Progressive decreases in coronary vein flow during reperfusion in acute myocardial infarction: Clinical documentation of the no reflow phenomenon after successful thrombolysis

Komamura, Kazuo; Kitakaze, Masafumi; Nishida, Keiya; Naka, Masashi; Tamai, Jun; Uematsu, Masaaki; Horetsune, Yukihiro; Nanto, Shinsuke; Kori, Masatsugu; Inoue, Michitoshi; Kamada, Takenobu; Kodama, Kazuhisa

doi:10.1016/0735-1097(94)90290-9

Cited by 64 publications

(24 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…85 In another clinical study, patients with no reflow were older and had a lower incidence of preinfarction angina. 86 The absence of preinfarction angina was also noted in the series of Komamura et al 84 This may be related to the concept that the presence of preinfarct angina is associated with smaller infarcts and a possible preconditioning-like effect and may correlate with collateral formation. 87 The no-reflow phenomenon was also linked to ventricular arrhythmias, 88 early congestive heart failure, 89 and even cardiac rupture.…”

Section: Clinical Presentationmentioning

confidence: 70%

See 1 more Smart Citation

No-Reflow Phenomenon

2002

View full text Add to dashboard Cite

Section: Clinical Presentationmentioning

confidence: 70%

“…82 New Q waves may appear, 83 and some of those patients may be diagnosed as having infarct extensions. In a study by Komamura et al, 84 9 patients with acute anterior myocardial infarction, early reperfusion, and probable no reflow were studied. The patients had continuous monitoring of the great cardiac vein blood flow.…”

Section: Clinical Presentationmentioning

confidence: 99%

No-Reflow Phenomenon

2002

View full text Add to dashboard Cite

“…Although it is difficult to explain the mechanism of this association, Komamura et al [30] have made a similar observation in patients treated with thrombolysis following acute myocardial infarction. They demonstrated that patients who suffered from pre-infarction anginal symptoms had shorter no-reflow duration and a better myocardial functional outcome.…”

Section: Discussionmentioning

confidence: 87%

Myocardial tissue oxygen supply and utilization during coronary artery bypass surgery: evidence of microvascular no-reflow

Al-Obaidi¹,

Etherington²,

Barron³

et al. 2000

Clinical Science

View full text Add to dashboard Cite

The supply and utilization of oxygen by the myocardium reflect the dynamic efficiency of the microcirculation. The present study examines these parameters during coronary artery bypass surgery. We used a voltammetric microelectrode technique to assess regional variations in myocardial tissue partial pressure of oxygen (PO(2)) and myocardial tissue perfusion (MTP) in patients undergoing coronary artery bypass surgery. A total of 29 myocardial regions were studied in 17 patients to assay tissue PO(2), and 13 regions in 10 patients to measure MTP. There was an increase in MTP from 53+/-9 ml.min(-1).100 g(-1) before cardiopulmonary bypass to 72+/-13 ml. min(-1).100 g(-1) after (means+/-S.E.M.; P=0.05). Tissue PO(2) showed an overall increase from a baseline level of 45+/-8 mmHg to a final level of 88+/-10 mmHg (P<0.0001). Following release of the aortic cross-clamp there was a variable time delay before a change in tissue PO(2) was observed. There was an immediate response in five regions, whereas in 20 regions the response was delayed by between 0.5 and 32 min. In the remaining four regions there was no change in tissue PO(2). The duration of the delay in response was correlated positively with the cross-clamp time (r=0.45, P<0.05) and negatively with the final tissue PO(2) (r=-0.5, P<0.05). Voltammetric methods for monitoring changes in oxygen supply and utilization offer new insights into the changes that occur during ischaemia and reperfusion. A delay in the delivery of oxygen to the myocardium occurs in many patients following coronary artery bypass surgery.

show abstract

“…Iwakura et al reported that more severe myocardial damage before recanalization is closely related to the no-reflow phenomenon in patients with successful coronary recanalization, 27 and other studies Previous studies have suggested that microvascular damage can develop even after recanalization. 28,29 Persistent hyperglycemia may have additionally increased the microvascular damage thereafter. Our results indicate that persistent hyperglycemia is independently associated with LV dysfunction before discharge, which is a strong predictor of long-term prognosis.…”

Section: Hyperglycemia and Severe Myocardial Damagementioning

confidence: 99%

Persistent Hyperglycemia is Associated With Left Ventricular Dysfunction in Patients With Acute Myocardial Infarction

Kosuge

Kimura

Ishikawa

et al. 2005

Circ J

View full text Add to dashboard Cite

cute hyperglycemia, irrespective of a previous diagnosis of diabetes mellitus, is associated with increased risks of congestive heart failure, cardiogenic shock, and death after acute myocardial infarction (AMI). [1][2][3][4][5] Recent studies have shown that not only restoration of Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow 6 in the epicardial infarct-related artery, but also complete and sustained myocardial reperfusion of the jeopardized myocardium are required to maintain left ventricular (LV) function and improve the outcome for patients with AMI. 7,8 In addition, it has been recently demonstrated that hyperglycemia (≥8.9 mmol/L) on admission is associated with the no-reflow phenomenon on myocardial contrast echocardiography after recanalized AMI, resulting in a larger infarct and worse functional recovery. 9 Previous studies assessing the significance of acute hyperglycemia in patients with AMI have focused mainly on the blood glucose concentration on admission, but the association of a change in the blood glucose concentration after admission with LV function remains to be elucidated and was the aim of the present study. Circulation Journal Vol.69, January 2005 Methods Study GroupWe enrolled 210 consecutive patients with an anterior wall AMI (mean age 59±11 years [range 29-84]; 167 men and 43 women) who fulfilled the following criteria: (1) no history of prior myocardial infarction; (2) absence of conditions precluding electrocardiographic (ECG) evaluation of ST-segment changes (ie, left or right bundle-branch block, ventricular pacing); (3) achievement of TIMI grade 3 flow of the left anterior descending (LAD) coronary artery as confirmed by coronary angiography within 6 h of symptom onset; (4) adequate assessment of myocardial blush grade 10 after recanalization; (5) measurement of blood glucose concentration on admission and fasting blood glucose concentrations 24 and 48 h after symptom onset, and on day 7; and (6) a patent infarct-related artery and left ventriculograms obtained a median of 14 days after AMI. Patients receiving oral hypoglycemic drugs or insulin during the first 48 h and those with cardiogenic shock were excluded. The diagnosis of anterior AMI was based on typical chest pain lasting ≥30 min, ≥2 mm ST-segment elevation in at least 2 contiguous precordial leads, and a typical increase in serum creatine kinase to more than twice the upper limit of normal. All patients were informed that some results of their general examinations during hospitalization may be used for research purposes. Informed consent was obtained before the data were included in analysis. Coronary AngiographyCoronary angiography was performed immediately after admission. In the right coronary artery and the left circumflex coronary artery, stenosis was considered clinically Circ J 2005; 69: 23 -28 (Received July 23, 2004; revised manuscript received September 29, 2004; accepted October 7, 2004 Background The relationship of changes in blood glucose concentrations after admission to left ventricular (LV)...

show abstract

Progressive decreases in coronary vein flow during reperfusion in acute myocardial infarction: Clinical documentation of the no reflow phenomenon after successful thrombolysis

Cited by 64 publications

References 46 publications

No-Reflow Phenomenon

No-Reflow Phenomenon

Myocardial tissue oxygen supply and utilization during coronary artery bypass surgery: evidence of microvascular no-reflow

Persistent Hyperglycemia is Associated With Left Ventricular Dysfunction in Patients With Acute Myocardial Infarction

Contact Info

Product

Resources

About