TY - JOUR
T1 - Effect of remote ischaemic conditioning on infarct size and remodelling in ST-segment elevation myocardial infarction patients
T2 - the CONDI-2/ERIC-PPCI CMR substudy
AU - Francis, Rohin
AU - Chong, Jun
AU - Ramlall, Manish
AU - Bucciarelli-Ducci, Chiara
AU - Clayton, Tim
AU - Dodd, Matthew
AU - Engstrøm, Thomas
AU - Evans, Richard
AU - Ferreira, Vanessa M
AU - Fontana, Marianna
AU - Greenwood, John P
AU - Kharbanda, Rajesh K
AU - Kim, Won Yong
AU - Kotecha, Tushar
AU - Lønborg, Jacob T
AU - Mathur, Anthony
AU - Møller, Ulla Kristine
AU - Moon, James
AU - Perkins, Alexander
AU - Rakhit, Roby D
AU - Yellon, Derek M
AU - Bøtker, Hans Erik
AU - Bulluck, Heerajnarain
AU - Hausenloy, Derek J
N1 - © 2021. The Author(s).
PY - 2021/10/14
Y1 - 2021/10/14
N2 - 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.
AB - 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.
KW - Humans
KW - Magnetic Resonance Spectroscopy
KW - Myocardial Infarction/diagnostic imaging
KW - Percutaneous Coronary Intervention
KW - ST Elevation Myocardial Infarction/diagnostic imaging
KW - Single-Blind Method
KW - Stroke Volume
KW - Treatment Outcome
KW - Ventricular Function, Left
KW - Myocardial infarct size
KW - Cardiovascular magnetic resonance
KW - Cardioprotection
KW - Remote ischaemic conditioning
UR - http://www.scopus.com/inward/record.url?scp=85117300011&partnerID=8YFLogxK
U2 - 10.1007/s00395-021-00896-2
DO - 10.1007/s00395-021-00896-2
M3 - Journal article
C2 - 34648075
VL - 116
SP - 59
JO - Basic Research in Cardiology
JF - Basic Research in Cardiology
SN - 0300-8428
IS - 1
M1 - 59
ER -