This publication is protected and can be accessed only from certain IPs.
This publication is protected and can be accessed only from certain IPs.

Title: Determinants and consequences of impaired reperfusion in patients with ST-segmentelevation myocardial infarction treated with primary percutaneous coronaryintervention


Introduction: Mechanical reperfusion significantly improves the results oftreatment in patients with acute ST-segment elevation myocardialinfarction(STEMI). Its effectiveness is limited by the occurrence ofmicrovascular damage, known as impaired reperfusion (no-reflowphenomenon).Objective: To find factors independently associated with the occurrence ofimpaired reperfusion, and to determine the prognostic value of the no-reflowphenomenon for left ventricula(LV) remodeling and function recovery inpatients with STEMI treated with primary percutaneous coronaryintervention(PCI).Methods: Data of 108 patients with STEMI were studied. Myocardial perfusionwas assessed using angiography and ecg. The enzymatic injury was evaluatedaccording to CK,CK-MB, TnI level. The LV function and remodeling wasexamined by echocardiography and magnetic resonance imaging(MRI) atbaseline and then after 4 months. The microvascular obstruction (MVO) areawas measured by MRIResults: The multivariate analysis showed that left anterior descending arterywas independently associated with the lack of restoration of full epicardialflow(TIMI<3) or incomplete tissue reperfusion (TMPG-0/1) after PCI (p=0,049p=0,035). The strongest determinant of MVO was infarct size (p<0,0001). TheLV remodeling expressed as a 20% increase of the end-diastolic volume index(EDVI) within 4 m. after STEMI was determined by baseline EDVI ( ; p<0,0001),infarct size (p=0,015) and MVO (p=0,043). 20% increase of the end-systolicvolume index(ESVI) was associated with enzymatic damage (p=0,007)Conclusions: The size of ischemic territory is the strongest predictor of theoccurrence and severity of the impaired reperfusion in patients with STEMI. TheMVO depends on the size of the infarct area. The LV function recovery andremodeling within the first 4 m. after mechanically reperfused STEMI areinfluenced by the baseline LV functional and structural condition and the extentof myocardial damage.

Place of publishing:


Level of degree:

2 - studia doktoranckie

Degree discipline:

choroby układu krążenia

Degree grantor:

Wydział Lekarski


Żmudka, Krzysztof

Date issued:




Call number:




Access rights:

tylko w bibliotece

Object collections:

Last modified:

Mar 20, 2023

In our library since:

Apr 7, 2014

Number of object content hits:


Number of object content views in PDF format


All available object's versions:


Show description in RDF format:


Show description in OAI-PMH format:


Edition name Date
ZB-120427 Mar 20, 2023


Citation style:

This page uses 'cookies'. More information