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- W2000308573 abstract "Background— No-reflow after reperfusion therapy for myocardial infarction is a strong predictor of clinical outcome. But its fate on a long-term basis and potential significance for infarct healing are not yet known. Methods and Results— Twenty-nine female Fisher rats were subjected to 60 minutes of coronary occlusion followed by reperfusion. At 4 weeks, 15 survivors were euthanized after measurement of regional myocardial blood flow (radioactive microspheres) and in vivo staining of perfused tissue (0.5 mL 50% Uniperse blue IV). Infarct size (34.3±3.4%), scar thickness (1.19±0.10 mm), and infarct expansion index (0.51±0.04) were assessed from histological sections (2 additional exclusions because of failed occlusion). Regional myocardial blood flow in the reperfused infarct was reduced significantly compared with noninfarcted tissue (1.98±0.47 versus 4.55±0.86 mL · min −1 · g −1 , P <0.003, apical slice, and 1.77±0.44 versus 5.34±0.38 mL · min −1 · g −1 , P <0.0001, second slice), accompanied by a striking reduction of perfused capillaries within the infarct (n=23±4 versus 163±8 in the noninfarcted tissue, P <0.0001, microscopically assessed as capillaries containing blue particles per high-power field). Macroscopically, no-reflow areas were visible in 9 of 13 hearts. The number of perfused capillaries within the infarct correlated significantly with infarct expansion index ( r =−0.76, P <0.003), infarct thickness ( r =0.60, P <0.03), and the ratio of infarct to septum thickness ( r =0.74, P <0.004). Conclusions— The no-reflow phenomenon persists for 1 month after reperfusion and predicts worse scar thinning and infarct expansion. Thus, one might shift the “open-artery” hypothesis downstream to an “open-microvessel” hypothesis, relating infarct healing, infarct expansion, and outcome to the completeness of microvascular reperfusion above and beyond epicardial artery patency." @default.
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- W2000308573 date "2003-12-09" @default.
- W2000308573 modified "2023-10-02" @default.
- W2000308573 title "No-Reflow Phenomenon Persists Long-Term After Ischemia/Reperfusion in the Rat and Predicts Infarct Expansion" @default.
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- W2000308573 doi "https://doi.org/10.1161/01.cir.0000101917.80668.e1" @default.
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