Mechanical reperfusion in acute myocardial infarction does not always result in desirable optimal microvascular perfusion. Failure to achieve a normal myocardial blush in the infarcted region by contrast injection immediately after percutaneous coronary intervention—the 'no-reflow' phenomenon—is an ominous sign whose prognostic importance may go beyond its intimate association with infarct size.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Ndrepepa, G. et al. 5-year prognostic value of no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction. J. Am. Coll. Cardiol. 55, 2383–2389 (2010).
Galiuto, L. et al. Temporal evolution and functional outcome of no reflow: sustained and spontaneously reversible patterns following successful coronary recanalisation. Heart 89, 731–737 (2003).
Angeja, B. G. et al. TIMI myocardial perfusion grade and ST-segment resolution: association with infarct size as assessed by single photon emission computed tomography imaging. Circulation 105, 282–285 (2002).
Francone, M. et al. Impact of primary coronary angioplasty delay on myocardial salvage, infarct size, and microvascular damage in patients with ST-segment elevation myocardial infarction: insight from cardiovascular magnetic resonance. J. Am. Coll. Cardiol. 54, 2145–2153 (2009).
Iwakura, K. et al. Chronic pre-treatment of statins is associated with the reduction of the no-reflow phenomenon in the patients with reperfused acute myocardial infarction. Eur. Heart J. 27, 534–539 (2006).
Dudek, D. et al. Patency of infarct related artery after pharmacological reperfusion during transfer to primary percutaneous coronary intervention influences left ventricular function and one-year clinical outcome. Int. J. Cardiol. 124, 326–331 (2008).
Svilaas, T. et al. Thrombus aspiration during primary percutaneous coronary intervention. N. Engl. J. Med. 358, 557–567 (2008).
Aymong, E. D. et al. Abciximab attenuates coronary microvascular endothelial dysfunction after coronary stenting. Circulation 105, 2981–2985 (2002).
Iwakura, K. et al. Predictive factors for development of the no-reflow phenomenon in patients with reperfused anterior wall acute myocardial infarction. J. Am. Coll. Cardiol. 38, 472–477 (2001).
Yellon, D. M. & Hausenloy, D. J. Myocardial reperfusion injury. N. Engl. J. Med. 357, 1121–1135 (2007).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Magro, M., Serruys, P. No-reflow—an ominous sign of cardiac dysfunction. Nat Rev Cardiol 7, 480–482 (2010). https://doi.org/10.1038/nrcardio.2010.117
Issue Date:
DOI: https://doi.org/10.1038/nrcardio.2010.117
This article is cited by
-
Ist die Thrombusaspiration beim ST-Hebungsinfarkt noch indiziert?
Der Kardiologe (2014)
