Sul fenomeno del "no-reflow miocardico" nei pazienti con infarto miocardico. Attuali concetti

Translated title of the contribution: Myocardial no-reflow phenomenon: Recent knowledges

Maria Luisa Pontecorvo, Cristina Spaziani, Rocco Antonio Montone, Nicola Cosentino, Silvia Minelli, Giampaolo Niccoli

Research output: Contribution to journalArticle

Abstract

Early revascularization of the infarct-related artery by primary percutaneous coronary intervention (PPCI) has become the gold standard therapy in ST-segment elevation myocardial infarction (STEMI). However, in a number of patient undergoing PPCI, epicardial coronary artery reperfusion: does not translate intomyocardial reperfusion: a phenomenon called as no-reflow. The no-reflow phenomenon has a multifactorial pathogenesis, including: distal embolization, ischemia-reperfusion injury, and individual predisposition of coronary microcirculation to injury. Angiographic and electrocardiographic indexes may be used for the diagnosis. Also, lack of ST-segment elevation resolution is considered an established marker of no-reflow. Importantly, the no-reflow phenomenon provides prognostic information in STEMI patients because it is associated with low ventricular ejection fraction, adverse left ventricular remodelling and mortality at follow-up. Various mechanical devices and pharmacological approaches have been proposed to prevent and to treat the phenomenon: the assessment of mechanisms of no-reflow might guide the development of personalized form of treatment. This paper will be focused on the postulatedmechanisms of the phenomenon, modalities for the diagnosis, and the main treatment options.

Translated title of the contributionMyocardial no-reflow phenomenon: Recent knowledges
Original languageItalian
Pages (from-to)53-57
Number of pages5
JournalRecenti Progressi in Medicina
Volume102
Issue number2
DOIs
Publication statusPublished - Feb 2011

ASJC Scopus subject areas

  • Medicine(all)

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