MINI-SYMPOSIUM

Management of microvascular dysfunction and reperfusion injury

A Prasad, B J Gersh

Division of Cardiovascular Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA

Correspondence to:
Correspondence to:
Abhiram Prasad
MD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; prasad.abhiram@mayo.edu

Abbreviations: AMI, acute myocardial infarction; CTFC, corrected TIMI frame count; MBG, myocardial blush grade; MCE, myocardial contrast echocardiography; MRI, magnetic resonance imaging; PCI, percutaneous coronary intervention; RISK, reperfusion injury salvage kinase; STR, ST segment elevation resolution; TIMI, thrombolysis in myocardial infarction

Keywords: acute myocardial infarction; microvascular dysfunction; reperfusion injury

The first 150 words of the full text of this article appear below.

The aim of reperfusion therapy for acute myocardial infarction (AMI) is to rapidly restore coronary blood flow and myocardial perfusion with the objective of salvaging myocardium. The treatment of AMI for many years has focused on achieving patency of the conduit epicardial artery at the site of plaque rupture and occlusive thrombus. Major advances in interventional techniques and adjunctive pharmacological treatment have made it possible to achieve normal (TIMI grade 3) epicardial flow in approximately 95% of patients.¹ This success has also highlighted the limitations of current treatment with regards to the goal of restoring myocardial perfusion. A significant proportion of patients, perhaps as many as 40%, do not regain microvascular and myocardial perfusion despite the restoration of TIMI grade 3 flow.^1,2 The major source of these data has been acquired from patients treated with primary percutaneous coronary intervention (PCI), but likely also applies to those receiving thrombolytic therapy. Failure . . . [Full text of this article]

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