Circulation, Vol 69, 611-617, Copyright © 1984 by American Heart Association
H Hammerman, FJ Schoen, E Braunwald and RA Kloner
It has been established that glucocorticoids and several nonsteroidal
antiinflammatory drugs, when administered early after coronary occlusion,
interfere with myocardial scar formation. To determine whether this action
is associated with expansion of myocardial infarct during the first week of
coronary occlusion and whether expansion affects ventricular function, the
effects of indomethacin on the left ventricle in the early phase of
infarction were studied. In a blinded randomized study, experimental
myocardial infarction was produced in 17 open-chest dogs by ligation of the
proximal left anterior descending coronary artery; the treated group (n =
8) received 10 mg/kg iv indomethacin at 15 min and 3 hr after occlusion,
and the control group (n = 9) received saline. After 7 days, regional
function expressed as percent change of area (% delta A) of the left
ventricular cavity was calculated from short-axis two-dimensional
echocardiograms at the level of the infarct, the animals were killed, and
their hearts were examined. The ratio of infarct thickness to noninfarcted
wall thickness was 1.20 +/- 0.08 (mean +/- SEM) in the control group, and
the ratio was lower in the indomethacin group, 0.96 +/- 0.04 (p less than
.025). An expansion index of myocardial infarction was calculated as
previously described and was 1.02 +/- 0.04 in the control group vs 1.29 +/-
0.06 in the indomethacin group (p less than .005). In eight dogs (six
control and two treated) without expansion (expansion index less than
1.09), regional function expressed as % delta A was 46.8 +/- 2.6% (SEM),
and in nine dogs (six treated and three control) with expansion, % delta A
was significantly lower, 28.7 +/- 4.0% (p less than .005).(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
Drug-induced expansion of infarct: morphologic and functional correlations
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