期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 55, 期 12, 页码 1200-1205出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2009.10.052
关键词
acute myocardial infarction; cyclosporine; remodeling; magnetic resonance imaging
资金
- French Federation of Cardiology (Federation Francaise de Cardiologie)
Objectives This study examined the effect of a single dose of cyclosporine administered at the time of reperfusion on left ventricular (LV) remodeling and function by cardiac magnetic resonance 5 days and 6 months after myocardial infarction. Background In a human study, administration of cyclosporine at the time of acute reperfusion was associated with a smaller infarct size. Methods Twenty-eight patients of the original cyclosporine study had an acute (at 5 days) and a follow-up (at 6 months) cardiac magnetic resonance study to determine LV volumes, mass, ejection fraction, myocardial wall thickness in infarcted and remote noninfarcted myocardium, and infarct size. Results There was a persistent reduction in infarct size at 6 months in the cyclosporine group compared with the control group of patients (29 +/- 15 g vs. 38 +/- 14 g; p = 0.04). There was a significant reduction of LV end-systolic volume (and a trend for LV end-diastolic volume; p = 0.07) in the cyclosporine group compared with the control group, both at 5 days and 6 months after infarction. There was no significant difference between the 2 groups in either global LV mass or regional wall thickness of the remote noninfarcted myocardium at 5 days or 6 months. Attenuation of LV dilation and improvement of LV ejection fraction by cyclosporine at 6 months were correlated with infarct size reduction. Conclusions Cyclosporine used at the moment of acute myocardial infarction reperfusion persistently reduces infarct size and does not have a detrimental effect on LV remodeling. These results are preliminary and must be supported by further studies. (Ciclosporin A and Acute Myocardial Infarction; NCT00403728) (J Am Coll Cardiol 2010; 55: 1200-5) (C) 2010 by the American College of Cardiology Foundation
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