ABSTRACT
AIM: Our study aimed to investigate the impact of oxidative stress on myocardial reperfusion phenomenon. Since obtaining morphological evidence of oxidative stress is practically impossible in vivo, we used as "surrogate" evidence the primary percutaneous transluminal coronary angioplasty effects. MATERIAL AND METHODS: The study group consisted of 22 patients hospitalized with a diagnosis of acute myocardial infarction with ST segment elevation in the Institute of Cardiovascular Diseases "Prof. Dr. George I. M. Georgescu" Iasi. Patients were evaluated by coronary angiography. To restore myocardial reperfusion we applied primary percutaneous transluminal coronary angioplasty. Evidence resume coronary flow by primary percutaneous transluminal coronary angioplasty were assessed by: (1) Thrombolysis in Myocardial Infarction (TIMI) flow, Myocardial Blush Grade (MBG) and complications as no-reflow, distal emboli; (2) evolution of the electrocardiographic changes. RESULTS: Evaluation of myocardial blood flow resumption revealed, as final results, TIMI 3 flow with MBG 2-3 and without no-reflow in 21 cases. A single case has shown signs of irreversible no-reflow. Analysis of evolutionary electrocardiographic changes (ST segment elevation, depression) allowed assessment of the effectiveness of interventional reperfusion, dependent on the time of presentation and independent of the culprit artery patency. CONCLUSIONS: Assessment of myocardial reperfusion by alternative evidence provides a range of information how to restore the functional integrity of myocardium, but without allowing an analysis of biochemical and morphological substrate of the evolution of lesions, in terms of oxidative stress intervention. Studies of the dynamics of oxidative stress-induced changes at the structural level impose, under the peculiarities of myocardium, the design of an experimental model.