Effect of ventricular fibrillation on infarct size after myocardial infarction: a translational study.

Autor: Stevic N; Service de Médecine Intensive -Réanimation, Hospices Civils de Lyon, Hôpital Edouard Herriot, 5 Place d'Arsonval, 69437, Lyon Cedex 03, France.; Faculté de Médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.; INSERM UMR 1060, CarMeN, Lyon, IRIS, France., Pinède A; Service de Médecine Intensive -Réanimation, Hospices Civils de Lyon, Hôpital Edouard Herriot, 5 Place d'Arsonval, 69437, Lyon Cedex 03, France., Mewton N; Faculté de Médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.; INSERM UMR 1060, CarMeN, Lyon, IRIS, France.; Centre d'Investigation Clinique, CIC 1407, Hôpital Louis Pradel, Lyon, France., Ovize M; Faculté de Médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.; INSERM UMR 1060, CarMeN, Lyon, IRIS, France.; Centre d'Investigation Clinique, CIC 1407, Hôpital Louis Pradel, Lyon, France., Argaud L; Service de Médecine Intensive -Réanimation, Hospices Civils de Lyon, Hôpital Edouard Herriot, 5 Place d'Arsonval, 69437, Lyon Cedex 03, France.; Faculté de Médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.; INSERM UMR 1060, CarMeN, Lyon, IRIS, France., Lecour S; Cape Heart Institute, University of Cape Town, Cape Town, South Africa., Boiteux C; Institut de Cardiologie Des Hospices Civils de Lyon, Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel, Lyon, France.; Institut de Cardiologie Des Hospices Civils de Lyon, Service de Rythmologie, Bron, France., Bochaton T; Faculté de Médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.; INSERM UMR 1060, CarMeN, Lyon, IRIS, France.; Institut de Cardiologie Des Hospices Civils de Lyon, Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel, Lyon, France.; Centre d'Investigation Clinique, CIC 1407, Hôpital Louis Pradel, Lyon, France., Cour M; Service de Médecine Intensive -Réanimation, Hospices Civils de Lyon, Hôpital Edouard Herriot, 5 Place d'Arsonval, 69437, Lyon Cedex 03, France. martin.cour@chu-lyon.fr.; Faculté de Médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France. martin.cour@chu-lyon.fr.; INSERM UMR 1060, CarMeN, Lyon, IRIS, France. martin.cour@chu-lyon.fr.; Cape Heart Institute, University of Cape Town, Cape Town, South Africa. martin.cour@chu-lyon.fr.
Jazyk: angličtina
Zdroj: Basic research in cardiology [Basic Res Cardiol] 2024 Dec; Vol. 119 (6), pp. 911-921. Date of Electronic Publication: 2024 Nov 23.
DOI: 10.1007/s00395-024-01091-9
Abstrakt: Ventricular fibrillation (VF)-induced cardiac arrest frequently complicates ST-segment elevation myocardial infarction (STEMI). Although larger infarct sizes (IS) correlate with a higher risk of VF, the influence of VF itself on IS has remained poorly investigated. To address this knowledge gap, we analyzed the effect of VF on IS in patients and two experimental models. From a prospective cohort, 30 STEMI patients with VF were matched 1:2 with STEMI patients without VF on the common determinants of IS. The primary endpoint was IS, assessed using the 48-h area under the curve (AUC) for troponin. We also compared IS in pigs with/without spontaneous VF during STEMI (n = 15/group), and in an isolated rat heart model of myocardial infarction with/without electrically induced VF (n = 7/group). After matching, the patient characteristics, including the area at risk (AR), were similar. IS was 33% lower in the VF group compared to the control group (troponin AUC 1.6 [0.5-3.3] 10 6 arbitrary units vs. 2.4 [0.9-4.1] 10 6 arbitrary units; p < 0.05), but infarct scar size (assessed using MRI and ECG) did not differ between the groups at 1 and 6 months. In both experimental models, IS, expressed as a percentage of AR, was lower (p < 0.05) in the VF group than in the control group. When common determinants of IS are comparable, VF occurring prior to myocardial infarction reperfusion appears to be associated with smaller IS. Nevertheless, this finding, observed under specific experimental conditions and in a highly selected group of patients, was not associated with reduced infarct scar size.Registration (HIBISCUS-STEMI cohort): ClinicalTrials.gov NCT05794022.
Competing Interests: Declarations. Conflict of interests: The authors reports that they have no relationships relevant to the contents of this paper to disclose.
(© 2024. The Author(s).)
Databáze: MEDLINE
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