Effect of cyclosporine on left ventricular remodeling after reperfused myocardial infarction
Nathan Mewton, Pierre Croisille, Gerald Gahide, Gilles Rioufol, Eric Bonnefoy, Ingrid Sanchez, Thien Tri Cung, Catherine Sportouch, Denis Angoulvant, Gérard Finet, Xavier André-Fouët, Geneviève Derumeaux, Christophe Piot, Hélène Vernhet, Didier Revel, Michel Ovize, Nathan Mewton, Pierre Croisille, Gerald Gahide, Gilles Rioufol, Eric Bonnefoy, Ingrid Sanchez, Thien Tri Cung, Catherine Sportouch, Denis Angoulvant, Gérard Finet, Xavier André-Fouët, Geneviève Derumeaux, Christophe Piot, Hélène Vernhet, Didier Revel, Michel Ovize
Abstract
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).
Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Source: PubMed