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No-Reflow Fenomeni: Hikayenin Sonu mu?

Year 2015, Volume: 1 Issue: 2, 89 - 93, 01.01.2015

Abstract

Epikardiyal koroner arterde açıklığın elde edilmesine rağmen miyokard perfüzyonunun yeterli düzeyde sağlanamaması durumu no-Refl ow Fenomeni olarak isimlendirilmektedir. Akut miyokard infarktüsü sırasında gelişen no-refl ow prognozu olumsuz yönde etkilemektedir. Kullanılan tanısal görüntüleme yöntemlerine bağlı olarak farklı tanımlamaları mevcuttur. İntrakoroner uygulanan farmakolojik ajanlar, manuel trombüs aspirasyonu ve anjiyoplasti sırasında endotel hasarını arttıracak stratejilerden kaçınılması tedavinin temel prensiplerini oluşturmaktadır. Etkin tedavisinin olmaması nedeniyle klinik ve anjiyografi k risk faktörleri olan hastalarda no-refl ow gelişimini önlemeye yönelik stratejilerin uygulanması en önemli tedavi yaklaşımı olmayı sürdürmektedir

References

  • Keeley EC, Boura JA, Grines Cl. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: A quantitative review of 23 randomised trials. Lancet 2003;361:13–20.
  • Krug A, DuMesnil de Rochemont W, Korb G. Blood supply of the myocardium after temporary coronary occlusion. Circ Res 1966;19:57–62.
  • Kloner RA, Ganote CE, Jenning RB. The “no-refl ow” phenomenon after temporary coronary occlusion in the dog. J Clin Invest 1974;54:1496–508.
  • Durante A, Camici PG. Novel insights into an “old” phenomenon: the no refl ow. Int J Cardiol 2015;187:273–80
  • Tranum-Jensen J, Janse MJ, Fiolet WT, Krieger WJ, D’Alnoncourt CN, Durrer D. Tissue osmolality, cell swelling, and reperfusion in acute regional myocardial ischemia in the isolated porcine. Circ Res 1981;49:364–81.
  • Reffelmann T, Kloner RA. The no-refl ow phenomenon: A basic mechanism of myocardial ischemia and reperfusion. Basic Res Cardiol 2006;101:359 –72.
  • Bolli R, Jeroudi MO, Patel BS, DuBose CM, Lai EK, Roberts R, McCay PB. Direct evidence that oxygen- derived free radicals contribute to postischemic myocardial dysfunction in the intact dog. Proc Natl Acad Sci USA 1989; 86: 4695-99.
  • Ambrosio G, Tritto I. Reperfusion injury: Experimental evidence and clinical implications. Am Heart J 1999;138: S69 –75.
  • Skyschally A, Leineweber K, Gres P, Haude M, Erbel R, Heusch G. Coronary microembolization. Basic Res Cardiol 2006;101:373– 82.
  • Niccoli G, Burzotta F, Galiuto L, Crea F. Myocardial No- Refl ow in humans. J Am Coll Cardiol 2009;54:281–92.
  • Yip HK, Chen MC, Chang HW, et al. Angiographic morphologic features of infarct-related arteries and timely reperfusion in acute myocardial infarction: Predictors of slow-fl 2002;122:1322–32.
  • The TIMI Study Group. The thrombolysis in myocardial infarction [TIMI] trial. Phase I fi ndings. N Engl J Med 1985;312:932– 6.
  • van’t Hof AW, Liem A, Suryapranata H, Hoorntje JC, de Boer MJ, Zijlstra F; Zwolle Myocardial Infarction Study Group. Angiographic assessment of myocardial reperfusion in patients treated with primary angioplasty for acute myocardial infarction: Myocardial blush grade. Circulation 1998;97:2302– 6.
  • Schröder R. Prognostic impact of early ST-segment resolution in acute ST-elevation myocardial infarction. Circulation 2004;110:e506 –10.
  • Iliceto S, Marangelli V, Marchese A, Amico A, Galiuto L, Rizzon P. Myocardial contrast echocardiography in acute myocardial infarction. Pathophysiological background and clinical applications. Eur Heart J 1996;17:344 –53.
  • Albert TS, Kim RJ, Judd RM. Assessment of no- refl ow regions using cardiac MRI. Basic Res Cardiol 2006;101:383–90.
  • Petronio AS, De Carlo M, Ciabatti N, et al. Left ventricular remodeling after primary coronary angioplasty in patients treated with abciximab or intracoronary adenosine. Am Heart J 2005;150: 1015.
  • Danzi GB, Sesana M, Capuano C, Mauri L, Berra Centurini P, Baglini R. Comparison in patients having primary coronary angioplasty of abciximab versus tirofi ban on recovery of left ventricular function. Am J Cardiol 2004;94:35–9.
  • Young JJ, Cox DA, Stuckey T, et al. Prospective, multicenter study of thrombectomy in patients with acute myocardial infarction: The X-Tract AMI registry. J Interv Cardiol 2007;20:44 –50.
  • Burzotta F, Trani C, Romagnoli E, et al. Manual thrombus aspiration improves myocardial reperfusion: The randomized evaluation of the effect of mechanical reduction of distal embolization by thrombus-aspiration in primary and rescue angioplasty (REMEDIA) trial. J Am Coll Cardiol 2005;46:371– 6.
  • Marzilli M, Orsini E, Marraccini P, Testa R. Benefi cial effects of intracoronary adenosine as an adjunct to primary angioplasty in acute myocardial infarction. Circulation 2000;101:2154 –9.
  • Taniyama Y, Ito H, Iwakura K, et al. Benefi cial effect of intracoronary verapamil on microvascular and myocardial salvage in patients with acute myocardial infarction. J Am Coll Cardiol 1997;30:1193–9.
  • Amit G, Cafri C, Yaroslavtsev S, et al. Intracoronary nitroprusside for the prevention of the no-refl ow phenomenon after primary percutaneous coronary intervention in acute myocardial infarction. A randomized, double-blind, placebo-controlled clinical trial. Am Heart J 2006;152:887,e9 –14.
  • Ito H, Taniyama Y, Iwakura K, et al. Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. J Am Coll Cardiol 1999;33:654–60.
  • Burzotta F, Testa L, Giannico F, et al. Adjunctive devices in primary or rescue PCI: A meta-analysis of randomized trials. Int J Cardiol 2008;123:313–21.
  • Azzalini L, Millán X, Ly HQ , L’allier PL, Jolicoeur EM. Direct stenting versus pre-dilation in ST-elevation myocardial infarction: A systematic review and meta- analysis. J Interven Cardiol 2015;28:119–31.

No-Refl ow Phenomenon: Is it the End of the Story?

Year 2015, Volume: 1 Issue: 2, 89 - 93, 01.01.2015

Abstract

Ineffi cient myocardial perfusion in spite of successful accomplishment of epicardial coronary artery patency is referred to as the no-refl ow phenomenon. No-refl ow occurrence during the progression of acute myocardial infarction worsens the prognosis. There are many defi nitions of no-refl ow depending on the diagnostic imaging modality. Intracoronary drug administration, manual thrombus aspiration and avoiding strategies that cause endothelial injury are the main principles of no-refl ow treatment. Prevention in patients with clinical and angiographic high risk factors seems to be the mainstay strategy instead of using the present treatment options

References

  • Keeley EC, Boura JA, Grines Cl. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: A quantitative review of 23 randomised trials. Lancet 2003;361:13–20.
  • Krug A, DuMesnil de Rochemont W, Korb G. Blood supply of the myocardium after temporary coronary occlusion. Circ Res 1966;19:57–62.
  • Kloner RA, Ganote CE, Jenning RB. The “no-refl ow” phenomenon after temporary coronary occlusion in the dog. J Clin Invest 1974;54:1496–508.
  • Durante A, Camici PG. Novel insights into an “old” phenomenon: the no refl ow. Int J Cardiol 2015;187:273–80
  • Tranum-Jensen J, Janse MJ, Fiolet WT, Krieger WJ, D’Alnoncourt CN, Durrer D. Tissue osmolality, cell swelling, and reperfusion in acute regional myocardial ischemia in the isolated porcine. Circ Res 1981;49:364–81.
  • Reffelmann T, Kloner RA. The no-refl ow phenomenon: A basic mechanism of myocardial ischemia and reperfusion. Basic Res Cardiol 2006;101:359 –72.
  • Bolli R, Jeroudi MO, Patel BS, DuBose CM, Lai EK, Roberts R, McCay PB. Direct evidence that oxygen- derived free radicals contribute to postischemic myocardial dysfunction in the intact dog. Proc Natl Acad Sci USA 1989; 86: 4695-99.
  • Ambrosio G, Tritto I. Reperfusion injury: Experimental evidence and clinical implications. Am Heart J 1999;138: S69 –75.
  • Skyschally A, Leineweber K, Gres P, Haude M, Erbel R, Heusch G. Coronary microembolization. Basic Res Cardiol 2006;101:373– 82.
  • Niccoli G, Burzotta F, Galiuto L, Crea F. Myocardial No- Refl ow in humans. J Am Coll Cardiol 2009;54:281–92.
  • Yip HK, Chen MC, Chang HW, et al. Angiographic morphologic features of infarct-related arteries and timely reperfusion in acute myocardial infarction: Predictors of slow-fl 2002;122:1322–32.
  • The TIMI Study Group. The thrombolysis in myocardial infarction [TIMI] trial. Phase I fi ndings. N Engl J Med 1985;312:932– 6.
  • van’t Hof AW, Liem A, Suryapranata H, Hoorntje JC, de Boer MJ, Zijlstra F; Zwolle Myocardial Infarction Study Group. Angiographic assessment of myocardial reperfusion in patients treated with primary angioplasty for acute myocardial infarction: Myocardial blush grade. Circulation 1998;97:2302– 6.
  • Schröder R. Prognostic impact of early ST-segment resolution in acute ST-elevation myocardial infarction. Circulation 2004;110:e506 –10.
  • Iliceto S, Marangelli V, Marchese A, Amico A, Galiuto L, Rizzon P. Myocardial contrast echocardiography in acute myocardial infarction. Pathophysiological background and clinical applications. Eur Heart J 1996;17:344 –53.
  • Albert TS, Kim RJ, Judd RM. Assessment of no- refl ow regions using cardiac MRI. Basic Res Cardiol 2006;101:383–90.
  • Petronio AS, De Carlo M, Ciabatti N, et al. Left ventricular remodeling after primary coronary angioplasty in patients treated with abciximab or intracoronary adenosine. Am Heart J 2005;150: 1015.
  • Danzi GB, Sesana M, Capuano C, Mauri L, Berra Centurini P, Baglini R. Comparison in patients having primary coronary angioplasty of abciximab versus tirofi ban on recovery of left ventricular function. Am J Cardiol 2004;94:35–9.
  • Young JJ, Cox DA, Stuckey T, et al. Prospective, multicenter study of thrombectomy in patients with acute myocardial infarction: The X-Tract AMI registry. J Interv Cardiol 2007;20:44 –50.
  • Burzotta F, Trani C, Romagnoli E, et al. Manual thrombus aspiration improves myocardial reperfusion: The randomized evaluation of the effect of mechanical reduction of distal embolization by thrombus-aspiration in primary and rescue angioplasty (REMEDIA) trial. J Am Coll Cardiol 2005;46:371– 6.
  • Marzilli M, Orsini E, Marraccini P, Testa R. Benefi cial effects of intracoronary adenosine as an adjunct to primary angioplasty in acute myocardial infarction. Circulation 2000;101:2154 –9.
  • Taniyama Y, Ito H, Iwakura K, et al. Benefi cial effect of intracoronary verapamil on microvascular and myocardial salvage in patients with acute myocardial infarction. J Am Coll Cardiol 1997;30:1193–9.
  • Amit G, Cafri C, Yaroslavtsev S, et al. Intracoronary nitroprusside for the prevention of the no-refl ow phenomenon after primary percutaneous coronary intervention in acute myocardial infarction. A randomized, double-blind, placebo-controlled clinical trial. Am Heart J 2006;152:887,e9 –14.
  • Ito H, Taniyama Y, Iwakura K, et al. Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. J Am Coll Cardiol 1999;33:654–60.
  • Burzotta F, Testa L, Giannico F, et al. Adjunctive devices in primary or rescue PCI: A meta-analysis of randomized trials. Int J Cardiol 2008;123:313–21.
  • Azzalini L, Millán X, Ly HQ , L’allier PL, Jolicoeur EM. Direct stenting versus pre-dilation in ST-elevation myocardial infarction: A systematic review and meta- analysis. J Interven Cardiol 2015;28:119–31.
There are 26 citations in total.

Details

Primary Language Turkish
Journal Section Collection
Authors

Umuttan Doğan This is me

Publication Date January 1, 2015
Published in Issue Year 2015 Volume: 1 Issue: 2

Cite

Vancouver Doğan U. No-Reflow Fenomeni: Hikayenin Sonu mu?. Akd Med J. 2015;1(2):89-93.