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Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR

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...

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Autores principales: Rios-Navarro, Cesar, Marcos-Garces, Victor, Bayes-Genis, Antoni, Husser, Oliver, Nuñez, Julio, Bodi, Vicente
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912395/
https://www.ncbi.nlm.nih.gov/pubmed/31661823
http://dx.doi.org/10.3390/jcm8111805
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author Rios-Navarro, Cesar
Marcos-Garces, Victor
Bayes-Genis, Antoni
Husser, Oliver
Nuñez, Julio
Bodi, Vicente
author_facet Rios-Navarro, Cesar
Marcos-Garces, Victor
Bayes-Genis, Antoni
Husser, Oliver
Nuñez, Julio
Bodi, Vicente
author_sort Rios-Navarro, Cesar
collection PubMed
description 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.
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spelling pubmed-69123952020-01-02 Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR Rios-Navarro, Cesar Marcos-Garces, Victor Bayes-Genis, Antoni Husser, Oliver Nuñez, Julio Bodi, Vicente J Clin Med Review 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. MDPI 2019-10-28 /pmc/articles/PMC6912395/ /pubmed/31661823 http://dx.doi.org/10.3390/jcm8111805 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Rios-Navarro, Cesar
Marcos-Garces, Victor
Bayes-Genis, Antoni
Husser, Oliver
Nuñez, Julio
Bodi, Vicente
Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR
title Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR
title_full Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR
title_fullStr Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR
title_full_unstemmed Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR
title_short Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR
title_sort microvascular obstruction in st-segment elevation myocardial infarction: looking back to move forward. focus on cmr
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912395/
https://www.ncbi.nlm.nih.gov/pubmed/31661823
http://dx.doi.org/10.3390/jcm8111805
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