6533b85bfe1ef96bd12ba2c6

RESEARCH PRODUCT

Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR

Oliver HusserVíctor Marcos-garcésAntoni Bayes-genisJulio NúñezCesar Rios-navarroVicente Bodi

subject

medicine.medical_specialtymicrovascular obstructionlcsh:MedicineReview030204 cardiovascular system & hematologyMicrocirculation03 medical and health sciences0302 clinical medicineInternal medicinemedicineST segmentIn patient030212 general & internal medicineMyocardial infarctionbusiness.industrylcsh:RGeneral MedicineBlood flowreperfusion injurymedicine.diseasemyocardial infarctionmedicine.anatomical_structureCoronary occlusionCardiologybusinessReperfusion injuryArtery

description

After a myocardial infarction (MI), despite the resolution of the coronary occlusion, the deterioration of myocardial perfusion persists in a considerable number of patients. This phenomenon is known as microvascular obstruction (MVO). Initially, the focus was placed on re-establishing blood flow in the epicardial artery. Then, the observation that MVO has profound negative structural and prognostic repercussions revived interest in microcirculation. In the near future, the availability of co-adjuvant therapies (beyond timely coronary reperfusion) aimed at preventing, minimizing, and repairing MVOs and finding convincing answers to questions regarding what, when, how, and where to administer these therapies will be of utmost importance. The objective of this work is to review the state-of-the-art concepts on pathophysiology, diagnostic methods, and structural and clinical implications of MVOs in patients with ST-segment elevation MIs. Based on this knowledge we discuss previously-tested and future opportunities for the prevention and repair of MVO.

yearjournalcountryeditionlanguage
2019-10-01Journal of Clinical Medicine
https://doi.org/10.3390/jcm8111805