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Basic Research in Cardiology

, 108:383 | Cite as

Postconditioning attenuates no-reflow in STEMI patients

  • Nathan MewtonEmail author
  • Hélène Thibault
  • François Roubille
  • Olivier Lairez
  • Gilles Rioufol
  • Catherine Sportouch
  • Ingrid Sanchez
  • Cyrille Bergerot
  • Thien Tri Cung
  • Gérard Finet
  • Denis Angoulvant
  • Didier Revel
  • Eric Bonnefoy-Cudraz
  • Meyer Elbaz
  • Christophe Piot
  • Inesse Sahraoui
  • Pierre Croisille
  • Michel Ovize
Original Contribution

Abstract

After acute myocardial infarction, the presence of no-reflow (or microvascular obstruction: MVO) has been associated with adverse left ventricular (LV) remodeling and worse clinical outcome. This study examined the effects of mechanical ischemic postconditioning on early and late MVO size in acute ST-elevation myocardial infarction (STEMI) patients. Fifty patients undergoing primary coronary angioplasty for a first STEMI with TIMI grade flow 0–1 and no collaterals were randomized to ischemic postconditioning (PC) (n = 25) or control (n = 25) groups. Ischemic PC consisted in the application of four consecutive cycles of a 1-min balloon occlusion, each followed by a 1-min deflation at the onset of reperfusion. Early (3 min post-contrast) and late (10 min post-contrast) MVO size were assessed by contrast-enhanced cardiac-MRI within 96 h after reperfusion. PC was associated with smaller early and late MVO size (3.9 ± 4.8 in PC versus 7.8 ± 6.6 % of LV in controls for early MVO, P = 0.02; and 1.8 ± 3.1 in PC versus 4.1 ± 3.9 % of LV in controls for late MVO; P = 0.01). This significant reduction was persistent after adjustment for thrombus aspiration, which neither had any significant effect on infarct size, nor on early or late MVO (P = NS for all). Attenuation of MVO was associated to infarct size reduction. Mechanical postconditioning significantly reduces MVO in patients with acute STEMI treated with primary angioplasty.

Keywords

Magnetic resonance imaging Microvascular obstruction Reperfusion injury ST-elevation myocardial infarction Postconditioning 

Notes

Acknowledgments

The authors wish to express their sincere acknowledgements to all the research coordinators, nurses and catheterization laboratory staff in the different centers for their help on the screening, enrollment and data collection of participants. This project was supported by a research grant from the Hospices Civils de Lyon (Appel d’Offre HCL Actions Incitatives 2007). Dr. Hélène Thibault was supported by a joint research grant from the French Federation of Cardiology and the French Society of Cardiology (Dotations de Recherche Communes) for this project.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Nathan Mewton
    • 1
    • 5
    • 6
    • 8
    Email author
  • Hélène Thibault
    • 1
    • 5
  • François Roubille
    • 3
    • 4
  • Olivier Lairez
    • 2
  • Gilles Rioufol
    • 1
  • Catherine Sportouch
    • 3
    • 4
  • Ingrid Sanchez
    • 1
    • 6
  • Cyrille Bergerot
    • 1
  • Thien Tri Cung
    • 3
    • 4
  • Gérard Finet
    • 1
  • Denis Angoulvant
    • 7
  • Didier Revel
    • 6
  • Eric Bonnefoy-Cudraz
    • 1
  • Meyer Elbaz
    • 2
  • Christophe Piot
    • 3
    • 4
  • Inesse Sahraoui
    • 1
  • Pierre Croisille
    • 6
  • Michel Ovize
    • 1
    • 5
  1. 1.Cardiology Division, Centre d’Investigation Clinique de Lyon (CIC)Groupement Hospitalier Est, Hôpital Louis Pradel, Hospices Civils de LyonBronFrance
  2. 2.Service de Cardiologie, Hôpital RangueilUniversité Paul SabatierToulouseFrance
  3. 3.INSERM U661MontpellierFrance
  4. 4.Hôpital Arnaud de VilleneuveUniversité de Montpellier I and IIMontpellierFrance
  5. 5.INSERM UMR-1060, CarMeN Laboratory, Faculté de Médecine Lyon EstUniversité Claude Bernard Lyon1LyonFrance
  6. 6.CREATIS-LRMN, CNRS UMR 5220, INSERM U630Université Claude Bernard Lyon 1VilleurbanneFrance
  7. 7.Centre Hospitalier Universitaire de Tours, Hôpital TrousseauUniversité François RabelaisToursFrance
  8. 8.Hôpital Louis PradelLyon Cedex 03France

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