Predictors of myocardial reperfusion syndrome: a modern view of the issue and current problems. Part 1: Reperfusion arrhythmias, injury and stunning myocardium (review of literature)

G G Khubulava,A N Shishkevich,D A Pachkov,A Ya Khandokhov,E Yu Bessonov,E I Umancev,K L Kozlov,S S Mikhailov

doi:10.24884/1682-6655-2021-20-2-20-26

G G Khubulava, A N Shishkevich + Show 6 more

Open Access

https://doi.org/10.24884/1682-6655-2021-20-2-20-26

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Abstract

Myocardial reperfusion syndrome is a complex set of pathological processes that occur in the heart muscle due to restoration of coronary blood flow in patients with ST-segment elevation myocardial infarction. Despite the fact that it has been known for a long time, there is still no unequivocal opinion about the predictors, and, accordingly, the risk groups for its occurrence. This prevents predicting the further course of the disease and studying the effectiveness of surgical and therapeutic methods for preventing the consequences of reperfusion in patients with ST-segment elevation myocardial infarction, which in turn significantly worsens the postoperative and long-term prognosis in this group of patients. We used the search engines such as E-lilbrary, Google Scholar and Pubmed to search for studies on this issue. The article presents research data highlighting predictors of myocardial reperfusion syndrome. In addition, the problems of verification of irreversible reperfusion injury and myocardial stunning are described.

Highlights

Summary Myocardial reperfusion syndrome is a complex set of pathological processes that occur in the heart muscle due to restoration of coronary blood flow in patients with ST-segment elevation myocardial infarction
Despite the fact that it has been known for a long time, there is still no unequivocal opinion about the predictors, and, the risk groups for its occurrence
This prevents predicting the further course of the disease and studying the effectiveness of surgical and therapeutic methods for preventing the consequences of reperfusion in patients with ST-segment elevation myocardial infarction, which in turn significantly worsens the postoperative and long-term prognosis in this group of patients

Summary

Introduction

Это связано с увеличением зоны инфаркта миокарда у пациентов с жизнеугрожающими аритмиями после ЧКВ [11], или сложностью в определении генеза аритмий. Huang et al [6], основанного на ретроспективном анализе 607 пациентов с ИМпST, перенесших ЧКВ, было построение шкалы риска развития ранней и поздней желудочковой тахикардии или фибрилляции желудочков после реперфузии. Факт уменьшения размера зоны инфаркта при терапевтическом вмешательстве, применяемом в начале реперфузии, послужил доказательством того, что НРПМ существует у людей и является актуальной мишенью для кардиопротекции (рисунок).

Results

Conclusion