Effects of postconditioning in ST-elevation myocardial infarction: Assessment of myocardium at risk and infarct size
نویسنده
چکیده
5 Sammanfattning 6 List of original papers 7 Abbreviations 8 Introduction 9 Acute myocardial infarction 9 Pathophysiology 9 Diagnosis and current treatment 10 Reperfusion injury 11 Myocardial conditioning 13 Potential mechanisms and pathways involved in ischemic conditioning 17 Quantification of myocardial salvage 18 Cardiac imaging techniques 19 Aims 23 Material and methods 24 Study populations 24 Study design 25 Angiographic determination of MaR 26 Cardiovascular Magnetic Resonance 27 SPECT 28 Blood analysis 29 Statistics 29 Results 31 Study I 31 Study II 34 Study III 35 Study IV 37 General discussion 39 Myocardium at risk and CMR 39 Short-term effects of postconditioning in patients with STEMI 41 Long-term effects of postconditioning in patients with STEMI 42 Cardiac biomarkers 43 Study limitations 43 Future perspectives and comments 45 CMR-sequences 45 Postconditioning 45 Translation from preclinical to clinical studies 45 Conclusions 47 Acknowledgements 48 Bibliography 50 Effects of postconditioning in myocardial infarction
منابع مشابه
Cardioprotective effects of ischemic postconditioning in patients treated with primary percutaneous coronary intervention, evaluated by magnetic resonance.
BACKGROUND Postconditioning has been suggested to reduce myocardial damage during primary percutaneous coronary intervention (PPCI) in patients with ST-segment-elevation myocardial infarction. However, because clinical experience is limited, we examined the cardioprotective effects of postconditioning, using cardiac MRI in patients treated with PPCI. METHODS AND RESULTS One hundred eighteen p...
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BACKGROUND Ischemic postconditioning (PostC), reperfusion in brief cycles, is known to induce short-term reduction in infarct size in patients with ST elevation myocardial infarction (STEMI), especially among those with large myocardium at risk (MaR). The aim of the present study was to investigate the long-term effect of PostC on infarct size and left ventricular ejection fraction (LVEF). ME...
متن کاملMyocardial conditioning: opportunities for clinical translation.
Myocardial conditioning is an endogenous cardioprotective phenomenon that profoundly limits infarct size in experimental models. The current challenge is to translate this paradigm from the laboratory to the clinic. Accordingly, our goal in this review is to provide a critical summary of the progress toward, opportunities for, and caveats to, the successful clinical translation of postcondition...
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OBJECTIVES Postconditioning has been reported to reduce infarct size in ST-segment myocardial infarction (STEMI). However, recently, few other studies did not show any effect of postconditioning and suggested that it may be even harmful. We sought to assess whether postconditioning could reduce infarct size and improve myocardial reperfusion in early presenters with STEMI. METHODS 72 STEMI pa...
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BACKGROUND Reduction of infarct size by ischemic postconditioning (IPost) has been reported in smaller proof-of-concept clinical studies, but has not been confirmed in other smaller studies. The principle needs to be evaluated in larger groups of ST-elevation myocardial infarction (STEMI) patients before being implemented in clinical practice. This study assessed the effect of ischemic postcodi...
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