1009 Myocardial injury following percutaneous coronary intervention in complex lesion: a cardiovascular magnetic resonan
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Meeting abstract
1009 Myocardial injury following percutaneous coronary intervention in complex lesion: a cardiovascular magnetic resonance imaging and cardiac marker study Didier Locca*, Chiara Bucciarelli-Ducci, Agata Grasso, Peter Barlis, Rick Wage, Giuseppe Ferrante, Sanjay K Prasad, Dudley J Pennell and Carlo Di Mario Address: Royal Brompton Hospital, London, UK * Corresponding author
from 11th Annual SCMR Scientific Sessions Los Angeles, CA, USA. 1–3 February 2008 Published: 22 October 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A134
doi:10.1186/1532-429X-10-S1-A134
Abstracts of the 11th Annual SCMR Scientific Sessions - 2008
Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/pdf/1532-429X-10-S1-info.pdfThis abstract is available from: http://jcmr-online.com/content/10/S1/A134 © 2008 Locca et al; licensee BioMed Central Ltd.
Introduction In patients undergoing percutaneous coronary intervention (PCI), 15 to 26% develop elevated creatine kinase isoenzyme MB (CKMB) levels after the procedure. Troponin rise is even more frequent and is observed in 29– 48% of patients in a standard daily practice procedure. Little is known about the mechanism of this damage specifically in patient with complex PCI. Cardiovascular Magnetic Resonance (CMR) with gadolinium-based contrast media administration can non-invasively detect myocardial fibrosis. Inversion recovery preparation with segmented gradient echo readout (GRE) using recovery sequences is considered the gold standard sequence for the detection of late gadolinium myocardial enhancement (LGE).
Purpose Aim of this study was the correlation of pre- and post-procedural changes in cardiac enzymes and extent of initial/ post procedural areas of LGE measured by CMR in complex lesion.
The amount of enhancement was quantified by planimetry based on signal intensity (> 2 SD) of surrounding nulled myocardium.
Results From a consecutive series of 36 patients with complex coronary lesions using the ACC/AHA score (19 type B, 17 type C) which 2 had a PCI of 2 vessels, 23 patients (63.9%) had stable angina and 13 unstable angina. 36 of them had successful PCI (28 men), 21 patients (58.3%) had troponin I elevation (> 0.04 ug/l) post PCI of which 6 had unstable angina. Thirty four patients had a followup scan. Two patients had an unsuccessful second CMR scan due to claustrophobia. Three patients with atypical LGE pattern and troponin I elevation were excluded. All patients (n = 19, 51%) with troponin (+) had more LGE in the post PCI scan than at baseline value (8 type M lesion, and 11 type H lesion). In the troponin (-) group there was no increase in LGE in the post PCI scan. There was a correlation between troponin elevation, severity of the lesion and the amount of new infarction as determined by LGE (r = 0.84).
Methods Patients admitted to the hospital for PCI, stable/unstable angina or silent ischemia were enrolled. Only patients
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