Hydrogen sulfide and cardioprotection--Mechanistic insights and clinical translatability.

Hydrogen sulfide (H2S) has been long recognized as a highly poisonous gas that is rapidly lethal in intoxicating dosage. However, discoveries during the last decade on the endogenous synthesis of H2S in the mammalian system and its protective role in combating cellular necrosis, apoptosis, oxidative stress, inflammation as well as promoting angiogenesis and modulation of mitochondrial respiration in the setting of myocardial ischemia and reperfusion injury have prompted vast interest in the possibility of developing new therapies based around mimicry or facilitation of endogenous H2S for cardioprotection. These observations have inspired rapid development of H2S-releasing drugs in hopes of swift clinical translation in patients with cardiovascular disease. This review will discuss our current understanding of the protective signaling pathways elicited by H2S in the heart with an emphasis on the versatile benefits of this gasotransmitter and its potential for clinical translation in patients with cardiovascular disease.