Reperfusion injury natural history: Difference between revisions

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'''Editors-In-Chief:''' {{AC}}; [[C. Michael Gibson]], M.S., M.D. [mailto:Mgibson@perfuse.org]; '''Associate Editors-In-Chief: '''[[User:Kashish Goel|Kashish Goel, M.D.]]
'''Editors-In-Chief:''' {{AC}}; [[C. Michael Gibson]], M.S., M.D. [mailto:Mgibson@perfuse.org]; '''Associate Editors-In-Chief: '''[[User:Kashish Goel|Kashish Goel, M.D.]]
==Overview==
==Overview==
Animal studies have shown that [[reperfusion injury]] may be responsible for about 50% of the total infarct size after an acute [[myocardial infarction]].<ref name="pmid17855673">{{cite journal |author=Yellon DM, Hausenloy DJ |title=Myocardial reperfusion injury |journal=N. Engl. J. Med. |volume=357 |issue=11 |pages=1121–35 |year=2007 |month=September |pmid=17855673 |doi=10.1056/NEJMra071667 |url=}}</ref>.
[[Reperfusion injury]] may be responsible for about 50% of the total infarct size after an acute [[myocardial infarction]] as well as [[myocardial stunning]], [[congestive heart failure]] and [[reperfusion arrhythmias]] such as [[ventricular arrhythmias]].<ref name="pmid17855673">{{cite journal |author=Yellon DM, Hausenloy DJ |title=Myocardial reperfusion injury |journal=N. Engl. J. Med. |volume=357 |issue=11 |pages=1121–35 |year=2007 |month=September |pmid=17855673 |doi=10.1056/NEJMra071667 |url=}}</ref>.


==Complications==
==Complications==

Revision as of 15:28, 19 August 2015

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Editors-In-Chief: Anjan K. Chakrabarti, M.D. [1]; C. Michael Gibson, M.S., M.D. [2]; Associate Editors-In-Chief: Kashish Goel, M.D.

Overview

Reperfusion injury may be responsible for about 50% of the total infarct size after an acute myocardial infarction as well as myocardial stunning, congestive heart failure and reperfusion arrhythmias such as ventricular arrhythmias.[1].

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 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.

References

  1. Yellon DM, Hausenloy DJ (2007). "Myocardial reperfusion injury". N. Engl. J. Med. 357 (11): 1121–35. doi:10.1056/NEJMra071667. PMID 17855673. Unknown parameter |month= ignored (help)