Ghobrial Mina, Bawamia Bilal, Cartlidge Timothy, Spyridopoulos Ioakim, Kunadian Vijay, Zaman Azfar, Egred Mohaned, McDiarmid Adam, Williams Matthew, Farag Mohamed, Alkhalil Mohammad
Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK.
Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK.
J Clin Med. 2023 Sep 13;12(18):5934. doi: 10.3390/jcm12185934.
Microvascular obstruction (MVO) is a recognised phenomenon following mechanical reperfusion in patients presenting with ST-segment elevation myocardial infarction (STEMI). Invasive and non-invasive modalities to detect and measure the extent of MVO vary in their accuracy, suggesting that this phenomenon may reflect a spectrum of pathophysiological changes at the level of coronary microcirculation. The importance of detecting MVO lies in the observation that its presence adds incremental risk to patients following STEMI treatment. This increased risk is associated with adverse cardiac remodelling seen on cardiac imaging, increased infarct size, and worse patient outcomes. This review provides an outline of the pathophysiology, clinical implications, and prognosis of MVO in STEMI. It describes historic and novel pharmacological and non-pharmacological therapies to address this phenomenon in conjunction with primary PCI.
微血管阻塞（MVO）是ST段抬高型心肌梗死（STEMI）患者机械再灌注后的一种公认现象。检测和测量MVO程度的侵入性和非侵入性方法在准确性上存在差异，这表明该现象可能反映了冠状动脉微循环水平上一系列的病理生理变化。检测MVO的重要性在于观察到其存在会给STEMI治疗后的患者增加额外风险。这种增加的风险与心脏成像上出现的不良心脏重塑、梗死面积增加以及更差的患者预后相关。本综述概述了STEMI中MVO的病理生理学、临床意义及预后。它描述了与直接经皮冠状动脉介入治疗（PCI）相结合来解决这一现象的传统和新型药物及非药物疗法。
