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Updated: Nov 17, 2025
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Door-to-unload: left ventricular unloading before reperfusion in ST-elevation myocardial infarction
Malav J Parikh1, Karl H Schuleri2, Anjan K Chakrabarti2
1Spectrum Health, Frederik Meijer Heart & Vascular Institute, 100 Michigan Street NE, Grand Rapids, MI 49503, USA.
Insights
Reducing heart attack damage may be possible by unloading the left ventricle before reperfusion. This approach aims to decrease infarct size and improve outcomes for ST-elevation myocardial infarction patients.
Area of Science:
- Cardiology
- Cardiovascular Research
- Acute Myocardial Infarction
Background:
- Modern ST-elevation myocardial infarction (STEMI) treatment prioritizes rapid reperfusion to limit infarct size and improve survival.
- Despite advancements in reducing door-to-balloon times, heart failure incidence post-myocardial infarction remains a significant clinical challenge.
- Preclinical research suggests that left ventricular unloading prior to reperfusion may mitigate myocardial damage.
Purpose of the Study:
- To investigate the efficacy of pre-reperfusion left ventricular unloading in reducing infarct size in STEMI patients.
- To evaluate the impact of left ventricular unloading on heart failure-related events compared to standard care.
Main Methods:
- The DTU-STEMI trial is a randomized prospective study.
- Participants will be randomized to either left ventricular unloading for at least 30 minutes before coronary reperfusion or current standard of care.
Main Results:
- This section is to be filled upon study completion.
Conclusions:
- This section is to be filled upon study completion.
Abstract:
ST-elevation myocardial infarction treatment in the modern era has focused on minimizing time of ischemia by reducing door-to-balloon time to limit infarct size and improve survival. Although there have been significant improvements in minimizing time to coronary reperfusion, the incidence of heart failure following a myocardial infarction has remained high. Preclinical studies have shown that unloading the left ventricle for 30 min prior to coronary reperfusion can reduce infarct size and promote myocardial recovery. The DTU-STEMI randomized prospective trial will test the hypothesis that left ventricular unloading for at least 30 min prior to coronary reperfusion will improve infarct size and heart failure-related events as compared with the current standard of care.
