title: The central role of conventional 12-lead ECG for the assessment of microvascular obstruction after percutaneous myocardial revascularization.
abstract: Guidelines report that the optimal treatment for ST-elevation myocardial infarction (STEMI) is a primary percutaneous coronary intervention (PPCI) when performed timely by trained operators. Yet, the reopening of the infarct-related artery (IRA) is not always followed by myocardial reperfusion. This phenomenon is most commonly called "no-reflow", is caused by microvascular obstruction (MVO) and is associated to a worse outcome. Electrocardiogram (ECG) is crucial for the diagnosis of STEMI, but is also useful for the assessment of MVO. In this review we summarize ECG-derived parameters associated to MVO and their prognostic relevance.
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Infusino
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: gniccoli73@hotmail.it.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fracassi
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Roberto
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Falcioni
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Gaetano A
authors.initials: GA
authors.lastname: Lanza
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D023921:Coronary Stenosis / Q000175:diagnosis* / Q000209:etiology*; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: Acute myocardial infarction; CMR; ECG; Electrocardiogram; HRT; HRV; IRA; MBG; MCE; MVO; Microvascular obstruction; PPCI; PTCA; ST segment elevation; ST segment elevation myocardial infarction; ST segment elevation resolution; STE; STEMI; STER; STR; TIMI; Thrombolysis In Myocardial Infarction; cardiovascular magnetic resonance; electrocardiogram; heart rate turbulence; heart rate variability; infarct-related artery; microvascular obstruction; myocardial blush grade; myocardial contrast echocardiography; percutaneous transluminal coronary angioplasty; primary percutaneous coronary intervention; rate of ST segment elevation resolution