Relation Between Aldosterone and Cardiac Remodeling After Myocardial Infarction

Study Overview
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Brief Summary
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This study aims to determine whether aldosterone blood levels are predictive of cardiac remodeling at 6 months following myocardial infarction with ST elevation (STEMI), independently of conventional predictive factors (size of myocardial infarction, age, hypertension, etc.) in revascularized patients during the acute phase of MI.

Detailed Description
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After myocardial infarction, the evolution toward cardiac failure is generally linked to a progressive worsening of cardiac dysfunction and remodeling. Cardiac remodeling is largely the consequence of myocardial injury due to myocardial infarction, although other parameters including age, arterial hypertension, etc. may also represent important predictors. Aldosterone blood levels measured within the first hours of admission for myocardial infarction is associated with increased rates of adverse outcomes. Aldosterone acts on wound healing and fibrosis processes in the myocardium as well as on systemic volemia.

Official Title
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Multiparametric Study of Cardiac Remodeling After Myocardial Infarction Revascularized in Acute Phase : Relation With the Serum Concentrations in Aldosterone

Conditions
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Myocardial Infarction

Intervention / Treatment
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* Biological: blood sample
* Procedure: MRI
* Procedure: echocardiography
* Biological: urine sample
* Procedure: pulmonary echography
* Procedure: vascular check
* Procedure: renal echography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Man or woman hospitalized for a first myocardial infarction with known shift of the segment ST revascularized in acute phase by primary angioplasty and dated less than 4 days Patient presenting a stable clinical state Patient presenting a regular sinusal cardiac rhythm Patient having an age ≥ 18 years Exclusion Criteria: Counter-indication with examination MRI Severe claustrophobia Antecedent of over-sensitiveness to gadolinium salts Nonischaemic Cardiopathy Cardiac surgery planed in the 6 months Women into old to procreate without effective contraception

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Myocardial infarction<br>All patients. Patients hospitalized for a first myocardial infarction with known shift of the segment ST revascularized in acute phase by primary angioplasty and dated less than 4 days. Intervention: blood sample MRI echocardiography urine sample pulmonary echography vascular check renal echography | Biological: blood sample<br> <br> Procedure: MRI<br> <br> Procedure: echocardiography<br> <br> Biological: urine sample<br> <br> Procedure: pulmonary echography<br> <br> Procedure: vascular check<br> <br> Procedure: renal echography<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiac remodeling within 6 months of myocardial infarction as defined as the change in left ventricle volumes (increase of more than 20 % of the diastolic volume of the left ventricle) |  | from initial assessment to 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Vascular and cardiac parameters measured during the initial assesment and at 6 months (both functional and structural - by echocardiography or MRI) |  | from initial assessment to 6 months | 
| Long-term cardiac remodeling measured by echocardiography at 3 to 9 years of initial enrollment |  | at 3 to 9 years of initial enrollment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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aldosterone, myocardial infarction, cardiac remodeling