ST-Segment Elevated Myocardial Infarction
Conditions
Keywords
ST-Segment Elevated Myocardial Infarction, rhBNP, non-invasive myocardial work
Brief summary
The study intends to evaluate the efficacy of early rhBNP on myocardial work in patients with anterior ST-segment elevation myocardial infarction after percutaneous coronary intervention
Interventions
DRUGrhBNP
rhBNP intra-coronary injection 1.5 ug/kg loading dose, with intravenous injection 0.0075-0.01 ug/kg/min persistent for 72 hour.
DRUGControl
Saline intra-coronary injection 0.15ml/kg loading dose, with same intravenous injection speed for 72 hour.
Sponsors
RenJi Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* 1\. Anterior myocardial infarct (anterior myocardial infarct is defined as persistent chest pain for 30 mins at least, with ST-segment elevation of at least 0.2 mV in two or more contiguous precordial leads) within 12 hours after onsets of symptom; 2\. No contraindication for rhBNP; 3\. Left anterior descending (LAD) as culprit vessel, with TIMI 0-1 grade.
Exclusion criteria
* 1.Cardiogenic shock (systolic BP \<90mmHg after fluid infusion or systolic BP\<100mmHg after vasoactive drugs); 2\. History of myocardial infarct; 3.Severe arrhythmia: with III degree A-V block ,atrial fibrillation,ventricular fibrillation,ventricular tachycardia; 4\. Any history of severe renal or hepatic dysfunction (hepatic failure, cirrhosis, portal hypertension or active hepatitis); neutropenia or thrombocytopenia; known acute pancreatitis; 5\. Pregnant or lactating; 6\. life expectancy≤12 months; 7\. Inability to follow the protocol and comply with follow-up requirements or any other reason the investigator feels would place the patient at increased risk;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Global myocardial work efficiency by echocardiography | 30 days after PCI | Echocardial myocardial work (MW) may identify early abnormalities in left ventricular(LV) function and may establish a more sensitive index for early stage LV dysfunction.Global MW was quantified by calculating the rate of regional shortening by differentiation of the strain tracing and multiplying by instantaneous LV pressure. This instantaneous measure of power was this integrated over time to measure MW as a function of time during systole (time interval from mitral valve closure through to mitral valve opening). During LV ejection, segments were analyzed for wasted work (WW) and/or constructive work (CW), with global values determined as the averages of all segmental values and displayed on the LV pressure-strain loop diagram. Global myocardial work efficiency (GWE; %), constructive MW divided by the sum of CW and WW, expressed as a percentage. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Global myocardial work index by echocardiography | Day 1, 7, 30 after PCI | Global myocardial work index (GWI): total work within the area of the LV PSL calculated frommitral valve closure to mitral valve opening. |
| Global myocardial constructive work by echocardiography | Day 1, 7, 30 after PCI | Global myocardial constructive work (mm Hg %), an estimate of the work performed by the LV segments consisting of shortening during systole plus lengthening in isovolumic relaxation. |
| Global myocardial waste work by echocardiography | Day 1, 7, 30 after PCI | Global myocardial waste work (mm Hg %), an estimate of negative work of the LV segments consisting of myocardial lengthening during systole plus any shortening during isovolumic relaxation. |
| Clinical Outcomes | 30 days after PCI | Compound endpoints of all cause death, non-fatal reinfarction, heart failure, and stroke; |
Contacts
Primary ContactSong Ding, MD,Ph.D.
Outcome results
None listed