People’s Hospital, Affiliated Wujiang Hospital of Nantong University, Suzhou, China 5
Amelioration of ischemic cardiomyopathy in patients using physiological ischemic training According to the American Heart Association, approximately five million patients suffer from heart failure, with an incidence of 0.9% [1]. Therefore, heart failure has become a serious global public health problem. Heart failure is the terminal state of various heart diseases and ischemic cardiomyopathy is regarded as one of the most important causes [2]. Ischemic cardiomyopathy is defined as severe coronary artery stenosis caused by a variety of reasons. This leads to long-term ischemia and hypoxia of myocardial tissue and corresponding pathological changes. These conditions subsequently cause apoptosis, necrosis, fibrosis, and scarring of cardiomyocytes, which affect myocardial contraction or diastolic function, or both, and ultimately contribute to heart failure [3–5]. Coronary atherosclerosis is the major cause of ischemic cardiomyopathy [6]. The diagnosis of ischemic cardiomyopathy mainly depends on the results of coronary angiography. This diagnosis requires at least one coronary vascular stenosis of ≥50%, combined with symptoms and signs of a decreased left ventricular ejection fraction (LVEF) or cardiac insufficiency [3]. Recently, there have been many largeWeihai Chen, Jun Shen and Rongrong Chen contributed equally to this work.
scale clinical studies on ischemic cardiomyopathy, and the treatment plan has been largely optimized. However, the prognosis is unsatisfactory because progression of heart failure is unmanageable. Furthermore, the numberofpatients with ischemic cardiomyopathy is increasing. Therefore, ischemic cardiomyopathy has gradually become the focus of clinical attention. Consequently, finding therapies that can effectively improve the ischemic symptoms of ischemic cardiomyopathy and relieve the symptoms of heart failure are necessary. An increasing number of scholars have gradually realized that angiogenesis and establishment of coronary collateral circulation (CCC) are promising new treatment strategies that could alter the course of advanced coronary artery disease [7, 8]. Chronic myocardial ischemia can induce ischemic myocardial collateral circulation and reduce in
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