scholarly journals Predictors of myocardial reperfusion syndrome: a modern view of the issue and current problems. Part 2: no-reflow phenomenon (literature review)

2021 ◽  
Vol 20 (3) ◽  
pp. 4-10
Author(s):  
G. G. Khubulava ◽  
K. L. Kozlov ◽  
A. N. Shishkevich ◽  
S. S. Mikhaylov ◽  
E. Yu. Bessonov ◽  
...  
Keyword(s):  
Risk Groups ◽  
Unanimous Opinion ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
No Reflow ◽  
St Segment ◽  
Surgical Methods ◽  
No Reflow Phenomenon ◽  
Long Term Prognosis

Despite the fact that the phenomenon of unrecovered coronary blood flow (no-reflow) has long been known, there is still no unanimous opinion about the predictors and, accordingly, the risk groups for its occurrence. This prevents predicting the further course of the disease and investigating the effectiveness of therapeutic and surgical methods for preventing the consequences of reperfusion in patients with ST-segment elevation myocardial infarction, which in turn worsens the postoperative and long-term prognosis in this group of patients. We used the search engines E-library, Google Scholar and Pubmed to search for studies on this issue. The article presents and analyzes research data covering the predictors of the no-reflow phenomenon. The difficulties in identifying them are also described, the issue of a diagnostic approach ans sampling for research is raised. A review of studies dedicated to the identification of predictors of the no-reflow phenomenon using optical coherence tomography and intravascular ultrasound is given.

scholarly journals Predictors of myocardial reperfusion syndrome: a modern view of the issue and current problems. Part 1: Reperfusion arrhythmias, injury and stunning myocardium (review of literature)

2021 ◽  
Vol 20 (2) ◽  
pp. 20-26
Author(s):  
G. G. Khubulava ◽  
K. L. Kozlov ◽  
A. N. Shishkevich ◽  
S. S. Mikhailov ◽  
E. Yu. Bessonov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Groups ◽  
Myocardial Reperfusion ◽  
Review Of Literature ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Long Time ◽  
Long Term Prognosis

Myocardial reperfusion syndrome is a complex set of pathological processes that occur in the heart muscle due to restoration of coronary blood flow in patients with ST-segment elevation myocardial infarction. Despite the fact that it has been known for a long time, there is still no unequivocal opinion about the predictors, and, accordingly, the risk groups for its occurrence. This prevents predicting the further course of the disease and studying the effectiveness of surgical and therapeutic methods for preventing the consequences of reperfusion in patients with ST-segment elevation myocardial infarction, which in turn significantly worsens the postoperative and long-term prognosis in this group of patients. We used the search engines such as E-lilbrary, Google Scholar and Pubmed to search for studies on this issue. The article presents research data highlighting predictors of myocardial reperfusion syndrome. In addition, the problems of verification of irreversible reperfusion injury and myocardial stunning are described.

Hospital and long-term prognosis of patients with non-ST-segment elevation myocardial infarction

2008 ◽  
Vol 149 (45) ◽  
pp. 2115-2119 ◽  
Author(s):  
András Jánosi ◽  
Dániel Várnai ◽  
Zsófia Ádám ◽  
Adrienn Surman ◽  
Katalin Vas
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Long Term Prognosis

A szerzők 139, nem ST-elevációs infarktus miatt kezelt betegük adatait elemzik. Vizsgálják a betegek kórházi és késői prognózisát, egyes echokardiográfiás adatok prognózissal való összefüggését, valamint a kórházból elbocsátott betegek esetén a szekunder prevenció szempontjából ajánlott gyógyszeres kezelés gyakoriságát. Az utánkövetés a betegek 98%-ában sikeres volt, a bekövetkezett eseményekről, illetve az utánkövetés idején alkalmazott gyógyszeres kezelésről postai kérdőív útján szereztek adatokat. A nők átlagéletkora 78,6, a férfiaké 71,4 év volt. A kezelt betegeknél gyakori volt a társbetegségek (hypertonia, diabetes mellitus, korábbi ischaemiás szívbetegség) előfordulása. A kórházi kezelés időszakában 30 betegnél (22%) történt koronarográfia, és 29 betegnél revascularisatiós beavatkozásra is sor került. A kórházi halálozás 15% volt, az utánkövetés háromnegyed éve alatt 17%-os halálozást észleltek. A kórházban, illetve az utánkövetési idő alatt meghalt betegek szignifikánsan idősebbek voltak azoknál, akik életben maradtak. Egyes echokardiográfiás adatok (ejekciós frakció, végszisztolés átmérő, szegmentális falmozgászavar és a mitralis insufficientia nagysága) prognosztikus jelentőségűnek bizonyultak, mivel szignifikánsan különböztek az életben maradt és a meghalt betegek esetén. A kórházból elbocsátott betegek igen magas arányban részesültek a másodlagos prevenció szempontjából fontosnak ítélt gyógyszeres kezelésben (aszpirin, béta-blokkoló, ACE-gátló, statin). Az utánkövetés idején sem csökkent ezen gyógyszerek használatának aránya, ami a betegek jó compliance-ét igazolja.

A macrophage migration inhibitory factor as a predictor of reperfusion myocardial injury in patients with st-segment elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Vishnevskaya ◽  
T.Y.E Storozhenko ◽  
M.P Kopytsya
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Macrophage Migration Inhibitory Factor ◽  
Myocardial Injury ◽  
Macrophage Migration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
No Reflow ◽  
St Segment ◽  
No Reflow Phenomenon

Abstract Introduction Major adverse cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI) are still common despite the modern treatment approaches. It may be caused by the “no-reflow” phenomenon. One of the promising biomarkers for the coronary “no-reflow” phenomenon prediction is proinflammatory cytokine macrophage migration inhibitory factor (MIF). Purpose To estimate the role of MIF in the prediction of early reperfusion myocardial injury in patients with STEMI. Methods The study involved 341 STEMI patients (78.6% male and 21.4% female) with an average age of 59.08±9.65 years. Control group of 12 healthy volunteers included. All patients were made to undergo a baseline investigation. In addition, the level of MIF determined twice during the first 12 hours of STEMI, before the percutaneous coronary intervention (PCI) and after the procedure. Coronary blood flow evaluated using TIMI flow grade and myocardial blush grade (MBG). All patients had epicardial blood flow TIMI 3. The criteria for “no-reflow” diagnosis were myocardial perfusion at MBG 0 or MBG 1 level with complete recovery of epicardial blood flow or ST-segment resolution (rST) of less than 70% from baseline within 2 hours after PCI. All patients were divided into two groups according to MBG and rST after PCI more and less than 70%: 147 patients in the first group with MBG stage 0–1, 182 patients with MBG stage 2–3 Results 64% of STEMI patients had elevated MIF levels above the highest value in healthy controls (2778±217 ng/ml; 225±6,7 ng/ml; p=0,0003). The level of MIF biomarker, determined before PCI was significantly higher in the group of patients with MBG 0–1 in comparison to MBG 2–3. (4708±471 ng/ml vs 2914±347ng/ml; p=0,004). Using the multivariate regression analysis, the dependencies of the biomarker MIF on the parameters of the reperfusion myocardial injuries were obtained. MIF measured before revascularization as well as the patient's gender, was an independent predictor of MBG 0–1 and rST less than 70% (coefficients Beta 0,1; odd ratio 1,1; 95%confidential interval (CI) 1,0–1,2; p=0,037 and coefficient Beta 2,9; odd ratio 17.7; 95% CI 0,96–32; p=0,05, respectively). Conclusions The study revealed that MIF predicts reperfusion myocardial injury in patients with STEMI. Future investigations of the MIF biological effects are the perspective direction in the field of modern cardiology. Funding Acknowledgement Type of funding source: None

No-reflow phenomenon in ST-segment elevation myocardial infarction: still the Achilles’ heel of the interventionalist

2020 ◽  
Author(s):  
Jonathan L Ciofani ◽  
Usaid K Allahwala ◽  
Roberto Scarsini ◽  
Avedis Ekmejian ◽  
Adrian P Banning ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
No Reflow ◽  
St Segment ◽  
Percutaneous Coronary ◽  
No Reflow Phenomenon ◽  
Management Algorithms

Improvements in systems, technology and pharmacotherapy have significantly changed the prognosis over recent decades in patients presenting with ST-segment elevation myocardial infarction. These clinical achievements have, however, begun to plateau and it is becoming increasingly necessary to consider novel strategies to further improve outcomes. Approximately a third of patients treated by primary percutaneous coronary intervention for ST-segment elevation myocardial infarction will suffer from coronary no-reflow (NR), a condition characterized by poor myocardial perfusion despite patent epicardial arteries. The presence of NR impacts significantly on clinical outcomes including left ventricular dysfunction, heart failure and death, yet conventional management algorithms neither assess the risk of NR nor treat NR. This review will provide a contemporary overview on the pathogenesis, diagnosis and treatment of NR.

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