Myocardial reperfusion syndrome. Pathogenesis, clinic, diagnosis


Cite item

Full Text

Abstract

The basics of pathogenesis, clinic and diagnosis of myocardial reperfusion syndrome are considered. Myocardial reperfusion syndrome is defined. Its relevance as one of the most poorly studied and formidable complications of cardiac reperfusion in myocardial infarction with elevation of the S-T segment has been explained. A brief review of the historical review of this problem and such types of manifestations of myocardial reperfusion syndrome as: diastolic myocardial dysfunction, post-reperfusion disturbances of the heart rhythm, the phenomenon of no-reflow and irreversible damage to the myocardium are briefly reviewed. The modern views on the pathological physiology of diastolic myocardial dysfunction, post-reperfusion damage to the myocardium, and the no-reflow phenomenon are analyzed. A review of current views on the pathological physiology of the development of post-reperfusion disturbances in heart rhythm is carried out. The clinical picture and the effect on the hemodynamics of such a manifestation of myocardial reperfusion syndrome as diastolic myocardial dysfunction are described. A brief description of the clinical picture of irreversible post-reperfusion damage to the myocardium is given. The clinical picture and types of post-reperfusion rhythm disturbances are described. The diagnostics of the no-reflow phenomenon has been analyzed in detail, the coronary angiographic scales for assessing thrombolysis in myocardial infarction and for assessing myocardial perfusion are graphically shown. A description of the basics of diagnosing post-reperfusion disturbances in heart rhythm, diastolic myocardial dysfunction, and post-reperfusion irreversible damage to the myocardium is given. A brief description of the known in the world literature predictors of the development of myocardial reperfusion syndrome is presented.

About the authors

G G Khubulava

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

A N Shishkevich

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

S S Mikhailov

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

E Yu Bessonov

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

References

  1. Бобров, В.А. Реперфузионные аритмии. Механизмы возникновения, клиническая значимость, методы коррекции / В.А. Бобров // Клин. аритмология. - 2003. - № 73. - C. 34-41.
  2. Машина, Т.В. Диастолическая дисфункция левого желудочка у больных с фибрилляцией предсердий: патогенетические механизмы и современные ультразвуковые методы оценки (аналитический обзор) / Т.В. Машина, Е.З. Голухова // Креативная кардиол. - 2014. - № 4. - C. 43-52.
  3. Неймар, М.И. Предикторы развития реперфузионного синдрома на фоне острого инфаркта миокарда с подъемом сегмента ST / М.И. Неймар [и др.] // Казанский мед. журн. - 2011. - Т. 92, № 3. - C. 357-359.
  4. Хубулава, Г. Г. Мини-травматичная реваскуляризация миокарда / Г.Г. Хубулава [и др.] // Грудная и сердечно- сосудистая хирургия. - 2016. - Т. 58, № 4. - C. 207-213.
  5. Хубулава, Г.Г. Значение и роль рентгенэндоваскулярных методов в диагностике и лечении генерализованного атеросклероза у пациентов пожилого и старческого возраста / Г.Г. Хубулава [и др.] // Клин. геронтол. - 2014. - Т. 20, № 5-6. - C. 35-40.
  6. Braunwald, E. Myocardial reperfusion: a doubleedged sword? / E. Braunwald, R.A. Kloner // J. Clin. Invest. - 1985. - Vol. 76 (5). - P. 1713-1719.
  7. Bijnens, B.H. V elocity and deformation imaging for the asstessment of myocardial dysfunction / B.H. Bijnens [et al.] // Eur. J. Echocardogr. - 2009. - Vol. 10. - P. 216-226.
  8. Hayat, S.A. Myocardial contrast echocardiography in ST elevation myocardial infarction: ready for prime time? / S.A. Hayat, R. Senior // Eur. Heart J. - 2008. - Vol. 29. - P. 299-314.
  9. Iwakura, K. Association between hyperglycemia and the no-reflow phenomenon in patients with acute myocardial infarction / K. Iwakura [et al.] // J. Am. Coll. Cardiol. - 2003. - Vol. 41 (1). - P. 1-7.
  10. Krug, A. Blood supply of the myocardium after temporary coronary occlusion / A. Krug, W. Du Mesnil de Rochemont, G. Korb // Circ. Res. - 1966. - Vol. 19 (1). - P. 57-62.
  11. Lee, K.W. Management of «no-reflow» complicating reperfusion therapy / K.W. Lee, M.S. Norell // Acute Card. Care. - 2008. - Vol. 10 (1). - P. 5-14.
  12. Jennings, R.B. Myocardial necrosis induced by temporary occlusion of a coronary artery in the dog / R.B. Jennings [et al.] // Arch. Pathol. - 1960. - Vol. 70. - P. 68-78.
  13. Juan, C.K. Management of Myocardial Reperfusion Injury / C.K. Juan [et al.] // Springer Dordrecht Heidelberg New York. - 2014. - 310 p.
  14. Murphy, E. Mechanisms underlying acute protection from cardiac ischemia-reperfusion injury / E. Murphy, C. Steenbergen // Physiol. Rev. - 2013. - Vol. 88 (2). - P. 581-609.
  15. Niccoli, G. No-reflow: again prevention is better than treatment / G. Niccoli [et al.] // Eur. Heart J. - 2013. - Vol. 31 (20). - P. 2449-2455.
  16. Pomblum, V.J. Cardiac stunning in the clinic: the full picture / V.J. Pomblum [et al.] // Interact. Cardiovasc. Thorac. Surg. - 2010. - Vol. 10 (1). - P. 86-91.
  17. Ruiz-Meana, M. Mitochondrial connexin 43 as a new player in the pathophysiology of myocardial ischemia-reperfusion injury / M. Ruiz-Meana [et al.] // Cardiovasc. Res. - 2014. - Vol. 77 (2). - P. 325-333.
  18. Ruiz-Meana, M. Pathophysiology of ischemia-reperfusion injury: new therapeutic options for acute myocardial infarction / M. Ruiz-Meana, D. García-Dorado // Rev. Esp. Cardiol. - 2009. - Vol. 62 (2). - P. 199-209.
  19. Schofer, J. Scintigraphic evidence of the «no-reflow» phenomenon in human beings after coronary thrombolysis / J. Schofer, R. Montz, D.G. Mathey // J. Am. Coll. Cardiol. - 1985. - Vol. 5 (3). - P. 593-598.
  20. Thiemann, D.R. The association between hospital volume and survival after acute myocardial infarction in elderly patients / D.R. Thiemann [et al.] // N. Engl. J. Med. - 1999. - Vol. 340 (21). - P. 1640-1648.
  21. Van de Werf, F. Committee for Practice Guidelines (CPG). Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology / F. Van de Werf [et al.] // Eur. Heart J. - 2008. - Vol. 29 (23). - P. 2909-2945.
  22. Yellon, D.M. Myocardial reperfusion injury / D.M. Yellon, D.J. Hausenloy // New Engl. J. Med. - 2007. - Vol. 357 (11). - P. 1121-1135.
  23. Zuidema, M.Y. Ischemia/reperfusion injury: The role of immune cells / M.Y. Zuidema, C. Zhang // World J. Cardiol. - 2015. - Vol. 2 (10). - P. 325-332.

Copyright (c) 2020 Khubulava G.G., Shishkevich A.N., Mikhailov S.S., Bessonov E.Y.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies