he outcome of patients with acute myocardial infarction (MI) has been substantially improved by the introduction of reperfusion therapy and its continuous refinement. Current reperfusion methodology salvages more than 50% of the ischemic myocardium from infarction in approximately half of acute MI patients without cardiogenic shock. 1 However, in 25% of acute MI patients, myocardial salvage by ...

Background Microvascular obstruction is a major problem after reperfusion therapy of AMI. A recent study reported that longitudinal and circumferential strain after reperfusion therapy is an excellent predictor of left ventricular (LV) dysfunction in patients with anterior wall AMI [1,2]. In the current MRI investigation, we adapted a method routinely used in echocardiography for measuring LV, ...

OBJECTIVE To study the relation between resolution of ST segment deviation and infarct size using positron emission tomography. METHODS 45 patients with ST segment elevation acute myocardial infarction treated with thrombolysis or percutaneous coronary intervention were studied prospectively. An ECG was taken before and at (mean (SD)) 100 (45) min after reperfusion therapy. ECGs were analysed...

BACKGROUND Reperfusion therapy for myocardial infarction is hampered by detrimental inflammatory responses partly via Toll-like receptor (TLR) activation. Targeting TLR signaling may optimize reperfusion therapy and enhance cell survival and heart function after myocardial infarction. Here, we evaluated the role of TLR2 as a therapeutic target using a novel monoclonal anti-TLR2 antibody. METH...

BACKGROUND Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence...

There are an estimated 500,000 ST-segment elevation myocardial infarction (STEMI) events in the U.S. annually. Despite improvements in care, up to one-third of patients presenting with STEMI within 12 h of symptom onset still receive no reperfusion therapy acutely. Clinical studies indicate that speed of reperfusion after infarct onset may be more important than whether pharmacologic or mechani...

BACKGROUND Appropriate utilization of acute reperfusion therapy is not a national performance measure for ST-elevation myocardial infarction at this time, and the extent of its contemporary use among ideal patients is unknown. METHODS From the National Registry of Myocardial Infarction, we identified 238,291 patients enrolled from June 1994 to May 2003 who were ideally suited for acute reperf...

There is a growing body of evidence that leukocyte recruitment into inflamed liver sinusoids does not require selectins, with one notable exception being ischemia/reperfusion. In this study we used intravital microscopy to directly visualize the liver microcirculation during ischemia/reperfusion and during localized endotoxemia (LPS superfused on liver). In additional experiments, general anti-...

BACKGROUND AND PURPOSE Controversy exists about the role of perfusion imaging in patient selection for endovascular reperfusion therapy in acute ischemic stroke. We hypothesized that perfusion imaging versus noncontrast CT- based selection would be associated with improved functional outcomes at 3 months. MATERIALS AND METHODS We reviewed consecutive patients with anterior circulation strokes...