Myocardial and Beloc


Myocardial Symptoms and Causes

Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly becomes blocked. Without the blood coming in, the heart can't get oxygen. If not treated quickly, the heart muscle begins to die. But if you do get quick treatment, you may be able to prevent or limit damage to the heart muscle. That's why it's important to know the symptoms of a heart attack and call 911 if you or someone else is having them. You should call, even if you are not sure that it is a heart attack.

The most common symptoms in men and women are

  • Chest discomfort. It is often in center or left side of the chest. It usually lasts more than a few minutes. It may go away and come back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion.
  • Shortness of breath. Sometimes this is your only symptom. You may get it before or during the chest discomfort. It can happen when you are resting or doing a little bit of physical activity.
  • Discomfort in the upper body. You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach.

You may also have other symptoms, such as nausea, vomiting, dizziness, and lightheadedness. You may break out in a cold sweat. Sometimes women will have different symptoms then men. For example, they are more likely to feel tired for no reason.

The most common cause of heart attacks is coronary artery disease (CAD). With CAD, there is a buildup of cholesterol and other material, called plaque, on their inner walls or the arteries. This is atherosclerosis. It can build up for years. Eventually an area of plaque can rupture (break open). A blood clot can form around the plaque and block the artery.

A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery.

At the hospital, health care providers make a diagnosis based on your symptoms, blood tests, and different heart health tests. Treatments may include medicines and medical procedures such as coronary angioplasty. After a heart attack, cardiac rehabilitation and lifestyle changes can help you recover.

NIH: National Heart, Lung, and Blood Institute

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Myocardial Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Recruiting Characterization of Myocardial Blood Flow Measurements Using Lexiscan®™ (Regadenoson) (Lexiscan®™) Rubidium-82 Myocardial Perfusion PET: A Temporal-Dependency Investigation
Condition: Myocardial Blood Flow Reserve
Interventions: Drug: Regadenoson;   Radiation: Rubidium-82
Outcome Measures: Measure Quantitated Myocardial Perfusion Reserve after a 4 Minute Delay in Lexiscan (Regadenoson);   Measure Quantitated Myocardial Perfusion Reserve after a 2 Minute Delay in Lexiscan (Regadenoson);   Measure Quantitated Myocardial Perfusion Reserve after a 10 Second Delay in Lexiscan (Regadenoson)
2 Recruiting CYCLosporinE A in Reperfused Acute Myocardial Infarction
Condition: Acute Myocardial Infarction
Intervention: Drug: Cyclosporine A
Outcome Measures: Improvement of Myocardial reperfusion, measured with ST-segment resolution >=70%;   High sensitive cardiac troponin T (hs-cTnt).;   Clinical events: all-cause mortality, HF or shock; rehospitalization for CV reasons;   Infarct size: Troponin curve (T or I, assayed locally);   LV remodeling and function as assessed by echocardiography;;   No reflow, as assessed by Myocardial blush
3 Not yet recruiting Myocardial Oedema in ST Segment Elevation Myocardial Infarction Myocardial
Conditions: ST Segment Elevation Myocardial Infarction;   Myocardial Oedema
Intervention: Other: Cardiac magnetic resonance imaging
Outcome Measures: The mass of Myocardial oedema measured by CMR;   Extra cellular volume
4 Recruiting China Acute Myocardial Infarction Registry
Condition: Acute Myocardial Infarction
Outcome Measures: In-hospital mortality of the patients with acute Myocardial infarction in different-level hospitals across China;   The rate of the application of thrombolysis and primary percutaneous coronary intervention for Chinese patients with acute Myocardial infarction in different-level hospitals;   provoking factors of Chinese patients with AMI across different areas and different population in China
5 Unknown  Sitagliptin Plus Granulocyte-colony Stimulating Factor in Acute Myocardial Infarction
Condition: Acute Myocardial Infarction
Interventions: Drug: Lenograstim (GRANOCYTE)=GCSF;   Drug: Sitagliptin (Januvia);   Drug: Sodium Chloride (NaCl) 0.9 %;   Drug: Gelatin
Outcome Measures: Change of global Myocardial function from baseline to 6 months of follow-up.;   Segmental end-diastolic Myocardial thickness, segmental systolic wall thickening, regional contractile reserve, end-diastolic and end-systolic volumes, stroke volume, and cardiac output in MRI;   Extent of non-viable myocardium will be monitored from baseline up to 6 months measured by MRI delayed enhancement.;   Change of Myocardial perfusion at rest up to 6 months as measured by signal-time curve parameters using first-pass perfusion MRI;   Occurrence of major adverse cardiac events (death, Myocardial infarction, CABG, or re-intervention) up to 12 months.;   Safety of a treatment of Sitagliptin in combination with G-CSF in CAD patients suffering from MI (spontaneously reported adverse events (AEs) up to 12 months).;   Change of peripheral blood stem cell populations: CD34, CD34/KDR and CD34/CD26 positive cells prior to and 5 days after therapy initiation.;   Change of plasma levels of NT-pro-BNP, glucose, complete blood count, CRP, platelets, CK, cTnI prior to and 5 and 28 days, and 6 months after therapy initiation;   Assessment of in stent restenosis using angiography 6 months after facultative PCI
6 Unknown  Effect of Additional Treatment With EXenatide in Patients With an Acute Myocardial Infarction (the EXAMI Trial)
Condition: Patients With a First Acute Myocardial Infarction to be Treated With Primary Percutaneous Coronary Intervention (PCI).
Interventions: Drug: Exenatide infusion;   Drug: Placebo infusion.
Outcome Measures: Safety of GLP-1 receptor agonist Exenatide infusion compared to placebo in patients with an acute Myocardial infarction undergoing primary PCI;   Infarct size, assessed by means of the final infarct size at 4 months post Myocardial infarction (CMRI) as a percentage of the area at risk at 1 week post Myocardial infarction (T2 weighed CMRI).;   Regional Myocardial function based on a MRI segmental analysis at 1 weeek and at 4 months post Myocardial infarction.;   Global left ventricular ejection fraction (EF), Left Ventricular End Systolic Volume (LVESV), Left Ventricular End Diastolic Volume (LVEDV) at 1 week and at 4 months post Myocardial infarction measured by Cardiac MRI.;   Regional Myocardial function assessed by 2D and 3D echocardiography at 1 week and at 4 months post Myocardial infarction.;   Global left ventricular EF, LVESV, LVEDV at 1 week and at 4 months post Myocardial infarction measured by 2D and 3D echocardiography.;   Angiographic parameters as Trombolysis In Myocardial Infarction (TIMI) frame count and TIMI blush grade after PCI.;   The occurrence within 4 months of a Major Adverse Cardiac Event (MACE) defined as cardiac death, Myocardial infarction, coronary bypass grafting, or a repeat PCI .;   Side effects of exenatide;   Serum-glucose levels during the first 72 hours.
7 Recruiting The Role of Myocardial SPECT in Evaluation of Irradiation-induced Changes.
Condition: Breast Cancer, Female
Intervention: Radiation: Thallium-201 Myocardial Perfusion Study
Outcome Measure: To investigate the correlation of post-RT cardiovascular effects with Myocardial Tl-201 Myocardial perfusion images
8 Recruiting Early Mineralocorticoid Receptor Antagonist Treatment to Reduce Myocardial Infarct Size
Condition: ST-elevation Myocardial Infarction
Interventions: Drug: Mineralocorticoid receptor antagonist potassium-canrenoate;   Drug: placebo
Outcome Measures: Myocardial infarct (MI) size, as assessed by cardiac magnetic resonance imaging;   Markers of Myocardial reperfusion injury;   Microvascular obstruction on cardiac MRI;   Myocardial salvage;   Acute Myocardial infarct size;   LV remodelling;   Clinical outcome measures
9 Not yet recruiting Early Routine Catheterisation After Alteplase Fibrinolysis vs. Primary PCI in Acute ST-elevation Myocardial Infarct
Condition: Acute ST-segment Elevation Myocardial Infarction
Interventions: Drug: Alteplase;   Procedure: Early post-fibrinolytic catheterisation;   Procedure: Primary PCI
Outcome Measures: Complete epicardial and Myocardial reperfusion for Myocardial reperfusion;   TIMI Myocardial Perfusion Frame Count (TMPFC);   TIMI Myocardial Perfusion Grade (TMPG);   TIMI Frame Count (CTFC);   TIMI Flow Grade (TFG);   Resolution of the initial sum of ST-segment elevation ≥ 70%
10 Recruiting MAP-IDM: Identification of Molecular Markers of Sudden Death at the Acute Phase of Myocardial Infarction
Condition: Myocardial Infarction
Intervention: Genetic: Blood sample
Outcome Measure: Correlation phenotype/genotype of sudden death at the acute phase of Myocardial infarct.
11 Recruiting ASV for Sleep Apnea After Myocardial Infarction
Conditions: Acute Myocardial Infarction;   Sleep Apnea
Intervention: Device: Adaptive servo-ventilation
Outcome Measures: Myocardial salvage index, MSI;   infarct size and left ventricular remodelling;   B-type natriuretic peptide (NT-proBNP);   disease specific symptom burden;   suppresses sleep apnea;   renal function
12 Recruiting Artifact-Free High-Resolution Myocardial Perfusion MRI in Subjects With Abnormal Nuclear Myocardial Perfusion Studies
Conditions: Coronary Artery Disease;   CAD
Interventions: Drug: regadenoson;   Drug: Optimark®;   Device: Myocardial perfusion MRI
Outcome Measure: Presence and severity of perfusion deficit on images
13 Recruiting Effect of Conditioning on Myocardial Damage in STEMI
Condition: ST-elevation Myocardial Infarction
Interventions: Device: Combined intrahospital pre- and postconditioning;   Device: Postconditioning
Outcome Measures: Myocardial salvage assessed by MRI;   Composite of death, reinfarction and readmission for congestive heart failure
14 Recruiting Omega-3 Fatty Acids in Elderly Patients With Acute Myocardial Infarction
Conditions: Myocardial Infarction;   Heart Failure;   Myocardial Revascularization;   Atrial Fibrillation
Interventions: Drug: Pikasol;   Other: Corn oil
Outcome Measures: Combined total mortality, first event of non-fatal Myocardial infarction, stroke and revascularization.;   Occurence of new onset atrial fibrillation
15 Recruiting Etanercept Treating Patient With Acute ST Segment Elevated Myocardial Infarction
Condition: Myocardial Infarction
Interventions: Drug: Etanercept;   Drug: saline
Outcome Measures: Composite of major adverse cardiovascular events (MACE) consisting of cardiovascular death, fatal Myocardial infarction and fatal stroke;   Composite endpoint of major cardiovascular events, non-elective coronary revascularization procedures and hospitalization for unstable angina Cardiovascular death Non-fatal Myocardial infarction Non-fatal stroke of all classifications;   Elevation of ALT, AST and CK;   serum adiponectin concentration, activity and isoforms
16 Recruiting Strategies of Revascularization in Patients With ST-segment Elevation Myocardial Infarction (STEMI) and Multivessel Disease
Conditions: Myocardial Infarction;   Angioplasty, Transluminal, Percutaneous Coronary;   Echocardiography, Stress
Interventions: Procedure: complete multivessel revascularization;   Procedure: stress echocardiography and revascularization if required
Outcome Measures: Combined event of cardiovascular death/re-Myocardial infarction/revascularization of any vessel/admission due to heart failure;   Incidence of acute renal failure (contrast induced nephropathy);   Cost analysis of both strategies;   Death;   re-Myocardial infarction;   revascularization of any vessel;   admission due to heart failure
17 Recruiting Verification of the Safety of Early Discharge in Patients After Acute ST-segment Myocardial Infarction
Conditions: Coronary Artery Disease;   Acute Myocardial Infarction With ST-segment Elevation;   Primary Percutaneous Coronary Intervention;   Early Discharge
Interventions: Other: Early discharge;   Other: Standard discharge
Outcome Measures: • Composite of incidence of death, reinfarction, unstable angina pectoris, stroke, unplanned rehospitalization, repeat target vessel revascularization and stent thrombosis in 30 days after Myocardial infarction (MI);   Composite of incidence of death, reinfarction, unstable angina pectoris, stroke, unplanned rehospitalization, repeat target vessel revascularization and stent thrombosis in 90 days after MI;   Complications associated with the puncture site requiring treatment in 30 days after Myocardial infarction (MI)
18 Recruiting An Efficacy and Outcome Study of Supplemental Oxygen Treatment in Patients With Suspected Myocardial Infarction
Conditions: Acute Coronary Syndrome;   Non-ST Elevation (NSTEMI) Myocardial Infarction;   Acute ST Segment Elevation Myocardial Infarction;   Angina, Unstable
Intervention: Drug: Oxygen
Outcome Measures: 1-year all-cause mortality;   Myocardial damage;   Mortality and morbidity;   Heart failure evaluation;   Health economics
19 Recruiting Myocardial Blood Flow by 15O Water PET
Condition: Coronary Heart Disease
Interventions: Other: Computed tomography Myocardial perfusion imaging;   Other: Oxygen 15 labelled water positron emission tomography
Outcome Measures: Myocardial blood flow;   Fractional flow reserve;   Myocardial perfusion
20 Not yet recruiting CO2 as a Stress Agent for Perfusion Imaging
Condition: Coronary Artery Disease
Interventions: Device: Delivery of precise levels of carbon dioxide with the RespirAct™ Gen3 sequential gas delivery system;   Device: Delivery of rubidium radioisotope (Rb-82) using the automated pump/elution system
Outcome Measures: Myocardial blood flow differences;   Absolute Myocardial blood flow differences between end-tidal CO2 scans;   Difference bewteen absolute Myocardial blood flow with hypercapnia and with adenosine stress.