Acute coronary syndromes: No-reflow--an ominous sign of cardiac dysfunction
Michael Magro1, Patrick W Serruys
1Thoraxcenter, Erasmus Medical Centre, Dr. Molewaterplein 40, Rotterdam, The Netherlands.
Nature Reviews. Cardiology
|August 21, 2010
Insights
Optimal microvascular perfusion after mechanical reperfusion for acute myocardial infarction is not always achieved. The
Area of Science:
- Cardiology
- Interventional Cardiology
- Myocardial Infarction Research
Background:
- Mechanical reperfusion aims to restore blood flow in acute myocardial infarction (AMI).
- Optimal microvascular perfusion is crucial for myocardial recovery post-reperfusion.
- The 'no-reflow' phenomenon, characterized by poor microvascular perfusion, is a known complication.
Purpose of the Study:
- To investigate the prognostic significance of the 'no-reflow' phenomenon.
- To understand if the impact of 'no-reflow' extends beyond infarct size.
Main Methods:
- Assessed myocardial blush grade via contrast injection post-percutaneous coronary intervention (PCI).
- Correlated 'no-reflow' phenomenon with patient outcomes.
- Analyzed prognostic importance independent of infarct size.
Main Results:
- Failure to achieve normal myocardial blush (the 'no-reflow' phenomenon) was observed.
- The 'no-reflow' phenomenon is associated with adverse outcomes.
- Prognostic importance of 'no-reflow' may exceed its link to infarct size.
Conclusions:
- The 'no-reflow' phenomenon is an ominous sign in acute myocardial infarction.
- Its prognostic implications warrant further investigation beyond infarct size correlation.
Abstract:
Mechanical reperfusion in acute myocardial infarction does not always result in desirable optimal microvascular perfusion. Failure to achieve a normal myocardial blush in the infarcted region by contrast injection immediately after percutaneous coronary intervention--the 'no-reflow' phenomenon--is an ominous sign whose prognostic importance may go beyond its intimate association with infarct size.
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