123 Functional recovery after acute myocardial infarction: a comparison between angiography, electrocardiography and car
- PDF / 333,523 Bytes
- 2 Pages / 610 x 792 pts Page_size
- 89 Downloads / 207 Views
BioMed Central
Open Access
Meeting abstract
123 Functional recovery after acute myocardial infarction: a comparison between angiography, electrocardiography and cardiovascular magnetic resonance measures of microvascular injury Robin Nijveldt*1, Aernout M Beek1, Alexander Hirsch2, Martin G Stoel3, Mark BM Hofman1, Victor AWM Umans4, Paul R Algra4, Jos WR Twisk1 and Albert C van Rossum1 Address: 1VU University Medical Center, Amsterdam, The Netherlands, 2Academic Medical Center, Amsterdam, The Netherlands, 3Medisch Spectrum Twente, Enschede, The Netherlands and 4Medical Center Alkmaar, Alkmaar, The Netherlands * 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):A24
doi:10.1186/1532-429X-10-S1-A24
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/A24 © 2008 Nijveldt et al; licensee BioMed Central Ltd.
Introduction
Results
Thrombolysis In Myocardial Infarction (TIMI) flow grade, Myocardial Blush Grade (MBG) and resolution of ST-segment elevation indirectly reflect microvascular injury. Cardiovascular magnetic resonance (CMR) allows direct visualization and quantification of microvascular obstruction (MVO) with transmural resolution.
This study was designed to examine the relation between angiographic, electrocardiographic and CMR characteristics of microvascular injury, and its predictive value on functional recovery after acute myocardial infarction (AMI).
First pass perfusion defects and LGE MVO were both related to incomplete ST resolution (p = 0.002 and p = 0.01 respectively), but not to TIMI flow and MBG. Of all angiographic, electrocardiographic, and CMR variables, LGE infarct size was the strongest predictor for baseline LV function and volumes. However, presence of LGE MVO was the strongest parameter to predict change at followup. Regional analysis showed that only 6% (23/372) of dysfunctional segments with MVO completely recovered during follow-up, compared to 35% (631/1.786) without MVO (odds ratio 0.18, p < 0.0001). MVO was associated with wall thinning and less improvement of wall thickening, independent of infarct transmurality.
Methods
Conclusion
TIMI flow grade, MBG and ST-segment resolution were assessed in 60 patients with AMI, treated with primary stenting. CMR was performed within 9 days and at 4 months, to determine global and regional LV function, first pass perfusion defects, size and extent of late gadolinium-enhanced (LGE) infarct and MVO (Figure 1).
LGE MVO is a better prognostic marker than other currently used determinants of microvascular injury, and predicts global and regional functional recovery in patients after reperfused AMI, beyond infarct transmurality.
Purpose
Page 1 of 2 (pag
Data Loading...
