Effect of diabetes on myocardial hypoxia-inducible factor-1 and its research progress

Abstract

Myocardial ischemia reperfusion injury (MIRI) caused by cardiac surgery under extracorporeal circulation anesthesia seriously threatens the life safety of patients with cardiovascular diseases. When patients with diabetes mellitus, the cure rate of heart diseases is significantly reduced compared with those without diabetes, and the incidence of postoperative complications and mortality are significantly increased. Application of ischemic preconditioning and ischemic postconditioning can reduce MIRI. Hypoxia inducible factor-1 (HIF-1) is the key molecule of both. HIF-1 is a major nuclear transcription factor that regulates the hypoxic transcription response. It binds to hypoxic response elements to activate the HIF-1 signaling pathway, by regulating the expression of downstream target genes, it regulates the regeneration of cardiac blood vessels, energy metabolism, inhibits apoptosis, and regulates oxidative stress to alleviate the damage of ischemia and hypoxia on the myocardium. However, the HIF-1 signaling pathway under the action of diabetes is inhibited, making its protective effect on the myocardium disappear. The methods of stabilizing HIF-1 structure and genetic engineering in animal experiments have achieved certain results in terms of myocardial protection. Key words: Hypoxia inducible factor-1 (HIF-1); Myocardial ischemia reperfusion injury (MIRI); Diabetes; Myocardial protection