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Updated: Aug 10, 2025
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Effect of remote ischaemic conditioning on left ventricular function in ST-segment elevation myocardial infarction
Gregory Wood1,2, Pia Hedegaard Johnsen1,2, Anders Lehmann Dahl Pedersen1,2
1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Insights
Remote ischaemic conditioning (RIC) did not improve left ventricular function in ST-elevation myocardial infarction patients after primary percutaneous coronary intervention. This study found no significant difference in cardiac function metrics between RIC and standard care groups.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Remote ischaemic conditioning (RIC) reduces myocardial infarct size in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI).
- The impact of RIC on left ventricular ejection fraction (LVEF) after infarct healing is not well understood.
Purpose of the Study:
- To evaluate if pre-hospital RIC improves left ventricular (LV) function in STEMI patients three months post-infarction.
- To assess the efficacy of RIC as an adjunct therapy in STEMI management.
Main Methods:
- Echocardiography assessed LVEF, LV volumes, and global longitudinal strain (GLS) in 694 patients from the CONDI-2 study.
- Measurements were taken a median of 112 days post-admission using standardized echocardiographic techniques.
Main Results:
- No significant differences were observed in LVEF, LV GLS, or LV volumes between the RIC and control groups.
- 32% of controls and 37% of the RIC group had an ejection fraction < 50% (p=0.129).
Conclusions:
- RIC, when used as an adjunct to PPCI, did not demonstrate a significant improvement in echocardiographic measures of cardiac function.
- This large randomized imaging study suggests RIC does not alter cardiac function compared to PPCI alone in STEMI patients.
Background:
Remote ischaemic conditioning (RIC) applied to the arm by inflation and deflation of a pneumatic cuff has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (PPCI). However, the effect of RIC on left ventricular ejection fraction (LVEF) following infarct healing remains unknown.
Objective:
To investigate whether RIC applied in the ambulance before PPCI can improve left ventricular (LV) function in STEMI patients 3 months following infarction.
Methods:
Echocardiography was performed in a total of 694 patients from the CONDI-2 study a median of 112 days (IQR 63) after the initial admission. LVEF and LV end-diastolic and end-systolic volumes were calculated using the modified Simpsons biplane method of disks. LV global longitudinal strain (GLS) was estimated using 2-dimensional cine-loops with a frame rate > 55 frames/second, measured in the three standard apical views.
Results:
There was no difference in the measured echocardiographic parameters in the RIC group as compared to the control group, including LV EF, LV GLS, tricuspid annular plane systolic excursion or left ventricular volumes. In the control group, 32% had an ejection fraction < 50% compared to 37% in the RIC group (p = 0.129).
Conclusion:
In this largest to date randomized imaging study of RIC, RIC as an adjunct to PPCI was not associated with a change in echocardiographic measures of cardiac function compared to standard PPCI alone.
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