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Influence of ischemic postconditioning on myocardial dysfunction measured by speckle tracking echocardiography in patients with ST-elevation myocardial infarction

      Timely performed reperfusion and adjuvant drug therapy are essential in the treatment of acute ST elevation myocardial infarction (STEMI). Reperfusion of the infarct-related artery (IRA) may, paradoxically, result in further injury of the ischemic myocardium by mechanisms collectively termed ischemia/reperfusion (I/R) injury [
      • Yellon D.M.
      • Hausenloy D.J.
      Myocardial reperfusion injury.
      ]. Cardioprotection by ischemic postconditioning (IPost), performed by interrupted blood-flow to the ischemic myocardium at the time of reperfusion, has shown diverging effects on measures of infarct size and left ventricular (LV) function in clinical trials [
      • Abdelnoor M.
      • Sandven I.
      • Limalanathan S.
      • Eritsland J.
      Postconditioning in ST-elevation myocardial infarction: a systematic review, critical appraisal, and meta-analysis of randomized clinical trials.
      ]. Previous studies have shown good correlation between myocardial strain measured by 2-dimensional (2-D) speckle tracking echocardiography and infarct size and LV function [
      • Munk K.
      • Andersen N.H.
      • Terkelsen C.J.
      • et al.
      Global left ventricular longitudinal systolic strain for early risk assessment in patients with acute myocardial infarction treated with primary percutaneous intervention.
      ]. Furthermore, post-systolic shortening has been suggested to be associated with ischemic segments with potential for recovery in patients with non-STEMI [
      • Eek C.
      • Grenne B.
      • Brunvand H.
      • et al.
      Postsystolic shortening is a strong predictor of recovery of systolic function in patients with non-ST-elevation myocardial infarction.
      ]. However, little is known about a possible effect of IPost on myocardial strain in the acute stage of STEMI.

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      References

        • Yellon D.M.
        • Hausenloy D.J.
        Myocardial reperfusion injury.
        N. Engl. J. Med. 2007; 357: 1121-1135
        • Abdelnoor M.
        • Sandven I.
        • Limalanathan S.
        • Eritsland J.
        Postconditioning in ST-elevation myocardial infarction: a systematic review, critical appraisal, and meta-analysis of randomized clinical trials.
        Vasc. Health Risk Manag. 2014; 10: 477-491
        • Munk K.
        • Andersen N.H.
        • Terkelsen C.J.
        • et al.
        Global left ventricular longitudinal systolic strain for early risk assessment in patients with acute myocardial infarction treated with primary percutaneous intervention.
        J. Am. Soc. Echocardiogr. 2012; 25: 644-651
        • Eek C.
        • Grenne B.
        • Brunvand H.
        • et al.
        Postsystolic shortening is a strong predictor of recovery of systolic function in patients with non-ST-elevation myocardial infarction.
        Eur. J. Echocardiogr. 2011; 12: 483-489
        • Limalanathan S.
        • Andersen G.Ø.
        • Hoffmann P.
        • Kløw N.E.
        • Abdelnoor M.
        • Eritsland J.
        Effect of ischemic postconditioning on infarct size in patients with ST-elevation myocardial infarction treated by primary PCI, results of the POSTEMI randomized trial.
        J. Am. Heart Assoc. 2014; 23: e000679
        • Kukulski T.
        • Jamal F.
        • Herbots L.
        • et al.
        Identification of acutely ischemic myocardium using ultrasonic strain measurements. A clinical study in patients undergoing coronary angioplasty.
        J. Am. Coll. Cardiol. 2003; 5: 810-819
        • Limalanathan S.
        • Andersen G.Ø.
        • Hoffmann P.
        • Kløw N.E.
        • Abdelnoor M.
        • Eritsland J.
        Rationale and design of the POSTEMI (POstconditioning in ST-Elevation Myocardial Infarction) Study.
        Cardiology. 2010; 116: 103-109
        • Brown M.A.
        • Norris R.M.
        • Takayama M.
        • White H.D.
        Post-systolic shortening: a marker of potential for early recovery of acutely ischaemic myocardium in the dog.
        Cardiovasc. Res. 1987; 21: 703-716
        • Terkelsen C.J.
        • Poulsen S.H.
        • Nørgaard B.L.
        • et al.
        Does postsystolic motion or shortening predict recovery of myocardial function after primary percutaneous coronary intervention?.
        J. Am. Soc. Echocardiogr. 2007; 20: 505-511
        • Dalen H.
        • Thorstensen A.
        • Aase S.A.
        • et al.
        Segmental and global longitudinal strain and strain rate based on echocardiography of 1266 healthy individuals: the HUNT study in Norway.
        Eur. J. Echocardiogr. 2010; 11: 176-183