Microvascular Obstruction and Intramyocardial Hemorrhage in Reperfused Myocardial Infarctions: Pathophysiology and Clinical Insights From Imaging.
JACC Cardiovasc Imaging
; 17(7): 795-810, 2024 Jul.
Article
in En
| MEDLINE
| ID: mdl-38613553
ABSTRACT
Microvascular injury immediately following reperfusion therapy in acute myocardial infarction (MI) has emerged as a driving force behind major adverse cardiovascular events in the postinfarction period. Although postmortem investigations and animal models have aided in developing early understanding of microvascular injury following reperfusion, imaging, particularly serial noninvasive imaging, has played a central role in cultivating critical knowledge of progressive damage to the myocardium from the onset of microvascular injury to months and years after in acute MI patients. This review summarizes the pathophysiological features of microvascular injury and downstream consequences, and the contributions noninvasive imaging has imparted in the development of this understanding. It also highlights the interventional trials that aim to mitigate the adverse consequences of microvascular injury based on imaging, identifies potential future directions of investigations to enable improved detection of disease, and demonstrates how imaging stands to play a major role in the development of novel therapies for improved management of acute MI patients.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Predictive Value of Tests
/
Coronary Circulation
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Hemorrhage
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Microcirculation
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Myocardial Infarction
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Myocardium
Limits:
Animals
/
Humans
Language:
En
Journal:
JACC Cardiovasc Imaging
Journal subject:
ANGIOLOGIA
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CARDIOLOGIA
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DIAGNOSTICO POR IMAGEM
Year:
2024
Document type:
Article