End-systolic volume index at 90 to 180 minutes into reperfusion therapy for acute myocardial infarction is a strong predictor of early and late mortality. The Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-I Angiographic Investigators

Migrino, Raymond Q.; Young, James B.; Ellis, Stephen G.; White, Harvey D.; Lundergan, Conor F.; Miller, Dave P.; Granger, Christopher B.; Ross, Allan M.; Califf, Robert M.; Topol, Eric J.

doi:10.1161/01.cir.96.1.116

Cited by 160 publications

(80 citation statements)

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“…This is a significant effect because one of the most important predictors of mortality in patients with MI is the degree of LV systolic dilatation. 21 Wall et al 6 recently presented computational models that suggest that the injection of passive materials alone may improve ejection fraction and reduce wall stress in the ventricle. Returning wall stress closer to its normal value might improve the stress-induced changes in the electric and mechanical properties of myocytes.…”

Section: Discussionmentioning

confidence: 99%

Effect of Injectable Alginate Implant on Cardiac Remodeling and Function After Recent and Old Infarcts in Rat

et al. 2008

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Background-Adverse cardiac remodeling and progression of heart failure after myocardial infarction are associated with excessive and continuous damage to the extracellular matrix. We hypothesized that injection of in situ-forming alginate hydrogel into recent and old infarcts would provide a temporary scaffold and attenuate adverse cardiac remodeling and dysfunction. Methods and Results-We developed a novel absorbable biomaterial composed of calcium-crosslinked alginate solution, which displays low viscosity and, after injection into the infarct, undergoes phase transition into hydrogel. To determine the outcome of the biomaterial after injection, calcium-crosslinked biotin-labeled alginate was injected into the infarct 7 days after anterior myocardial infarction in rat. Serial histology studies showed in situ formation of alginate hydrogel implant, which occupied up to 50% of the scar area. The biomaterial was replaced by connective tissue within 6 weeks. Serial echocardiography studies before and 60 days after injection showed that injection of alginate biomaterial into recent (7 days) infarct increased scar thickness and attenuated left ventricular systolic and diastolic dilatation and dysfunction. These beneficial effects were comparable and sometimes superior to those achieved by neonatal cardiomyocyte transplantation. Moreover, injection of alginate biomaterial into old myocardial infarction (60 days) increased scar thickness and improved systolic and diastolic dysfunction. Conclusions-We show for the first time that injection of in situ-forming, bioabsorbable alginate hydrogel is an effective acellular strategy that prevents adverse cardiac remodeling and dysfunction in recent and old myocardial infarctions in rat.

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Section: Discussionmentioning

confidence: 99%

Effect of Injectable Alginate Implant on Cardiac Remodeling and Function After Recent and Old Infarcts in Rat

et al. 2008

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“…28) LVESV is known to be a very strong predictor of life expectancy, morbidity and mortality after AMI, coronary artery disease, and ischemic cardiomyopathy. 2,11,[29][30][31] In this study, left ventricle volumes were measured within 24 hours and 3 months after AMI. Initial left ventricle volumes were significantly higher than the healthy control group, and they were still high in the 3rd month measurements as well.…”

Section: Discussionmentioning

confidence: 99%

Correlation of the Tei Index With Left Ventricular Dilatation and Mortality in Patients With Acute Myocardial Infarction

Uzunhasan

Okçun

et al. 2006

Int. Heart J.

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SUMMARYThe Tei index is an echocardiographic index of combined systolic and diastolic function, calculated as isovolumetric relaxation time plus isovolumetric contraction time divided by ejection time. The aim of this study was to define the correlation of the Tei index with left ventricular dilatation and mortality in patients with acute myocardial infarction (AMI).A total of 77 patients (58 men, 19 women) with a mean age of 53 ± 12 years, who had presented with an AMI in our clinic between June 2001 and February 2002 were compared with a control group of 88 healthy subjects (63 men, 25 women) with a mean age of 55 ± 6 years. Echocardiographic evaluation was carried out within 24 hours and the third month of AMI, using a 3.5 MHz probe with pulse wave Doppler recordings by the adult cardiac mode of an Acuson C 256 echocardiograph.There were statistically significant differences between the 2 groups in all echocardiographic parameters, except mitral A wave. Thirteen patients died during the follow-up period of 3 months. The Tei index was significantly higher in the patients who died compared with those who survived (0.70 ± 0.10 versus 0.61 ± 0.10; P < 0.001). The patients who had heart failure after AMI had a mean Tei index value of 0.76 ± 0.27, whereas the patients who did not have heart failure after AMI had a significantly lower Tei index value of 0.60 ± 0.32 (P < 0.05). Patients were divided into 2 groups according to their Tei index. Patients with a > 0.60 Tei index had significantly higher end-systolic and enddiastolic volumes compared to patients with a < 0.60 Tei index (P < 0.001 for both) in the acute phase of AMI. Within 3 months, patients with a Tei index < 0.60 had a significant reduction in end-diastolic volumes (P < 0.01), whereas the end-diastolic volumes did not change significantly in patients with an index > 0.60 (P = 0.19).The Tei index is an important indicator of left ventricular dysfunction and death after AMI. A greater Tei index at the onset of AMI is associated with a higher incidence of subsequent cardiac death, CHF, and progressive LV remodeling. (Int Heart J 2006; 47: 331-342)

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“…22 In addition to EF, LV volume has been shown to be an important predictor of survival in CHF and after myocardial infarction, 23,24 and a relation between attenuation of remodeling and clinical benefit has been observed in CHF patients. 23 The beneficial effect of thalidomide on LV remodeling, as assessed by the increased LVEF and decreased LVEDV, may therefore be clinically important.…”

Section: Discussionmentioning

confidence: 99%

Effect of Thalidomide on Cardiac Remodeling in Chronic Heart Failure

Gullestad¹,

Ueland²,

Fjeld³

et al. 2005

Circulation

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Background-Inflammation and matrix degradation may play a pathogenic role in chronic heart failure (CHF), and therefore, we examined whether thalidomide, a drug with potential immunomodulating and matrix-stabilizing properties, could improve left ventricular (LV) function in patients with CHF secondary to idiopathic dilated cardiomyopathy (IDCM) or coronary artery disease (CAD). Methods and Results-Fifty-six patients with CHF and an LV ejection fraction (LVEF) Ͻ40% who were already on optimal conventional cardiovascular treatment were randomized to thalidomide (25 mg QD increasing to 200 mg QD) or placebo and followed up for 12 weeks. Our main findings were as follows: (1) During thalidomide treatment but not during placebo, there was a marked increase in LVEF (Ϸ7 EF units) along with a significant decrease in LV end-diastolic volume and heart rate. (2) This improvement in LVEF was accompanied by a decrease in matrix metalloproteinase-2 without any changes in its endogenous tissue inhibitor, suggesting a matrix-stabilizing net effect.(3) Thalidomide also induced a decrease in total neutrophil count and an increase in plasma levels of tumor necrosis factor-␣, suggesting both proinflammatory and antiinflammatory effects. (4) The effect of thalidomide on LVEF was more marked in IDCM than in CAD, possibly partly reflecting that the former group was able to tolerate a higher thalidomide dosage. Conclusions-Although our results must be confirmed in larger studies that also examine the effects on morbidity and mortality, our findings suggest a role for thalidomide in the management of CHF in addition to traditional cardiovascular medications. (Circulation. 2005;112:3408-3414.)

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End-systolic volume index at 90 to 180 minutes into reperfusion therapy for acute myocardial infarction is a strong predictor of early and late mortality. The Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-I Angiographic Investigators

Cited by 160 publications

References 0 publications

Effect of Injectable Alginate Implant on Cardiac Remodeling and Function After Recent and Old Infarcts in Rat

Effect of Injectable Alginate Implant on Cardiac Remodeling and Function After Recent and Old Infarcts in Rat

Correlation of the Tei Index With Left Ventricular Dilatation and Mortality in Patients With Acute Myocardial Infarction

Effect of Thalidomide on Cardiac Remodeling in Chronic Heart Failure

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