Reperfusion injury natural history: Difference between revisions
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* Those patients who are identified and treated early, the prognosis is better along with the decreased incidence of intracranial hemorrhage. Outcomes usually depend on the timely recognition and prevention of precipitating factors. Hypertension management is most important before it can inflict damage in the form of edema or hemorrhage. | * Those patients who are identified and treated early, the prognosis is better along with the decreased incidence of intracranial hemorrhage. Outcomes usually depend on the timely recognition and prevention of precipitating factors. Hypertension management is most important before it can inflict damage in the form of edema or hemorrhage. | ||
*The prognosis following hemorrhagic transformation is poor. Mortality in such cases is 3663%, and 80% of survivors have significant morbidity. | *The prognosis following hemorrhagic transformation is poor. Mortality in such cases is 3663%, and 80% of survivors have significant morbidity. Abou-Chebl A, Yadav JS, Reginelli JP, Bajzer C, Bhatt D, Krieger DW. Intracranial hemorrhage and hyperperfusion syndrome following carotid artery stenting: risk factors, prevention, and treatment. J Am Coll Cardiol. 2004 May 5. 43(9):1596-601</ref> | ||
*Studies indicate that reperfusion injury is involved directly in the potentiation of stroke damage. Components of the inflammatory response, including cytokine release and leukocyte adhesion, appear to play key roles in these deleterious effects. | *Studies indicate that reperfusion injury is involved directly in the potentiation of stroke damage. Components of the inflammatory response, including cytokine release and leukocyte adhesion, appear to play key roles in these deleterious effects. | ||
Prognosis in CVS patients | Prognosis in CVS patients | ||
* Reperfusion injury contributes to up to 50% of the total myocardial damage. In spite of many successful results in animals, the translation into the clinical setting has been disappointing for many years.<ref name="urlReperfusion injury in acute myocardial infarction">{{cite web |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389482/ |title=Reperfusion injury in acute myocardial infarction |format= |work= |accessdate=}}</ref> | * Reperfusion injury contributes to up to 50% of the total myocardial damage. In spite of many successful results in animals, the translation into the clinical setting has been disappointing for many years.<ref> name="urlReperfusion injury in acute myocardial infarction">{{cite web |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389482/ |title=Reperfusion injury in acute myocardial infarction |format= |work= |accessdate=}}</ref> | ||
==References== | ==References== | ||
Revision as of 16:34, 14 August 2020
Editors-In-Chief: Anjan K. Chakrabarti, M.D. [1]; C. Michael Gibson, M.S., M.D. [2]; Dr. Shivam Singla M.D. [2] Associate Editors-In-Chief: Kashish Goel, M.D ;
Complications
Myocardial stunning: Delayed recovery, usually 2-3 days, of the viable myocardium after reperfusion is termed as "myocardial stunning". It is mainly due to the release of reactive oxygen species and intracellular calcium overload.
- Myocardial infarction: Irreversible myocyte cell death secondary to reduced oxygen delivery for more than 20-30 minutes, will lead to infarction. Reperfusion helps prevent complete loss of the involved area, however oxidative stress due to this may prevent complete resolution.
- Acute heart failure: Loss of myocardial contractility and systolic dysfunction associated with ischemia/reperfusion injury may lead to the development of acute heart failure. Early reperfusion in the course of STEMI prevents myocardial necrosis and may lead to complete recovery of function.
- Ventricular arrhythmias: Reperfusion of the blocked coronary artery can also precipitate arrhythmias ranging from ventricular premature beats to life-threatening ventricular fibrillation.
Prognosis
Prognosis in CNS patients
- Those patients who are identified and treated early, the prognosis is better along with the decreased incidence of intracranial hemorrhage. Outcomes usually depend on the timely recognition and prevention of precipitating factors. Hypertension management is most important before it can inflict damage in the form of edema or hemorrhage.
- The prognosis following hemorrhagic transformation is poor. Mortality in such cases is 3663%, and 80% of survivors have significant morbidity. Abou-Chebl A, Yadav JS, Reginelli JP, Bajzer C, Bhatt D, Krieger DW. Intracranial hemorrhage and hyperperfusion syndrome following carotid artery stenting: risk factors, prevention, and treatment. J Am Coll Cardiol. 2004 May 5. 43(9):1596-601</ref>
- Studies indicate that reperfusion injury is involved directly in the potentiation of stroke damage. Components of the inflammatory response, including cytokine release and leukocyte adhesion, appear to play key roles in these deleterious effects.
Prognosis in CVS patients
- Reperfusion injury contributes to up to 50% of the total myocardial damage. In spite of many successful results in animals, the translation into the clinical setting has been disappointing for many years.[1]
References
- ↑ name="urlReperfusion injury in acute myocardial infarction">"Reperfusion injury in acute myocardial infarction".