Author + information
- Leonarda Galiuto, MD, PhD, FACC⁎,
- Antonio G. Rebuzzi, MD and
- Filippo Crea, MD, FACC
Address for correspondence:
Dr. Leonarda Galiuto, Institute of Cardiology, Catholic University of the Sacred Heart, Policlinico A. Gemelli, Largo A. Gemelli, 8, 00168 Rome, Italy
LACK OF INTRAMYOCARDIAL REPERFUSION after successful coronary recanalization has been defined as the “no-reflow” phenomenon. The phenomenon is not uncommon (39% with myocardial contrast echocardiography [MCE] and 43% using myocardial blush grade at coronary angiography) in humans after successful primary percutaneous coronary intervention (PCI) in the setting of acute myocardial infarction (AMI). Ischemia, reperfusion, and atheroembolism are the 3 major players in the pathogenesis of no-reflow, mediating microvascular obstruction through endothelial damage, tissue edema, platelet/fibrin/leukocyte plugs, and free radical injury. MCE and contrast-enhanced cardiac magnetic resonance (CMR) are the most common techniques for its diagnosis. The role for MCE is summarized in Figures 1 to 3.⇓⇓ MCE can clearly delineate no reflow after primary PCI and helps in prognostication. MCE can be used to test if treating no reflow will be useful in humans.
- American College of Cardiology Foundation