The no-reflow phenomenon refers to the observation that when an organ is made ischemic by occlusion of a large artery supplying it, restoration of patency in that artery does not restore perfusion to the microvasculature supplying the parenchyma of that organ. This has been observed after prolonged arterial occlusions in the heart (30–90 min), brain, skin, and kidney. In experimental models, zones of no reflow in the heart are characterized by ultrastructural microvascular damage, including focal endothelial swelling obstructing the lumen of small vessels. Blood elements such as neutrophil plugs, platelets, and stacking of erythrocytes have also been implicated. No reflow is associated with poor healing of the myocardial infarction. In patients, no reflow is associated with a poor clinical outcome independent of infarct size, suggesting that therapy for no reflow may be an important approach to improving outcome for ST elevation myocardial infarction. No reflow occurs after reperfusion of experimental cerebral ischemia and may be observed after only 5-min episodes of ischemia. Aggregation of blood elements may play a greater role than in cardiac no reflow. No reflow in the brain may involve cortical spreading depression with disturbed local vascular control and high, vasculotonic levels of extracellular K + concentration, postischemic swelling in endothelial cells and abutting end feet of pericytes, pericyte contraction and death, interstitial edema with collapse of cerebral capillaries, and inflammatory reaction. New guidelines suggesting that reperfusion for stroke may be considered as late as 24 h after the onset of symptoms suggest that clinicians may be seeing more no reflow in the future.

Robert A. Kloner

Kevin S. King

Michael G. Harrington

AJP Heart and Circulatory Physiology

美国生理学杂志-心脏和循环生理学发表关于心脏、脉管系统和淋巴系统生理学的原始调查、评论和观点。这些文章包括从完整和整合的动物和器官功能到细胞、亚细胞和分子水平的各个组织水平的心血管功能的实验和理论研究。该杂志包含了对这些功能及其控制系统的新描述，以及它们在生物化学、生物物理学、遗传学和细胞生物学中的基础。优先考虑提供重要的新机械生理学见解的研究，这些见解可以确定正常和异常心脏和循环的表现。

The American Journal of Physiology - Heart and Circulatory Physiology publishes original investigations, reviews, and perspectives on the physiology of the heart, vascular system, and lymphatic system. These articles cover experimental and theoretical studies of cardiovascular function at various levels, from whole and integrated animal and organ functions to cellular, subcellular, and molecular levels. The journal includes new descriptions of these functions and their control systems, as well as their foundations in biochemistry, biophysics, genetics, and cell biology. Research providing significant new insights into mechanical physiology that can elucidate the performance of normal and abnormal heart and circulatory functions is prioritized.

《American Journal of Physiology - Heart and Circulatory Physiology》发表关于心脏、血管系统和淋巴系统生理学的原创研究、评论和观点。这些文章涵盖了从整体和综合的动物及器官功能到细胞、亚细胞和分子水平的心血管功能的实验和理论研究。该杂志包含对这些功能及其控制系统的新描述，以及它们在生物化学、生物物理学、遗传学和细胞生物学中的基础。优先考虑提供重要的新机械生理学见解的研究，这些见解能够阐明正常和异常心脏及循环的表现。

American Journal of Physiology - Heart and Circulatory Physiology

American Journal of Physiology-Heart and Circulatory Physiology

No-reflow phenomenon in the heart and brain

In patients, no reflow is associated with a poor clinical outcome independent of infarct size, suggesting that therapy for no reflow may be an important approach to improving outcome for ST elevation myocardial infarction.

Category	Quartile
医学	2
医学, 生理学	2
医学, 心脏和心血管系统	3
医学, 外周血管病	3

No-reflow phenomenon in the heart and brain

ivySCI AI Smartly Parses PDF, Answers Researchers' Questions, and Helps You Understand Papers in Seconds

Journal Info