DOI . ORG {
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Title[redir]:
Postconditioning the Human Heart | Circulation
Description:
Background— In animal models, brief periods of ischemia performed just at the time of reperfusion can reduce infarct size, a phenomenon called postconditioning. In this prospective, randomized, controlled, multicenter study, we investigated whether postconditioning may protect the human heart during coronary angioplasty for acute myocardial infarction. Methods and Results— Thirty patients, submitted to coronary angioplasty for ongoing acute myocardial infarction, contributed to the study. Patients were randomly assigned to either a control or a postconditioning group. After reperfusion by direct stenting, control subjects underwent no further intervention, whereas postconditioning was performed within 1 minute of reflow by 4 episodes of 1-minute inflation and 1-minute deflation of the angioplasty balloon. Infarct size was assessed by measuring total creatine kinase release over 72 hours. Area at risk and collateral blood flow were estimated on left ventricular and coronary angiograms. No adverse events occurred in the postconditioning group. Determinants of infarct size, including ischemia time, size of the area at risk, and collateral flow, were comparable between the 2 groups. Area under the curve of creatine kinase release was significantly reduced in the postconditioning compared with the control group, averaging 208 984±26 576 compared with 326 095±48 779 (arbitrary units) in control subjects, ie, a 36% reduction in infarct size. Blush grade, a marker of myocardial reperfusion, was significantly increased in postconditioned compared with control subjects: 2.44±0.17 versus 1.95±0.27, respectively (P<0.05). Conclusions— This study suggests that postconditioning by coronary angioplasty protects the human heart during acute myocardial infarction.
Title[redir]:
Postconditioning the Human Heart | Circulation
Description:
Background— In animal models, brief periods of ischemia performed just at the time of reperfusion can reduce infarct size, a phenomenon called postconditioning. In this prospective, randomized, controlled, multicenter study, we investigated whether postconditioning may protect the human heart during coronary angioplasty for acute myocardial infarction. Methods and Results— Thirty patients, submitted to coronary angioplasty for ongoing acute myocardial infarction, contributed to the study. Patients were randomly assigned to either a control or a postconditioning group. After reperfusion by direct stenting, control subjects underwent no further intervention, whereas postconditioning was performed within 1 minute of reflow by 4 episodes of 1-minute inflation and 1-minute deflation of the angioplasty balloon. Infarct size was assessed by measuring total creatine kinase release over 72 hours. Area at risk and collateral blood flow were estimated on left ventricular and coronary angiograms. No adverse events occurred in the postconditioning group. Determinants of infarct size, including ischemia time, size of the area at risk, and collateral flow, were comparable between the 2 groups. Area under the curve of creatine kinase release was significantly reduced in the postconditioning compared with the control group, averaging 208 984±26 576 compared with 326 095±48 779 (arbitrary units) in control subjects, ie, a 36% reduction in infarct size. Blush grade, a marker of myocardial reperfusion, was significantly increased in postconditioned compared with control subjects: 2.44±0.17 versus 1.95±0.27, respectively (P<0.05). Conclusions— This study suggests that postconditioning by coronary angioplasty protects the human heart during acute myocardial infarction.
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Keywords {🔍}
myocardial, coronary, crossref, postconditioning, hopital, reperfusion, size, google, scholar, pubmed, patients, lyon, circulation, infarct, grade, postconditioned, heart, infarction, control, group, study, performed, risk, angioplasty, time, area, acute, release, blush, ischemic, hours, preconditioning, artery, view, reflow, flow, left, ptca, ventricular, ami, stsegment, acs, article, phd, clinical, angiography, ischemia, minute, ischemiareperfusion, timi,
Topics {✒️}
aha/asa scientific statements author jean-françois aupetit phosphatidylinositol 3-kinase-akt pathway author xavier andré-fouët share previous article american heart association jean-françois aupetit xavier andré-fouët hôpital du bocage supplements download pdf phosphatidylinositol-3-kinase signal transduction american heart journal early st-segment resolution end-diastolic circumference divided maximal st-segment change maximal st-segment elevation st-elevation myocardial infarction international heart journal maximal st-segment shift author notes correspondence st-segment elevation recovery red ™ aha technetium-99m sestamibi imaging submit main content advertisement author gérard finet jean-luc fellahi american journal ethics committee trend rabbits end-diastolic perimeter myocardial ischemia-reperfusion injury hôpital cardiologique article recently published creatine kinase release discussion acknowledgments references 1 references inhibiting ros generation mitochondrial calcium concentrations heart failure stroke wall motion abnormality international users arteriosclerosis results— thirty patients early contrast ventriculography acute myocardial infarction download pdf international journal
Questions {❓}
- Does reperfusion injury exist in humans?
- Inhibiting mitochondrial permeability transition pore opening : a new paradigm for myocardial preconditioning?
- Myocardial reperfusion, limitation of infarct size, reduction of left ventricular dysfunction and improved survival: should the paradigm be expanded?
- Myocardial reperfusion: a double-edged sword ?
- Previous angina alters in-hospital outcome in TIMI 4: a clinical correlate to preconditioning?
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