PMID: 15378136Sep 21, 2004Paper

Microvascular alterations after temporary coronary artery occlusion: the no-reflow phenomenon

Journal of Cardiovascular Pharmacology and Therapeutics
Thorsten ReffelmannRobert A Kloner

Abstract

In experimental models of temporary coronary artery occlusion, tissue perfusion at the microvascular level remains incomplete even after patency of the infarct-related epicardial coronary artery is established, and distinct perfusion defects develop within the risk zone. This no-reflow phenomenon can be regarded as a basic cardiac response to ischemia-reperfusion. Perfusion defects observed in the clinical realm after reperfusion therapy for myocardial infarction may substantially be related to this mechanism in addition to microembolization and activation of platelets, as suggested in several recent studies. A major determinant of the amount of no-reflow seems to be infarct size itself. Reperfusion-related expansion of no-reflow zones occurs within the first hours after the reopening of the coronary artery with a parallel reduction of regional myocardial flow, resulting in a potential therapeutic window. With various cardioprotective interventions, a close correlation between the size of the anatomic no-reflow and necrosis is a reproducible feature, which suggests a causal link between both entities of ischemic cardiac damage. Although vasodilating interventions failed to uncouple no-reflow zones from necrosis, the steps in th...Continue Reading

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Jul 16, 2003·Circulation·Thorsten Reffelmann, Robert A Kloner

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Citations

Nov 26, 2008·Cardiovascular Research·Angel Luis García-VillalónGodofredo Diéguez
Sep 4, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Abdel ShafyJuan C Chachques
Jul 20, 2005·Proceedings of the National Academy of Sciences of the United States of America·Monica CoradaElisabetta Dejana
Nov 21, 2008·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Shereif H Rezkalla, Robert A Kloner
Aug 4, 2011·Microvascular Research·Yu-tong ChengJing-lin Zhao
Aug 9, 2011·Journal of Cardiovascular Pharmacology and Therapeutics·Robert A Kloner
Feb 16, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Tadashi MuraiTsunekazu Kakuta
Aug 15, 2012·Experimental Biology and Medicine·Angel Luis García-VillalónGodofredo Diéguez
Feb 8, 2018·Acta Cirúrgica Brasileira·Jianjun RenZhenming Dong

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