[Myocardial no-reflow phenomenon: recent knowledges].

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiovascular Research

Context:

• Primary percutaneous coronary intervention (PPCI) is the standard for ST-segment elevation myocardial infarction (STEMI).
• No-reflow, a failure of myocardial reperfusion despite epicardial artery opening, complicates PPCI.
• This phenomenon has significant prognostic implications in STEMI patients.

Purpose:

• To review the mechanisms, diagnosis, and treatment of the no-reflow phenomenon in STEMI.
• To highlight the importance of understanding no-reflow for personalized treatment strategies.
• To discuss current and potential therapeutic interventions for no-reflow.

Summary:

• No-reflow results from multifactorial causes including distal embolization, ischemia-reperfusion injury, and microvascular predisposition.
• Diagnosis involves angiographic and electrocardiographic markers, notably lack of ST-segment elevation resolution.
• No-reflow is linked to adverse outcomes such as reduced ejection fraction, ventricular remodeling, and mortality.

Impact:

• Understanding no-reflow mechanisms can guide personalized treatment development.
• Effective management of no-reflow may improve long-term prognosis for STEMI patients.
• This review provides insights into diagnostic modalities and therapeutic options for no-reflow.