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Treatment strategies for microvascular dysfunction following acute myocardial infarction.

Publication ,  Journal Article
Roe, MT
Published in: Curr Cardiol Rep
September 2000

Successful reperfusion following acute myocardial infarction is considered to be restoration of epicardial infarct vessel patency, but recent studies suggest that disrupted microvascular function and inadequate myocardial tissue perfusion are often present despite epicardial patency. New angiographic techniques, including the corrected Thrombolysis in Myocardial Infarction (TIMI) frame count and myocardial blush grade, have been used to demonstrate that restoration of downstream coronary flow and tissue perfusion may be the key links to improved clinical outcomes. Additionally, other diagnostic techniques, including infarct size measurement with cardiac marker release patterns, or (99m) Tc-sestamibi single photon emission computed tomography imaging, and analysis of ST-segment resolution have also been used to assess microvascular function and tissue perfusion. Promising adjunctive therapies that target microvascular dysfunction, including platelet glycoprotein IIb/IIIa inhibitors, anti-inflammatory agents, vasodilators, glucose-insulin-potassium, and embolization protection devices, may ameliorate microvascular dysfunction following epicardial reperfusion. However, these therapies have not yet been shown to improve clinical outcomes and are thus currently being studied together with fibrinolytics and primary angioplasty in clinical trials. Therefore, shifting the focus of reperfusion therapy to the microcirculation offers the potential to further improve myocardial salvage and clinical outcomes following acute myocardial infarction.

Duke Scholars

Published In

Curr Cardiol Rep

DOI

ISSN

1523-3782

Publication Date

September 2000

Volume

2

Issue

5

Start / End Page

405 / 410

Location

United States

Related Subject Headings

  • Vasodilator Agents
  • Vascular Patency
  • Platelet Aggregation Inhibitors
  • Myocardium
  • Myocardial Reperfusion
  • Myocardial Infarction
  • Microcirculation
  • Humans
  • Coronary Angiography
  • Cardiovascular System & Hematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Roe, M. T. (2000). Treatment strategies for microvascular dysfunction following acute myocardial infarction. Curr Cardiol Rep, 2(5), 405–410. https://doi.org/10.1007/s11886-000-0053-y
Roe, M. T. “Treatment strategies for microvascular dysfunction following acute myocardial infarction.Curr Cardiol Rep 2, no. 5 (September 2000): 405–10. https://doi.org/10.1007/s11886-000-0053-y.
Roe, M. T. “Treatment strategies for microvascular dysfunction following acute myocardial infarction.Curr Cardiol Rep, vol. 2, no. 5, Sept. 2000, pp. 405–10. Pubmed, doi:10.1007/s11886-000-0053-y.

Published In

Curr Cardiol Rep

DOI

ISSN

1523-3782

Publication Date

September 2000

Volume

2

Issue

5

Start / End Page

405 / 410

Location

United States

Related Subject Headings

  • Vasodilator Agents
  • Vascular Patency
  • Platelet Aggregation Inhibitors
  • Myocardium
  • Myocardial Reperfusion
  • Myocardial Infarction
  • Microcirculation
  • Humans
  • Coronary Angiography
  • Cardiovascular System & Hematology