Reduction in myocardial infarction by postconditioning in patients during primary coronary angioplasty
- VernacularTitle:心脏缺血后适应减轻急性心肌梗死再灌注损伤临床研究
- Author:
Xinchun YANG
;
Yu LIU
;
Lefeng WANG
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Myocardial reperfusion injury;
Postconditioning
- From:
Chinese Journal of Interventional Cardiology
2003;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the hypothesis that postconditioning during percutaneous transluminal coronary angioplasty (PTCA) would improve cardiac function and reduce infarct size after prolonged reperfusion. Methods Forty-one patients undergoing primary PTCA with acute myocardial infarction were randomized into the control group (n=16) or the postconditioning (n=23) group within 90 minutes after admission. In the control group, no intervention was given at the onset of reperfusion, while in the postconditioning group, three cycles of repetitive angioplasty balloon inflation and deflation was performed within 1 minute after reperfusion. ST segment regression, TIMI flow and blush grade were analyzed for all patients after the procedure. Ejection fraction and infarct size assessed by nuclear imaging were quantified respectively at 7 days after restoration of reperfusion. Results ST segment resolution, TIMI flow and blush grade between the two groups were compatible. Area under the curve of serum CK release during the first 72 hours of reperfusion was significantly reduced in the postconditioning group than that in the control group (58?002 vs 79?787, P=0.04). There was a tendency towards amelioration in ejection fraction in the postconditioning compared with the control group (52.1%?12.9% vs 44.5%?16.7%, P=0.29). Conclusion Postconditioning during PTCA protects the heart against acute myocardial ischemic-reperfusion injury. More importantly, the study indicates that protection with postconditioning is still preserved after an extended reperfusion, suggesting a permanent protection.
