Relationship Between Left Ventricular Remodeling, Coronary Endothelial Function and Myocardial Fibrosis Using Positron Emission Tomography in Patients With ST-elevation Myocardial Infarction

Study Overview
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Brief Summary
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Left ventricular remodeling is a common complication in patients with ST-elevation myocardial infarction (STEMI ) and may lead to heart failure. Hemodynamic, metabolic and inflammatory mechanisms are involved in this pathophysiological process. Recent data demonstrated that remote, noninfarct-related region of the myocardium is also implicated. There is no data about the assessment of coronary endothelial function or myocardial fibrosis in the remote zone in patients with STEMI . The correlation between these parameters and left ventricular remodeling is not known.

Official Title
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Assessment of Coronary Endothelial Function and Myocardial Fibrosis in Positron Emission Tomography With the Waning of Acute Coronary Syndrome With Elevated ST Segment : Relationship With Left Ventricular Remodeling

Conditions
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ST Elevation Myocardial Infarction

Intervention / Treatment
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* Other: (15)-O water positron emission tomography and Biomarkers


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: First ST Elevation Myocardial Infarction Primary Percutaneous Coronary Intervention (TIMI 3) Single vessel coronary artery disease Age over 18 years Informed Consent dated and signed Written and spoken French Beneficiary of social security insurance Exclusion Criteria: No Primary Percutaneous Coronary Intervention TIMI 0-2 after Primary Percutaneous Coronary Intervention Significant two or three-vessel coronary artery disease (> 70% stenosis in at least one of the other two coronary arteries) Past history of myocardial infarction before STEMI Mechanical complication (ischaemic mitral regurgitation, interventricular septal defect, cardiac tamponade) or clinical signs of heart failure Pregnant and / or lactating Age under 18 years or guardianship

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: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: STEMI<br>All patients included in this study (1 arm) | Other: (15)-O water positron emission tomography and Biomarkers<br>* Coronary endothelial function is assessed using (15)-O water positron emission tomography and cold pressor test . The response to the test is defined by the percentage increase myocardial blood flow . Assessment of fibrosis, inflammation an endothelial function is performed using biomarkers.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of coronary endothelial function | 3 months following an acute coronary syndrome STEMI an ST segment (segments in myocardial infarcted area and remote ) . | 3 months | 
| Measurement of fibrosis | 3 months following an acute coronary syndrome STEMI an ST segment (segments in myocardial infarcted area and remote ) . | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlating biomarkers with local and global parameters of coronary endothelial function , inflammation and myocardial fibrosis with early echocardiographic parameters of left ventricular remodeling and cardiac magnetic resonance imaging |  | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ST Elevation Myocardial Infarction, Ventricular remodeling, Biomarkers, Coronary endothelial function, Positron Emission Tomography