急性心肌梗死后心肌内出血

在急性心肌梗死患者中, 通过经皮冠状动脉介入治疗进行血管重建能够有效降低死亡率。然而, 即使成功开通了心外膜血管, 仍有相当比例的急性心肌梗死患者发展为慢性心力衰竭。研究发现, 冠状动脉微血管阻塞引起的"无复流"现象及随后出现的心肌内出血是参与此过程的重要因素。了解心肌内出血在"无复流"现象和心肌损伤中的作用, 对制定新的急性心肌梗死治疗策略至关重要。本文将对心肌内出血的病理生理学、影像学、临床意义和治疗策略等最新进展进行综述。

Intramyocardial Haemorrhage after Acute Myocardial Infarction

In patients with acute myocardial infarction, mechanical revascularization by percutaneous coronary intervention can effectively reduce mortality. However, a substantial proportion of patients with acute myocardial infarction develop chronic cardiac failure, despite restoration of epicardial vessel patency. It is found that the phenomenon of "no-reflow" caused by coronary microvascular obstruction and the subsequent myocardial hemorrhage are the important factors involved in this process. Understanding of the role of intramyocardial haemorrhage in the no-reflow phenomenon and myocardial injury is crucial to the development of new therapeutic strategies to treat acute myocardial infarction. In this article, we reviewed the latest development in pathophysiology, imaging, clinical significance, and therapeutic strategies of intramyocardial hemorrhage.