Clinical Impact of Ischemic Preconditioning on Infarct Size and Coronary No-reflow Phenomenon after Successful Recanalization in the Acute Myocardial Infarction

  • Kazuo Komamura
  • Kazuhisa Kodama
  • Masafumi Kitakaze
  • Masatsugu Hori
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 194)


Now that reperfusion therapy for acute myocardial infarction is established and achieved better survival rate, attention on “no-reflow phenomenon ” after complete reperfusion of epicardial coronary artery has been growing recently. In the clinical setting, no-reflow after successful thrombolysis has been visualized using coronary angiography,1 Tl-201 SPECT2 and myocardial contrast echocardiography.3 Frequency of no-reflow after revascularization differs from 0.3% to 91%, according to the means of detection of no-reflow, duration of ischemia, extent of ischemia including collateral flow and extent of infarction. Although how much no-reflow counts on the prognosis of infarction remains to be determined, some impact of no-reflow on infarct size and ventricular function.4 Clinical implication of ischemic preconditioning on myocardial infarction has been reported in terms of infarct size,5 contractile function6 and prognosis.7 In the present review, we summarize the clinical impact of ischemic preconditioning on no-reflow phenomenon and infarct size using coronary vein flow measurement during the initial course of reperfused acute myocardial infarction.8


Acute Myocardial Infarction Infarct Size Left Anterior Descend Ischemic Precondition Myocardial Contrast Echocardiography 
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Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Kazuo Komamura
  • Kazuhisa Kodama
  • Masafumi Kitakaze
  • Masatsugu Hori

There are no affiliations available

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