title: The challenges and impact of microvascular injury in ST-elevation myocardial infarction.
abstract: Despite successful restoration of epicardial coronary blood flow, a significant proportion of patients with ST-elevation myocardial infarction suffer from an impairment of the microvascular perfusion - a phenomenon termed no-reflow or microvascular injury (MVI). The underlying pathophysiology is complex and likely multifactorial. It is well established that MVI is associated with worse clinical outcome. Although MVI can be detected during coronary intervention and the post-infarction period, its prevention and treatment strategies remain a major challenge since most results of clinical studies have been disappointing so far. This review provides an overview on the main pathophysiological mechanisms of MVI and its diagnostic approaches. Moreover, it will discuss its clinical consequences and current strategies of prevention and treatment.
authors.affiliation: a University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine , University of Lübeck , Lübeck , Germany.|b German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck , Lübeck , Germany.|c University Clinic of Internal Medicine III, Cardiology and Angiology , Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Sebastian Johannes
authors.initials: SJ
authors.lastname: Reinstadler
authors.affiliation: a University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine , University of Lübeck , Lübeck , Germany.|b German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck , Lübeck , Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Stiermaier
authors.affiliation: a University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine , University of Lübeck , Lübeck , Germany.|b German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck , Lübeck , Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Fuernau
authors.affiliation: a University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine , University of Lübeck , Lübeck , Germany.|b German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck , Lübeck , Germany.
authors.forename: Suzanne
authors.initials: S
authors.lastname: de Waha
authors.affiliation: a University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine , University of Lübeck , Lübeck , Germany.|b German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck , Lübeck , Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Desch
authors.affiliation: c University Clinic of Internal Medicine III, Cardiology and Angiology , Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Metzler
authors.affiliation: a University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine , University of Lübeck , Lübeck , Germany.|b German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck , Lübeck , Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
authors.affiliation: a University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine , University of Lübeck , Lübeck , Germany.|b German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck , Lübeck , Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Eitel
mesh_terms: D003326:Coronary Circulation; D006801:Humans; D055806:Microvessels; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy; D015428:Myocardial Reperfusion Injury / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D054318:No-Reflow Phenomenon / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy
keywords: No-reflow; ST-elevation myocardial infarction; microvascular injury; microvascular obstruction; myocardial infarction; prevention; prognosis; treatment