AimsThe aim of this study was to assess the effect of granulocyte colony-stimulating factor (G-CSF) on left ventricular (LV) function and volumes in patients with anterior ST-elevation myocardial infarction (STEMI) and depressed LV ejection fraction (EF). Methods and resultsSixty consecutive patients with anterior STEMI, undergoing primary angioplasty percutaneous coronary intervention (PCI), with symptom-to-reperfusion time of 2 -12 h and EF ≤45% after PCI, were randomized to G-CSF 5 mg/kg b.i.d. subcutaneously (n ¼ 24) or placebo (n ¼ 25) for 5 days, starting ,12 h after PCI. The primary endpoint was an increase from baseline to 6 months of 5% in left ventricular ejection fraction (LVEF), as measured by magnetic resonance imaging (MRI). Co-primary endpoint was a ≥20 mL difference in end-diastolic volume (EDV). Infarct size and perfusion were evaluated with late gadolinium enhancement (LGE) and gated There were no significant differences in EF or perfusion between groups. A significant reduction in transmural LGE segments was seen at 6 months in the G-CSF vs. placebo groups (4.38 + 2.9 to 3.3 + 2.6, P ¼ 0.04 and 4.2 + 2.6 to 3.6 + 2.7, P ¼ 0.301,

G-CSF therapy may be beneficial in attenuating ventricular remodelling subsequent to a large anterior STEMI in the long term. No differences have been detected in clinical outcome.

In spite of an enhanced sympathetic activity, MTWA testing during exercise at high altitude was negative in all participants. Healthy trained subjects during exercise under hypoxia seem to be at low risk for dangerous arrhythmias.

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A case of a young man with myocarditis simulating acute coronary syndrome is reported. The possibility of vasospasm is discussed. The use of cardiac magnetic resonance imaging (MRI) is highlighted.