scholarly journals VEGF-A plasma levels are associated with microvascular obstruction in patients with ST-segment elevation myocardial infarction

2019 ◽  
Vol 291 ◽  
pp. 19-24 ◽  
Author(s):  
Rodrigue Garcia ◽  
Claire Bouleti ◽  
Marc Sirol ◽  
Damien Logeart ◽  
Catherine Monnot ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Plasma Levels ◽  
Microvascular Obstruction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

scholarly journals Microvascular Obstruction in Acute Myocardial Infarction

2017 ◽  
Vol 3 (4) ◽  
pp. 197-202
Author(s):  
Ioana Dregoesc ◽  
Adrian Iancu ◽  
Simona Manole ◽  
Şerban Bălănescu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Pressure Wave ◽  
Microvascular Obstruction ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Left Anterior Descending Artery ◽  
St Segment ◽  
Wedge Pressure

Abstract Introduction: The no-reflow phenomenon has been described in 20–40% of patients with acute ST-segment elevation myocardial infarction, despite restoration of TIMI 3 myocardial flow. It is associated with adverse left ventricular remodeling and an unfavorable long-term prognosis. Case presentation: A 45-year-old gentleman was admitted one hour after the onset of an acute anterior ST-segment elevation myocardial infarction. Emergency coronary angiography was performed, and a severe stenosis of the left anterior descending artery was identified. The lesion was crossed with a pressure-wire, and a drug-eluting stent was directly implanted, with restoration of TIMI 3 epicardial flow. Predilatation was not performed. Coronary wedge pressure was measured during stent deployment. The mean pressure value was 27 mmHg. However, a tall systolic wave was identified in the morphology of the pressure curve. Myocardial blush grade and ST-segment resolution were concordant with early micro-vascular obstruction. Similarly, at transthoracic Doppler echocardiography, the flow in the left anterior descending artery revealed the same pattern. An apical left ventricular aneurysm was echocardiographically detected. The MRI described extensive interstitial edema that affected the anterior, septal, and apical regions of the left ventricle. Areas of intramyocardial hemorrhage and microvascular obstruction were also detected. According to recent literature data, the morphology of the coronary wedge pressure wave suggested at least the presence of pre-procedural distal embolization. Conclusions: In the setting of acute myocardial infarction, the integrity of coronary microvasculature is an important issue. The distal coronary pressure wave pattern before primary percutaneous revascularization can be a deciding factor for an early therapeutic approach.

scholarly journals Association of microRNA-224-3p and microRNA-155-5p expressions with plasma long pentraxin 3 concentration and coronary microvascular obstruction following primary angioplasty for acute ST-segment elevation myocardial infarction

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Surya Dharma ◽  
Iwan Dakota ◽  
Shoma Wijaya ◽  
Elok Ekawati ◽  
Renan Sukmawan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Microvascular Obstruction ◽  
Primary Angioplasty ◽  
Specific Gene ◽  
Pentraxin 3 ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Inflammatory Stimuli ◽  
First Time

Abstract Objective Pro-inflammatory stimuli induce a variety set of microRNAs (miRs) expression that regulate long pentraxin-3 (PTX3) protein, which associates with a procoagulant state in the endothelial cells. We evaluated, for the first time in human, the association of miR-224-3p and miR-155-5p expressions with plasma PTX3 concentration and coronary microvascular obstruction (MVO) in patients with acute ST-segment elevation myocardial infarction (STEMI) with symptom onset ≤ 12 h and treated by primary angioplasty. Blood samples for miRs and PTX3 measurement were drawn at emergency department presentation, and were measured by TaqMan real-time PCR and human ELISA kit, respectively. Results Of the 217 patients (median age: 54 years, male: 88%), 130 (60%) had angiographic MVO. Spearman analysis showed no correlation between miR-224-3p and miR-155-5p expressions with plasma PTX3 concentration. After adjustment with sex, age, diabetes mellitus, and plasma PTX3 concentration, miR-224-3p ≥ median group was associated with angiographic MVO (odds ratio, 2.60; 95% confidence interval, 1.24 to 5.44, p = 0.01). This study suggests that miR-224-3p and miR-155-5p expressions did not correlate with plasma PTX3 concentration. However, miR-224-3p expression associates with angiographic MVO following primary angioplasty for STEMI. Future studies are needed to identify the specific gene/protein related with miR-224-3p expression in MVO.

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