Efforts to limit the size of myocardial infarcts.
Throughout the last decade, multiple interventions have been shown to decrease myocardial ischemic injury and limit infarct size in animal models of acute myocardial infarction. Results of pilot studies have suggested that some of these interventions may also have beneficial effects in humans with evolving myocardial infarction. This review focuses on the rationale for limiting infarct size, efficacy of methods for estimating size of infarcts, and current clinical data on specific intervention therapy. No intervention has yet been proved sufficiently efficacious to warrant its routine clinical use. However, treatment with beta-adrenergic blockers, intravenous nitroglycerin, and hyaluronidase has been shown to affect one or more indexes of infarct size in patients with acute myocardial infarction. Large, randomized clinical trials of these and other promising interventions are underway and will provide data on whether infarct size can be limited in humans and whether residual cardiac function and patient prognosis can thereby be improved.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003402:Creatine Kinase / Q000032:analysis; D004562:Electrocardiography; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007423:Intra-Aortic Balloon Pumping; D007527:Isoenzymes; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D005996:Nitroglycerin / Q000627:therapeutic use; D010100:Oxygen / Q000627:therapeutic use; D010477:Perfusion; D011188:Potassium / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000893:Anti-Inflammatory Agents; D005343:Fibrinolytic Agents; D007328:Insulin; D007527:Isoenzymes; D014665:Vasodilator Agents; D003402:Creatine Kinase; D006821:Hyaluronoglucosaminidase; D005996:Nitroglycerin; D005947:Glucose; D011188:Potassium; D010100:Oxygen