No abstract

BackgroundLeft ventricular ejection fraction (LVEF) is a major determinant of long‐term prognosis after ST‐segment elevation myocardial infarction (STEMI). STEMI patients with reduced LVEF have a poor prognosis, despite successful reperfusion and the use of renin‐angiotensin‐aldosterone inhibitors.HypothesisIntracoronary infusion of bone marrow–derived mononuclear cells (BMMC) may improve LVEF in STEMI patients successfully reperfused.MethodsThe main inclusion criteria for this double‐blind, randomized, multicenter study were patient age 30 to 80 years, LVEF ≤50%, successful angioplasty of infarct‐related artery, and regional dysfunction in the infarct‐related area analyzed before cell injection. Cardiac magnetic resonance imaging was used to assess LVEF, left ventricular volumes, and infarct size at 7 to 9 days and 6 months post–myocardial infarction.ResultsOne hundred and twenty‐one patients were included (66 patients in the BMMC group and 55 patients in the placebo group). The primary endpoint, mean LVEF, was similar between both groups at baseline (44.63% ± 10.74% vs 42.23% ± 10.33%; P = 0.21) and at 6 months (44.74% ± 12.95 % vs 43.50 ± 12.43%; P = 0.59). The groups were also similar regarding the difference between baseline and 6 months (0.11% ± 8.5% vs 1.27% ± 8.93%; P = 0.46). Other parameters of left ventricular remodeling, such as systolic and diastolic volumes, as well as infarct size, were also similar between groups.ConclusionsIn this randomized, multicenter, double‐blind trial, BMMC intracoronary infusion did not improve left ventricular remodeling or decrease infarct size.

No abstract

Radiation Risks and the Importance of Radiological Protection in Interventional Cardiology: A Systematic ReviewWe discuss some aspects related to the legal framework, international recommendations and training programs on radiological protection; image quality and equipment; the biological effects and risks of ionizing radiation; lesions in patients and operators; patient's reference levels; occupational dose limit and preventive actions. The use of ionizing radiation involves risks that are justified in diagnostic and therapeu tic procedures. The awareness and knowledge of these risks minimizes the damage, optimizing the quality of images and safe use of ionizing radiation. There is evidence of radiationin duced cataracts in individuals who work in catheterization laboratories. Several studies suggest there may be a significant risk of lens opacity, if radiological protection devices are not properly used. Additionally, these interventional procedures are performed in Latin America, usually by medical specialists in collaboration with nurses, technologists and technicians, who often do not have adequate training in radiological protection.

No abstract