Boukhris Marouane, Bousselmi Radhouane, Tomasello Salvatore Davide, Elhadj Zied Ibn, Azzarelli Salvatore, Marzà Francesco, Galassi Alfredo R
Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Catania, Italy ; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.
Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.
J Saudi Heart Assoc. 2015 Jul;27(3):192-200. doi: 10.1016/j.jsha.2014.11.001. Epub 2014 Nov 20.
Although early myocardial reperfusion via primary percutaneous coronary intervention (PCI) allows the preservation of left ventricular function and improves outcome, the acute restoration of blood flow may contribute to the pathophysiology of infarction, a complex phenomenon called reperfusion injury. First described in animal models of coronary obstruction, mechanical post-conditioning, a sequence of repetitive interruption of coronary blood flow applied immediately after reopening of the occluded vessel, was able to reduce the infarct size. However, evidence of its real benefit remains controversial. This review describes the mechanisms of post-conditioning action and the different protocols employed focusing on its impact on primary PCI outcome.
尽管通过直接经皮冠状动脉介入治疗(PCI)实现早期心肌再灌注可保留左心室功能并改善预后,但血流的急性恢复可能会导致梗死的病理生理学变化,这是一种称为再灌注损伤的复杂现象。机械性后适应最初在冠状动脉阻塞的动物模型中被描述,即在闭塞血管重新开放后立即应用一系列重复的冠状动脉血流中断,能够缩小梗死面积。然而,其实际益处的证据仍存在争议。本综述描述了后适应作用的机制以及所采用的不同方案,重点关注其对直接PCI预后的影响。