Although the widespread adoption of timely invasive reperfusion strategies over the last two decades has significantly improved the prognosis of patients with ST-segment elevation myocardial infarction (STEMI), up to half of patients after angiographically successful primary percutaneous coronary intervention (PCI) still have signs of inadequate reperfusion at the level of coronary microcirculation. This phenomenon, termed coronary microvascular dysfunction (CMD), has been associated with impaired prognosis. The aim of the present review is to describe the collected evidence on the occurrence of CMD following primary PCI, means of assessment and its association with the infarct size and clinical outcomes. Therefore, the practical role of invasive assessment of CMD in the catheterization laboratory, at the end of primary PCI, is emphasized, with an overview of available technologies including thermodilution- and Doppler-based methods, as well as recently developing functional coronary angiography. In this regard, we review the conceptual background and the prognostic value of coronary flow reserve (CFR), index of microcirculatory resistance (IMR), hyperemic microvascular resistance (HMR), pressure at zero flow (PzF) and angiography-derived IMR. Finally, the so-far investigated therapeutic strategies targeting coronary microcirculation after STEMI are revisited.
Nastupajući s kursom historije ruskog jezika, moram kao prvo pitanje postaviti: od kojega momenta počinje ta historija? Kojim se momentom ruski jezik izdvaja kao specifična jezička kategorija iz općih normi staroslavenskog jezika? Poznata je stvar koju ne treba ponavljati: da staroslavenski jezik nije jedan općeslavenski jezik, jednak kod svih slavenskih naroda. Takav bi mogao biti tzv. pra- slavenski, koji stavljamo u epohu prije raseljavanja slavenskih plemena iz pradomovine, iako se i u ono vrijeme u sastavu Slavenstva naslućuju dvije zasebne grupe. Već u doba slavenske seobe zapadni i bizantski suvremenici, kao Jordan, konstatiraju da slavenski narod ima dvije velike grane: Venete — sjeveroistočnu, i Ante — jugozapadnu. U svakoj od tih grana već su postojale mnogobrojne dijalekatske skupine i svaka je od njih na svojim međama stajala u kulturnim vezama sa susjedima različitog etničkog porijekla i s različitim kulturnim tradicijama.
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