Recent advances in nanomedicines for imaging and therapy of myocardial ischemia-reperfusion injury.

Myocardial ischemia-reperfusion injury (IRI) is becoming a typical cardiovascular disease with increasing worldwide incidence. It is usually induced by the restoration of normal blood flow to the ischemic myocardium after a period of recanalization and directly leads to myocardial damage. Notably, the pathological mechanism of myocardial IRI is closely related to inflammation, oxidative stress, Ca2+ overload, and the opening of mitochondrial permeability transition pore channels. Therefore, monitoring of these changes and imaging lesions is a key to timely clinical diagnosis. Nanomedicines have shown great value in the diagnosis and treatment of myocardial IRI, with advantages including passive/active targeting, prolonged circulation, improved bioavailability, versatile carrier selection, and synergistic integration of different imaging and therapeutic agents in single particles with the same pharmaceutics. Because theranostic nanomedicines for myocardial IRI have advanced rapidly, we conduct an updated review on this topic. The special focus is on how to rationally design the nanomedicines to achieve optimal imaging and therapy. We hope this review would stimulate the interest of researchers with different backgrounds and expedite the development of nanomedicines for myocardial IRI. [Display omitted] • Inflammation, oxidative stress, and opening of mPTP channels cause myocaydial IRI. • Clinical myocardial IRI drugs have low targeting efficiency and side effects. • Nanomedicines can real-time monitor myocardial IRI-specific biomarkers. • Nanomedicines would revolutionize diagnosis and treatment paradigms on myocardial IRI. [ABSTRACT FROM AUTHOR]