[Prevention of post-infarction remodelling with L-carnitine: multicenter study CEDIM (L-Carnitine digital echocardiography myocardial infarction)].

Prevention of post-infarction ventricular remodeling is an important therapeutic aim since left ventricular dilatation is one of the most important prognostic post-infarction determinants. Early reperfusion and chronic treatment with ACE-inhibitors are able to limit remodeling by means of two distinct mechanisms. Early reperfusion limits the extent of the infarcted area by salvaging a part of the myocardial area at risk of necrosis. ACE-inhibition, on the other hand, by reducing afterload, facilitates cardiac ejection and therefore tends to reduce left ventricular volume. Remodeling could be limited also by drugs which, like L-carnitine, act, as has been demonstrated by experimental studies, on the use of energy substrates both in the area at risk of necrosis and in the area subjected to a greater wall stress because of remodeling and which will progressively dilate over time. The CEDIM study is a double-blind, randomized, placebo-controlled, multicentre trial which has involved 36 Heart Divisions. The CEDIM study aims at evaluating the effects of L-carnitine on left ventricular function, as assessed by echocardiography, in patients with acute anterior myocardial infarction.