Статья
Феномен no-reflow во время первичного чрескожного коронарного вмешательства у пациентов с острым инфарктом миокарда с подъемом сегмента ST, обусловленным массивным коронарным тромбозом. Патогенез и предикторы no-reflow
Несмотря на успешную и своевременную реваскуляризацию инфаркт-связанной артерии, у отдельных пациентов ткань миокарда остается в состоянии гипоперфузии. Такое состояние известно как феномен no-reflow и связано с худшим прогнозом. Первая часть систематического обзора феномена no-reflow посвящена описанию его патогенеза и предикторов. Это явление имеет сложный многофакторный патогенез, включающий дистальную эмболизацию, ишемическое повреждение, реперфузионное повреждение, а также компонент индивидуальной предрасположенности. Между тем у ряда пациентов феномен подвергается самопроизвольной регрессии. В ряде исследований продемонстрирована роль определенных биомаркеров и клинических параметров как предикторов риска развития no-reflow. Предполагается, что значимость каждого патогенетического компонента no-reflow у разных пациентов различна, что может служить основой для персонифицированного подхода к лечению.
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