Long Term Follow Up and Outcome of Left Ventricular Remodeling in ST Segment Myocardial Infarction Patients After pPCI

NCT ID: NCT03888781

Last Updated: 2019-03-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

127 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-05-01

Study Completion Date

2020-06-30

Brief Summary

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* To detect long-term effects of left ventricular remodeling in STEMI patients undergoing PPCI.
* And to evaluate outcome.

Detailed Description

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Acute myocardial infarction (AMI) with its accompanying adverse sequelae remains one of the most common causes of morbidity and mortality in the world .

Reperfusion therapy is by far the most important therapy for the treatment of acute MI. Reperfusion of the ischemic myocardium reduces the infarct size and improves left ventricular function, both of which contribute to an improved clinical outcome in patients with acute MI .

Using primary PCI has reduced the mortality of patients with acute MI . However, the increased survival rate resulted in the increased incidence of cardio vascular events mainly due to LV remodeling and congestive heart failure .

Post-infarct ventricular remodeling develops in about 30% of patients with a history of myocardial infarction. Ventricular remodeling is a predictor of heart failure and for this reason it assumes a negative prognostic value .

Left ventricular remodeling after ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention is a major determinant for the short-term and long-term clinical outcomes . Adverse left ventricular remodeling refers to alterations in ventricular architecture involving both the infarcted and non-infarcted zones leading to progressive increase in systolic and diastolic left ventricular volumes.

Left ventricular remodeling following a ST-segment elevated myocardial infarction (STEMI) is an adaptive response to maintain the cardiac output despite myocardial tissue loss. Limited studies have evaluated long term ventricular function after STEMI.

Left Ventricular remodeling, both positive and negative, is an ongoing process and continues at least up to 2 years after STEMI, involving the infarct zone and remote zones. Long-term left ventricular ejection fraction (LVEF) deterioration is characterized by an increase in end-systolic volume and less wall thickening in the remote zones. Patients with long-term LVEF improvement exhibit an increase in left ventricular wall thickening both in the transmural infarct and remote zones. For elucidation of long term effects of left ventricular remodeling, the current study is conducted.

Conditions

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Left Ventricle Remodeling

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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With Left Ventricular Remodeling

By Echocardiography

Echocardiography

Intervention Type DEVICE

An echocardiogram (also called an echo) is a type of ultrasound test that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of your heart. These echoes are turned into moving pictures of your heart that can be seen on a video screen.

Without Left Ventricular Remodeling

By Echocardiography

Echocardiography

Intervention Type DEVICE

An echocardiogram (also called an echo) is a type of ultrasound test that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of your heart. These echoes are turned into moving pictures of your heart that can be seen on a video screen.

Interventions

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Echocardiography

An echocardiogram (also called an echo) is a type of ultrasound test that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of your heart. These echoes are turned into moving pictures of your heart that can be seen on a video screen.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* All patients were treated successfully by primary PCI more than 2 years ago within 12 hours of onset of chest pain or up to 24 hour of onset of chest pain if there was ongoing ischemia at Assiut University Cardiac Hospital Cath. lab.

Exclusion Criteria

* Patients with clinical manifestations of acute heart failure or cardiogenic shock at presentation.
* Significant Mitral regurgitation or valve disease.
* Patients with permanent pacemaker insertion.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Yara Amir Adly Eskander

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Yara Amir, Resident Dr

Role: CONTACT

+201064010505

Hamdy Shams-eddin Mohammad, Assistant Pr

Role: CONTACT

+201065601161

References

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Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Nichol G, Paynter NP, Schreiner PJ, Sorlie PD, Stein J, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation. 2013 Jan 1;127(1):e6-e245. doi: 10.1161/CIR.0b013e31828124ad. Epub 2012 Dec 12. No abstract available.

Reference Type BACKGROUND
PMID: 23239837 (View on PubMed)

Rossini R, Senni M, Musumeci G, Ferrazzi P, Gavazzi A. Prevention of left ventricular remodelling after acute myocardial infarction: an update. Recent Pat Cardiovasc Drug Discov. 2010 Nov;5(3):196-207. doi: 10.2174/157489010793351999.

Reference Type BACKGROUND
PMID: 20874671 (View on PubMed)

Lunde K, Solheim S, Aakhus S, Arnesen H, Abdelnoor M, Egeland T, Endresen K, Ilebekk A, Mangschau A, Fjeld JG, Smith HJ, Taraldsrud E, Grogaard HK, Bjornerheim R, Brekke M, Muller C, Hopp E, Ragnarsson A, Brinchmann JE, Forfang K. Intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction. N Engl J Med. 2006 Sep 21;355(12):1199-209. doi: 10.1056/NEJMoa055706.

Reference Type BACKGROUND
PMID: 16990383 (View on PubMed)

Flachskampf FA, Schmid M, Rost C, Achenbach S, DeMaria AN, Daniel WG. Cardiac imaging after myocardial infarction. Eur Heart J. 2011 Feb;32(3):272-83. doi: 10.1093/eurheartj/ehq446. Epub 2010 Dec 16.

Reference Type BACKGROUND
PMID: 21163851 (View on PubMed)

St John Sutton M, Pfeffer MA, Moye L, Plappert T, Rouleau JL, Lamas G, Rouleau J, Parker JO, Arnold MO, Sussex B, Braunwald E. Cardiovascular death and left ventricular remodeling two years after myocardial infarction: baseline predictors and impact of long-term use of captopril: information from the Survival and Ventricular Enlargement (SAVE) trial. Circulation. 1997 Nov 18;96(10):3294-9. doi: 10.1161/01.cir.96.10.3294.

Reference Type BACKGROUND
PMID: 9396419 (View on PubMed)

Opie LH, Commerford PJ, Gersh BJ, Pfeffer MA. Controversies in ventricular remodelling. Lancet. 2006 Jan 28;367(9507):356-67. doi: 10.1016/S0140-6736(06)68074-4.

Reference Type BACKGROUND
PMID: 16443044 (View on PubMed)

Cohn JN, Ferrari R, Sharpe N. Cardiac remodeling--concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling. Behalf of an International Forum on Cardiac Remodeling. J Am Coll Cardiol. 2000 Mar 1;35(3):569-82. doi: 10.1016/s0735-1097(99)00630-0.

Reference Type BACKGROUND
PMID: 10716457 (View on PubMed)

Other Identifiers

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Long Term LV Remodeling

Identifier Type: -

Identifier Source: org_study_id

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