scholarly journals Influence of physical training after a myocardial infarction on left ventricular contraction mechanics

2022 ◽  
Author(s):  
Marcio Lima ◽  
Talia Falcão Dalçóquio ◽  
M. Cristina Abduch ◽  
Jeane Tsutsui ◽  
Wilson Mathias ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Physical Exercise ◽  
Training Program ◽  
Physical Training ◽  
Training Group ◽  
Left Ventricular ◽  
Control Group ◽  
Significant Difference ◽  
Basal Rotation ◽  
The Impact

BACKGROUND: Physical exercise adds benefits improving evolution of the ischemic heart disease, enhancing individual functional capacity and preventing ventricular remodeling. In this study we investigated the impact of a program of physical training started after an uncomplicated post-acute myocardial infarction (AMI) on the mechanics of left ventricle (LV) contraction. METHODS: A total of 53 patients were included, 27 of whom were randomized to a supervised training program (TRAINING group), and 26 to a CONTROL group, who received usual orientations for physical exercise after AMI. All patients underwent cardiopulmonary stress testing and an echocardiogram with speckle tracking technique to measure several parameters of LV contraction mechanics at 1 month and 5 months after AMI. RESULTS: No significant difference in the analysis of LV longitudinal, radial and circumferential strain parameters between groups after the training period was found. After the training program, analysis of torsional mechanics demonstrated a reduction in the LV basal rotation of the TRAINING group in comparison to the CONTROL group (TRAINING, -5.9±2.3 vs CONTROL, -7.5±2.9 ; P=0.03), and in the basal rotational velocity ​​( TRAINING, -53.6±18.4 vs CONTROL, -68.8±22.1 º/s; P=0.01), twist velocity (TRAINING, 127.4±32.2 vs CONTROL, 149.9±35.9 vs º/s; P=0.02) and torsion (TRAINING, 2.4±0.4 vs CONTROL, 2.8±0.8 vs º/cm; P=0.02). CONCLUSIONS: Physical activity did not cause a significant improvement in LV longitudinal, radial and circumferential deformation parameters. However, the exercise had a significant impact on the LV torsional mechanics, composed particularly of a reduction in basal rotation, twist velocity, torsion and torsional velocity which can be interpreted as a ventricular “torsion reserve” in this population.

scholarly journals Impact of collateralisation to a concomitant chronic total occlusion in patients with ST-elevation myocardial infarction: a subanalysis of the EXPLORE randomised controlled trial

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000810 ◽  
Author(s):  
Ivo M van Dongen ◽  
Joëlle Elias ◽  
K Gert van Houwelingen ◽  
Pierfrancesco Agostoni ◽  
Bimmer E P M Claessen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Decision Making ◽  
Controlled Trial ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Significant Difference ◽  
St Elevation ◽  
The Impact

ObjectiveThe impact on cardiac function of collaterals towards a concomitant chronic total coronary occlusion (CTO) in patients with ST-elevation myocardial infarction (STEMI) has not been investigated yet. Therefore, we have evaluated the impact of well-developed collaterals compared with poorly developed collaterals to a concomitant CTO in STEMI.Methods and resultsIn the EXPLORE trial, patients with STEMI and a concomitant CTO were randomised to either CTO percutaneous coronary intervention (PCI) or no-CTO PCI. Collateral grades were scored angiographically using the Rentrop grade classification. Left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV) at 4 months were measured using cardiac magnetic resonance imaging. Well-developed collaterals (Rentrop grades 2–3) to the CTO were present in 162 (54%) patients; these patients had a significantly higher LVEF at 4 months (46.2±11.4% vs 42.1±12.7%, p=0.004) as well as a trend for a lower LVEDV (208.2±55.7 mL vs 222.6±68.5 mL, p=0.054) when compared with patients with poorly developed collaterals to the CTO. There was no significant difference in the total amount of scar in the two groups. Event rates were statistically comparable between patients with well-developed collaterals and poorly developed collaterals to the CTO at long-term follow-up.ConclusionsIn patients with STEMI and a concomitant CTO, the presence of well-developed collaterals to a concomitant CTO is associated with a better LVEF at 4 months. However, this effect on LVEF did not translate into improvement in clinical outcome. Therefore, the presence of well-developed collaterals is important, but should not solely guide in the clinical decision-making process regarding any additional revascularisation of a concomitant CTO in patients with STEMI.Clinical trial registrationNTR1108.

scholarly journals Interleukin-18 Promoter Gene Polymorphisms are not Associated with Myocardial Infarction in Type 2 Diabetes in Slovenia

2011 ◽  
Vol 14 (1) ◽  
pp. 3-9 ◽  
Author(s):  
S Kariž ◽  
D Petrovič
Keyword(s):  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Gene Polymorphisms ◽  
Serum Levels ◽  
Control Group ◽  
Interleukin 18 ◽  
Significant Difference ◽  
Promoter Gene ◽  
The Impact

Interleukin-18 Promoter Gene Polymorphisms are not Associated with Myocardial Infarction in Type 2 Diabetes in SloveniaType 2 diabetes is a major risk factor for myocardial infarction (MI) and chronic inflammation may play a central role in both diseases. Interleukin (IL)-18 is a potent proinflammatory cytokine, which is considered important in acute coronary syndromes and type 2 diabetes. We investigated the association of the -137 (G>C), polymorphism (rs187238) and the -607 (C<A) polymorphism (rs1946518) of the IL-18 gene promoter region in 495 Caucasians with type 2 diabetes, of whom 169 had MI and 326 subjects had no clinically evident coronary artery disease (controls). We also investigated the impact of these polymorphisms on the serum IL-18 level in subsets of both groups and in a normal group. Genotype distributions of the polymorphisms showed no significant difference between cases and controls. However, IL-18 serum levels were significantly lower in diabetics with the137 CC genotype than in those with other genotypes (241.5 ± 132.7 ng/Lvs.340.2 ± 167.4 ng/L; p <0.05). High sensitivity C-reactive protein and IL-18 serum levels were higher in diabetics in the MI group than in the control group. We conclude that these IL-18 promoter gene polymorphisms are not risk factors for MI in Caucasians with type 2 diabetes.

scholarly journals Effect of pelvic girdle stability training on functional sitting control in children with hypotonic cerebral palsy

2021 ◽  
Vol 9 (1) ◽  
pp. 24-33
Author(s):  
W. S. Ahmed ◽  
◽  
R. M. Gharib ◽  
H. M. Salah El-Din ◽  
H. A. El-Talawy ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Training Program ◽  
Pelvic Girdle ◽  
Trunk Muscles ◽  
Control Group ◽  
Upper Limbs ◽  
Significant Difference ◽  
Strengthening Exercises ◽  
Stability Training ◽  
The Impact

The aim of this research was to examine the impact of pelvic girdle stability training in children with hypotonic cerebral palsy on functional sitting control. Thirty children with hypotonic cerebral palsy in both sexes, with their ages ranging from two to four years were used in the study. There were fifteen children in the experimental group and fifteen children in the control group. The study group received pelvic girdle stability training program in addition to a selected program for upper limbs and trunk muscles strengthening exercises, while the control group received only the selected program for upper limbs and trunk muscles strengthening exercises. Results revealed significant difference of GMFM88 (sitting domain) (P < 0.01), stationary raw scores and stationary standard scores of PDMS-2 (P < 0.05) but no significant difference of age equivalent of PDMS-2 (P > 0.05). GMFM88, on the other hand, had a significant difference (sitting domain) (P < 0.05) but no significant difference of stationary raw scores, stationary standard scores and age equivalent of PDMS-2 (P > 0.05) in the control group. Paired t-test were conducted for comparison between pre and post treatment mean values of sitting domain and stationary scores in each group. From the obtained results of the present study, we conclude that pelvic girdle stability training program was more effective in generating core muscle activity for functional sitting control compared to traditional physical therapy of upper limbs and trunk muscles strengthening exercises in children with hypotonic cerebral palsy. Keywords: Pelvic girdle stability, functional sitting control, hypotonic cerebral palsy.

scholarly journals P1587 Echochardiographic estimation of the impact of long-term treatment with Trimetazidine on myocardial dysfunction in patients with ST elevation myocardial infarction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Svanidze ◽  
T Saralidze ◽  
I Mamatsashvili ◽  
T Bediashvili
Keyword(s):  
Myocardial Infarction ◽  
Heart Function ◽  
Myocardial Dysfunction ◽  
Reperfusion Therapy ◽  
Left Ventricular ◽  
Control Group ◽  
Long Term Treatment ◽  
St Elevation ◽  
The Impact

Abstract Outcome of ST elevation acute myocardial infarction (STEMI) is usually complicatedby congestive heart failure (HF) that impacts quality of life and prognosis. Spectrum of myocardial injury depends on intensity of impaired myocardial perfusion and on existing metabolic state. Metabolic changes occurring during early hours of myocardial infarction include increased secretion of catecholamines and production of circulating free fatty acids (FFAs). As myocardium depends on aerobic metabolism increased FFAs exert toxic effect on myocardium resulting in metabolic mismatch, decreased cardiac function and arrhythmias. Our aim was to diminish signs of HF after STEMI especially in patients (P)who could not undergo reperfusion therapy because of different reasons.We used long-term metabolic therapy (MT) with TrimetazidineMR(TMZ)just from the first day of STEMI during 3 months. Evaluation of heart function was based on ECG, Holter monitoring and echocardiographic (Echo) data received before and after treatment. We observed 50 P with STEMI who could not undergo reperfusion therapy. All were treated with standard therapy according to guideline. 35 of them (I group) additionally were treated with TMZ 80 mg p/o once a day for 3 months. The rest15 patients represented II - control group. P including in these groups were comparable according to echocardiographic data. These Patients did not reveal any life-threatening arrhythmias in the acute stage of MI and any prognostically indifferent arrhythmias in the following period. Echoinvestigation in dynamic (before treatment and after 3 months) showed significant improvement of ejection fraction (EF by 14,2%) and stroke volume (SVby14,8%) in patients with STEMI treated with TMZwhile in control group EF (by 4,5%) and SV (by 6,8%) wereincreasedslightly. After 3 months improvement of diastolic function was also prominent in patients treated with TMZ that was revealed by decreased diastolic volume. In patients treated with MT end diastolic diameter (EDD) diminished by 4,8%, end systolic diameter (ESD) - by 5,7%, end diastolic volume (EDV) - by 9,3% and end systolic volume (ESV) - by 14,9% while in control group EDD was decreased by 1,9%, ESD - by 2,8%, EDV - by 4,7% and ESV - by 4,1%. Diastolic dysfunction was also estimatedaccording to left ventricular filling pressure (LVFP) E/ethat was especially interesting in P with HF with mid-range and preserved EF. Before treatment (LVFP) was increased in 17 P from the first group and in 7 P in control group. In the first group increased LVFP significantly decreased in 12 P and moderately in 5, while in control group LVFPwas only decreased moderately in 4and slightly in 3 P. The received data make it relevant to useTMZmetabolic therapy for effective treatment of HF in patients with STEMI. MT not only improves the course of disease, but diminishes rehabilitation period as well.

scholarly journals Memory and communication support strategies in dementia: Effect of a training program for informal caregivers

2012 ◽  
Vol 24 (12) ◽  
pp. 1927-1942 ◽  
Author(s):  
Jacki Liddle ◽  
Erin R. Smith-Conway ◽  
Rosemary Baker ◽  
Anthony J. Angwin ◽  
Cindy Gallois ◽  
...  
Keyword(s):  
Training Program ◽  
Controlled Trial ◽  
Informal Caregivers ◽  
Training Group ◽  
Well Being ◽  
Care Recipient ◽  
Control Group ◽  
People With Dementia ◽  
Person With Dementia ◽  
The Impact

ABSTRACTBackground: People with dementia have a range of needs that are met by informal caregivers. A DVD-based training program was developed using research-based strategies for memory and communication in dementia. The effectiveness of the training on the caregiver experience and the well-being of the person with dementia was evaluated.Methods: A pre-test/post-test controlled trial was undertaken with caregiver–care-recipient dyads living in the community. Measures of the carers’ knowledge of memory and communication strategies, burden, positive perceptions of caregiving, and perceptions of problem behaviors were taken pre- and three months post-intervention. The depression and well-being of the person with dementia were also evaluated. Satisfaction with the training and feedback were measured.Results: Twenty-nine dyads (13 training group, 16 control group) participated. Bonferroni's correction was made to adjust for multiple comparisons, setting α at 0.00385. A significant improvement was found in caregivers’ knowledge for the training group compared to the control group (p = 0.0011). The training group caregivers reported a reduction in the frequency of care recipient disruptive behaviors (p = 0.028) and increased perceptions of positive aspects of caregiving (p = 0.039), both at a level approaching significance. The training group care recipients had increased frequency of verbally communicated depressive behaviors at a level approaching significance (p = 0.0126). The frequency of observed depressive behaviors was not significantly different between groups.Conclusions: This approach to training for caregivers of people with dementia appears promising for its impact on knowledge and the caregiving experience. Further research could monitor the impact of the training on broader measures of depression and well-being, with a larger sample.

scholarly journals Intriguing New Faces Of Covid-19: Persisting Clinical Symptoms And Cardiac Effects in Children

2021 ◽  
pp. 1-27
Author(s):  
Nurdan Erol ◽  
Abdullah Alpinar ◽  
Cigdem Erol ◽  
Erdal Sari ◽  
Kubra Alkan
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Health ◽  
Clinical Symptoms ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Study Group ◽  
Ventricular Ejection Fraction ◽  
Significant Difference ◽  
The Impact

Abstract Objective: This study was conducted to evaluate the persisting Covid-19-related symptoms of the cases included in our study and to assess their cardiac findings in order to determine the impact of Covid-19 on children’s cardiovascular health. Methods: In this study, 121 children between the ages of 0-18 with Covid-19 were evaluated based on their history, blood pressure values, and electrocardiography and echocardiography results. These findings were compared with the findings of the control group which consisted of 95 healthy cases who were in the same age range as the study group and did not have Covid-19. The results were evaluated using the statistics program, SPSS 21. Results: There was no significant difference between the study group and the control group in terms of age, weight, and body mass index. The clinical symptoms (chest and back pain, dizziness, headache, palpitation, fatigue, shortness of breath, loss of balance, coughing) of 37.2% of the cases persisted at least 1 month after Covid-19 recovery. Statistically significant differences were found in systolic blood pressure, left ventricular ejection fraction, relative wall thickness, and tricuspid annular plane systolic excursion. Conclusion: The continuation of some cases’ clinical symptoms post-recovery indicates that long Covid infection can be observed in children. The fact that statistically significant differences were observed between the echocardiographic parameters of the study and control groups suggests that Covid-19 may have effects on the cardiovascular system. To shed light on the long Covid cases among children and the infection’s cardiac impacts, it would be beneficial to conduct more comprehensive studies on this matter.

Effects of an 8-Week Structured Physical Activity Program on Psychosocial Behaviors of Children With Intellectual Disabilities

2016 ◽  
Vol 33 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Peggy Hiu Nam Choi ◽  
Siu Yin Cheung
Keyword(s):  
Physical Activity ◽  
Intellectual Disabilities ◽  
Training Group ◽  
Self Control ◽  
Physical Activity Program ◽  
Control Group ◽  
Classroom Context ◽  
Activity Program ◽  
Significant Difference ◽  
The Impact

The study aimed to investigate the impact of an 8-wk structured physical activity program on selected psychosocial behaviors of children with intellectual disabilities (ID) and to estimate whether generalization occurred. Thirty children (22 boys, 8 girls) with mild ID took part in the study. The ANCOVA results showed a significant difference between the training group and the control group in emotional self-control mean scores, F(1, 25) = 7.61, p = .011, with the posttest mean score of the training group being better than that of the control group. The correlation analysis showed a medium, positive correlation between the gain scores of emotional self-control in the training context and classroom context of the training group (r = .41, n = 16, p = .12). Hence, generalization appeared to have occurred.

scholarly journals Fasting glycaemia is a predictor of outcome after acute myocardial infarction

2016 ◽  
Vol 6 (2) ◽  
pp. 135
Author(s):  
Shofiullah ◽  
Ismail Patwary ◽  
Matiur Rahman ◽  
Shahabuddin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Impaired Fasting Glucose ◽  
Cardiovascular Mortality ◽  
Fasting Glucose ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Fasting Glycaemia ◽  
The Impact

<p><strong>Background:</strong> Patients with recent myocardial infarction have an increased incidence of impaired fasting glucose (IFG) and new-onset diabetes. There is a clear relationship between elevated fasting glucose during acute myocardial infarction and increased mortality and morbidity risk. <strong></strong></p><p><strong>Objective:</strong> To find out the impact of fasting glycaemia as a predictor of outcome of patients with acute myocardial infarction. <strong></strong></p><p><strong>Methods:</strong> A total of 102 patients with acute myocardial infarction of first attack were selected according to inclusion and exclusion criteria. Fifty-one patients with acute myocardial infarc­tion having fasting hyperglycaemia were enrolled as case group and another 51 patients with acute myocardial infarctions having fasting euglycaemia were enrolled as control group. <strong></strong></p><p><strong>Results:</strong> Among the diabetic patients, acute left ventricular failure (ALVF) developed in 22 (68.8% ), arrhythmias in 5 (16.6%) and cardiovascular mortality in 8 (25.0% ) patients ; it was 7 (36.8%), 4 (21.1 %) and 4 (21.1 %) respectively in IFG patients; and 7 (13.7%) ,4 (7.8%) and 2 (3.9%) respec­tively in euglycaemia patients. Acute left ventricular failme and 30 days CV mortality significantly differed among the groups (p&lt;0.001 and p=0.015 respectively). But no significant difference in arrhythmias (p=-0.284). <strong></strong></p><p><strong>Conclusions:</strong> The patients of impaired fasting glucose (IFG) and diabetes mellitus both were predictor for in hospital heart failure (ALVF) and 30-day cardiovascular mortality as compared to euglycaemia.</p>

scholarly journals The impact of periodized core training program on accurate service velocity of male tennis players aged 11-1311-13 yaş arası erkek tenisçilerde periyotlanmış core antrenman programının isabetli servis hızına etkisi

2017 ◽  
Vol 14 (3) ◽  
pp. 3022 ◽  
Author(s):  
Ozan Sever ◽  
Rıdvan Kır ◽  
Metin Yaman
Keyword(s):  
Training Program ◽  
Training Group ◽  
Control Group ◽  
Control Group Design ◽  
Tennis Players ◽  
Core Stabilization ◽  
Core Training ◽  
Training Control ◽  
The Impact ◽  
And Training

The purpose of this study is to examine the effect of periodized core training program on the serve velocity in male tennis players aged 11-13 years. 24 male nationally ranged (age 11.9±1.63, height 154.4±11.32, weight 43±8.76) participated to the study from a professional tennis club. Pre-post-training - control group design was applied and subjects were randomly assigned to Control Group and Training Group. Training Group participated to the core training program consisted of isometric and isotonic core stabilization exercises on stable and nonstable surfaces, three days in a week for 8 weeks in addition to tennis training sessions. Accurate service velocity, was assessed initially and at the end of the 8-week core program for both control and training groups. There was a significant improvement (6.6 %) in the serve velocity for the training group after the experiment, whereas there were no differences in the control group. Core stabilization training improved service velocity for young tennis players. It is recommended tennis coaches to apply periodized core stabilization exercises to young athletes and plan training programs in this way. Extended English abstract is in the end of PDF (TURKISH) file. ÖzetBu çalışmanın amacı 11-13 yaş arası erkek tenisçilerde periyodlanmış core antrenman programının isabetli servis hızına etkisini incelemektir. Çalışmaya profesyonel bir tenis kulübünden ulusal müsabık 24 erkek tenisçi (yaş 11.9±1.63, boy 154.4±11.32, ağırlık 43±8.76) katılmıştır. Araştırmada ön-test son-test kontrol gruplu model uygulanmış, denekler iki gruba rastgele atanmıştır. 12 sporcu Kontrol Grubunu, 12 sporcu ise Deney Grubunu oluşturmuştur. Deney Grubuna haftanın üç günü yarım saatlik 8 hafta boyunca toplamda 24 antrenman birimi stabil ve stabil olmayan yüzeylerde izometrik ve izotonik core stabilizasyon egzersizlerinden oluşan program, tenis antrenmanlarına ek olarak uygulanmıştır. Program öncesi ve sonrasında her katılımcı maksimal hızda 10 servis kullanarak en hızlı ve geçerli atışları kaydedilmiştir. Core antrenman uygulaması sonrası Kontrol Grubunun servis atış hızı değişmezken, Deney Grubu servis atış hızını ortalama 120.93 km/s hızdan 128.6 km/s hıza (% 6.6) çıkarmıştır. Core antrenman uygulamalarının genç tenisçilerde isabetli servis hızını olumlu etkilediği tespit edilmiştir. Tenis antrenörlerinin yüksek şiddet içermeyen, core antrenmanlarını ve stabilizasyon uygulamalarını genç sporcularda uygulamasının yararlı olacağı düşünülmekte ve antrenman programlarını buna göre planlamaları tavsiye edilmektedir.

Abstract 302: Cathepsin D Haploinsufficiency Exacerbates Post Myocardial Infarction Cardiac Remodeling and Malfunction by Impairing Autophagosome Removal

2016 ◽  
Vol 119 (suppl_1) ◽  
Author(s):  
Penglong Wu ◽  
Wei Zhu ◽  
Jingbo Li ◽  
Xuejun “XJ” Wang
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Remodeling ◽  
Cathepsin D ◽  
Left Ventricular ◽  
Post Myocardial Infarction ◽  
Control Group ◽  
Autophagic Flux ◽  
Protein Levels ◽  
Lysosomal Protease ◽  
The Impact

Background: A marked decrease in the protein level and activity of cathepsin D (Ctsd), a major lysosomal protease, has been observed in failing human hearts; however, the pathophysiological significance of Ctsd downregulation in the heart remains undefined. Given the increasingly recognized role of the autophagic-lysosomal pathway in cardiac pathobiology, we sought to determine the impact of Ctsd haploinsufficiency on post myocardial infarction (MI) cardiac remodeling and explore the underlying mechanism. Methods and Results: MI was induced in 2-3 months old mixed-sex wild type (WT) or heterozygous Ctsd knockout (Ctsd +/- ) mice via permanent ligation of the left anterior descending (LAD) coronary artery. Myocardial Ctsd protein levels are reduced by ~50% in Ctsd +/- mice, compared with WT mice. Echocardiography (Echo) did not detect discernible difference between Ctsd +/- and WT mice immediately before and 1 week (wk) after MI; however, compared with the WT MI group, significantly greater left ventricular (LV) internal diameters at end systole and at end diastole and significantly smaller ejection fraction and fractional shortening were detected in the Ctsd +/- MI group at 2, 3, and 4 wks post-MI (p<0.05 ~ 0.001). LV pressure-volume relationship analyses at 4 wks post-MI also revealed that LV maximum and minimum dP/dt values were significantly reduced in the WT MI group, compared with the WT sham control group (p<0.05, 0.01); these post-MI reductions were more pronounced in the Ctsd +/- MI group (P<0.05, 0.01). The infarct size at 4 wks post-MI measured with trichrome staining was significantly enlarged by Ctsd +/- (p<0.002). These results indicate that Ctsd haploinsufficiency exacerbates post-MI cardiac remodeling and malfunction. Post-MI myocardial Ctsd protein levels were increased in WT mice but this increase was not detectable in Ctsd +/- mice. However, the myocardial protein levels of LC3-II, beclin1, and Atg5 were further elevated in Ctsd +/- MI mice, compared with the WT MI mice, indicative of impairment of autophagic flux in Ctsd +/- MI mice. Conclusion: Ctsd haploinsufficiency exacerbates maladaptive post-MI cardiac remodeling and malfunction likely through impairing autophagosome removal.

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