Emerging Multidimensional Technologies for Myocardial Ischemia–Reperfusion Injury

Myocardial ischemia-reperfusion injury (MIRI) is a major contributor to myocardial damage across diverse ischemic conditions and remains a particular challenge in cardiac surgery. Its development cannot be explained by a single pathway, but reflects a complex injury process triggered by ischemia and amplified during reperfusion. Recent advances in omics profiling, artificial intelligence and machine-learning methods, advanced imaging, and gene-regulatory technologies have provided new opportunities to investigate MIRI at molecular, cellular, spatial, and temporal levels. In this review, we examine how these approaches have advanced the understanding of key pathological processes in MIRI, including regulated cell death, oxidative stress, inflammation, metabolic dysregulation, extracellular matrix remodeling, and brain-heart axis regulation. We also discuss their contributions to biomarker discovery, therapeutic target validation, myocardial injury assessment, and optimization of intervention strategies, while considering their implications for both mechanistic research and perioperative cardioprotection. Closer integration of these technological advances with clinically relevant questions may improve risk assessment and help guide more precise strategies for the prevention and treatment of MIRI.