Rios-Navarro Cesar, Marcos-Garces Victor, Bayes-Genis Antoni, Husser Oliver, Nuñez Julio, Bodi Vicente
Institute of Health Research INCLIVA, 46010 Valencia, Spain.
Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain.
J Clin Med. 2019 Oct 28;8(11):1805. doi: 10.3390/jcm8111805.
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.
心肌梗死（MI）后，尽管冠状动脉闭塞已解除，但仍有相当数量的患者心肌灌注持续恶化。这种现象被称为微血管阻塞（MVO）。最初，重点在于重建心外膜动脉血流。随后，MVO具有严重的负面结构和预后影响这一观察结果重新引发了对微循环的关注。在不久的将来，能够预防、最小化和修复MVO的辅助治疗方法（超越及时的冠状动脉再灌注）的出现，以及找到关于这些治疗方法的使用内容、时间、方式和部位等问题的令人信服的答案将至关重要。这项工作的目的是回顾ST段抬高型心肌梗死患者中MVO的病理生理学、诊断方法以及结构和临床意义的最新概念。基于这些知识，我们讨论了先前已测试的以及未来预防和修复MVO的机会。
