The challenges and impact of microvascular injury in ST-elevation myocardial infarction

Sebastian Johannes Reinstadler; Thomas Stiermaier; Georg Fuernau; Suzanne De Waha; Steffen Desch; Bernhard Metzler; Holger Thiele; Ingo Eitel

doi:10.1586/14779072.2016.1135055

The challenges and impact of microvascular injury in ST-elevation myocardial infarction

Sebastian Johannes Reinstadler, Thomas Stiermaier, Georg Fuernau, Suzanne De Waha, Steffen Desch, Bernhard Metzler, Holger Thiele, Ingo Eitel^*

^*Corresponding author for this work

University of Innsbruck

8 Citations (Scopus)

Abstract

Despite successful restoration of epicardial coronary blood flow, a significant proportion of patients with ST-elevation myocardial infarction suffer from an impairment of the microvascular perfusion-a phenomenon termed no-reflow or microvascular injury (MVI). The underlying pathophysiology is complex and likely multifactorial. It is well established that MVI is associated with worse clinical outcome. Although MVI can be detected during coronary intervention and the post-infarction period, its prevention and treatment strategies remain a major challenge since most results of clinical studies have been disappointing so far. This review provides an overview on the main pathophysiological mechanisms of MVI and its diagnostic approaches. Moreover, it will discuss its clinical consequences and current strategies of prevention and treatment.

Original language	English
Journal	Expert Review of Cardiovascular Therapy
Volume	14
Issue number	4
Pages (from-to)	431-443
Number of pages	13
ISSN	1477-9072
DOIs	https://doi.org/10.1586/14779072.2016.1135055
Publication status	Published - 02.04.2016

Research Areas and Centers

Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1586/14779072.2016.1135055

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AU - Reinstadler, Sebastian Johannes

AU - Stiermaier, Thomas

AU - Fuernau, Georg

AU - De Waha, Suzanne

AU - Desch, Steffen

AU - Metzler, Bernhard

AU - Thiele, Holger

AU - Eitel, Ingo

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N2 - Despite successful restoration of epicardial coronary blood flow, a significant proportion of patients with ST-elevation myocardial infarction suffer from an impairment of the microvascular perfusion-a phenomenon termed no-reflow or microvascular injury (MVI). The underlying pathophysiology is complex and likely multifactorial. It is well established that MVI is associated with worse clinical outcome. Although MVI can be detected during coronary intervention and the post-infarction period, its prevention and treatment strategies remain a major challenge since most results of clinical studies have been disappointing so far. This review provides an overview on the main pathophysiological mechanisms of MVI and its diagnostic approaches. Moreover, it will discuss its clinical consequences and current strategies of prevention and treatment.

AB - Despite successful restoration of epicardial coronary blood flow, a significant proportion of patients with ST-elevation myocardial infarction suffer from an impairment of the microvascular perfusion-a phenomenon termed no-reflow or microvascular injury (MVI). The underlying pathophysiology is complex and likely multifactorial. It is well established that MVI is associated with worse clinical outcome. Although MVI can be detected during coronary intervention and the post-infarction period, its prevention and treatment strategies remain a major challenge since most results of clinical studies have been disappointing so far. This review provides an overview on the main pathophysiological mechanisms of MVI and its diagnostic approaches. Moreover, it will discuss its clinical consequences and current strategies of prevention and treatment.

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The challenges and impact of microvascular injury in ST-elevation myocardial infarction

Abstract

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