Effect of remote ischaemic conditioning on infarct size and remodelling in ST-segment elevation myocardial infarction patients: the CONDI-2/ERIC-PPCI CMR substudy

Rohin Francis, Jun Chong, Manish Ramlall, Chiara Bucciarelli-Ducci, Tim Clayton, Matthew Dodd, Thomas Engstrøm, Richard Evans, Vanessa M Ferreira, Marianna Fontana, John P Greenwood, Rajesh K Kharbanda, Won Yong Kim, Tushar Kotecha, Jacob T Lønborg, Anthony Mathur, Ulla Kristine Møller, James Moon, Alexander Perkins, Roby D RakhitDerek M Yellon, Hans Erik Bøtker, Heerajnarain Bulluck, Derek J Hausenloy

13 Citations (Scopus)

Abstract

The effect of limb remote ischaemic conditioning (RIC) on myocardial infarct (MI) size and left ventricular ejection fraction (LVEF) was investigated in a pre-planned cardiovascular magnetic resonance (CMR) substudy of the CONDI-2/ERIC-PPCI trial. This single-blind multi-centre trial (7 sites in UK and Denmark) included 169 ST-segment elevation myocardial infarction (STEMI) patients who were already randomised to either control (n = 89) or limb RIC (n = 80) (4 × 5 min cycles of arm cuff inflations/deflations) prior to primary percutaneous coronary intervention. CMR was performed acutely and at 6 months. The primary endpoint was MI size on the 6 month CMR scan, expressed as median and interquartile range. In 110 patients with 6-month CMR data, limb RIC did not reduce MI size [RIC: 13.0 (5.1-17.1)% of LV mass; control: 11.1 (7.0-17.8)% of LV mass, P = 0.39], or LVEF, when compared to control. In 162 patients with acute CMR data, limb RIC had no effect on acute MI size, microvascular obstruction and LVEF when compared to control. In a subgroup of anterior STEMI patients, RIC was associated with lower incidence of microvascular obstruction and higher LVEF on the acute scan when compared with control, but this was not associated with an improvement in LVEF at 6 months. In summary, in this pre-planned CMR substudy of the CONDI-2/ERIC-PPCI trial, there was no evidence that limb RIC reduced MI size or improved LVEF at 6 months by CMR, findings which are consistent with the neutral effects of limb RIC on clinical outcomes reported in the main CONDI-2/ERIC-PPCI trial.

Original languageEnglish
Article number59
JournalBasic Research in Cardiology
Volume116
Issue number1
Pages (from-to)59
ISSN0300-8428
DOIs
Publication statusPublished - 14 Oct 2021

Keywords

  • Humans
  • Magnetic Resonance Spectroscopy
  • Myocardial Infarction/diagnostic imaging
  • Percutaneous Coronary Intervention
  • ST Elevation Myocardial Infarction/diagnostic imaging
  • Single-Blind Method
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Function, Left
  • Myocardial infarct size
  • Cardiovascular magnetic resonance
  • Cardioprotection
  • Remote ischaemic conditioning

Fingerprint

Dive into the research topics of 'Effect of remote ischaemic conditioning on infarct size and remodelling in ST-segment elevation myocardial infarction patients: the CONDI-2/ERIC-PPCI CMR substudy'. Together they form a unique fingerprint.

Cite this