[The no-reflow phenomenon and its clinical significance].
The no-reflow phenomenon is characterized by inadequate myocardial perfusion without angiographic manifestations of mechanical vascular occlusion. The phenomenon occurs after coronary vascular interventions (coronary angiography, percutaneous coronary angioplasty, stenting, coronary artery bypass surgery). The development of the no-reflow phenomenon significantly worsens clinical evolution of disease increasing the number of cases of congestive heart failure and hospital mortality. Changes of endothelial function and morphology, changes of blood rheology and microvascular autoregulation are important for pathogenesis of the phenomenon. The treatment include intracoronary introduction of verapamil, adenosine, intravenous introduction of activators of KATP channels (nicorandil), inhibitors of glycoprotein IIb/IIIa receptors. The reasons for early preventive use of intracoronary introduction of verapamil and other drugs in the presence of risk of development of no-reflow phenomenon are presented. The interrelationship between no-reflow phenomenon and syndrome X is also stressed.
Sidorenko
G I
GI
Ostrovskiĭ
Iu P
IuP
D000241:Adenosine / Q000008:administration & dosage / Q000627:therapeutic use; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D017073:Atherectomy / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003326:Coronary Circulation / Q000187:drug effects; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006333:Heart Failure / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D017566:Microvascular Angina / Q000175:diagnosis; D009203:Myocardial Infarction / Q000503:physiopathology; D020108:Nicorandil / Q000008:administration & dosage / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014700:Verapamil / Q000008:administration & dosage / Q000627:therapeutic use
D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014665:Vasodilator Agents; D020108:Nicorandil; D014700:Verapamil; D000241:Adenosine