2017 Validation of electrocardiographic and biochemical estimates of first acute myocardial infarct size using cardiac m
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Meeting abstract
2017 Validation of electrocardiographic and biochemical estimates of first acute myocardial infarct size using cardiac magnetic resonance imaging Thomas N Martin*, Galen Wagner, Allan Pettigrew, Bjoern Groenning, Robin Weir, Charles Maynard, Andrew Flapan and Henry Dargie Address: Glasgow University, Glasgow, 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):A286
doi:10.1186/1532-429X-10-S1-A286
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/A286 © 2008 Martin et al; licensee BioMed Central Ltd.
Introduction The extent of damage following acute myocardial infarction is closely related to a prognosis so it is of clinical importance to make an accurate in vivo estimate of infarct size. Routinely available data includes cardiac biomarkers and the 12 lead ECG.
(12.5) years were included in final analysis. Serum TnI was measured 8–12 hours following onset of chest pain. The complete 50-criteria, 31 point Selvester QRS scoring system was performed at the time of initial ceMRI by the Duke ECG core lab.
Results Purpose This study investigates the relationship between Troponin I (TnI), the ECG derived Selvester score (SS) and contrast enhanced Magnetic Resonance Imaging (ceMRI) measures of infarct size.
Methods 80 consecutive patients with first acute coronary syndrome underwent ceMRI at a mean (SD) of 64 (23) hours from chest pain on a Siemens Sonata 1.5 T system using a phased array chest coil. Left ventricular ejection fraction (LVEF) was evaluated using the steady state free precession breath-hold sequence. CeMRI was performed 15 minutes after peripheral injection of 0.2 mmol/kg gadolinium-DTPA using a breath-hold segmented gradientecho inversion-recovery sequence. The scans were assessed by 2 experienced observers and the area of delayed hyperenhancement (DE) was planimetered manually.23 patients were excluded based on ceMRI findings: 11 had DE in > 1 coronary territory; 3 had subendocardial sparing pattern of DE; and 9 were TnI positive with no evidence of DE. 57 patients (43 male) of mean (SD) age 59.8
Admission LVEF significantly correlates with DE (r = 0.45, 0.001) and SS (r = -0.52, p < 0.001) but not TnI. Infarct size by ceMRI is moderately correlated with TnI (r = 0.69, p < 0.005) and SS (r = 0.59, p < 0.005). The R2 value for SS alone is 0.41 and rises to 0.72 when combined with TnI. The Bland Altman limits of agreement are wide for both SS (mean difference = 15 (range -11, 41)) and TnI (mean difference=-18 (range -98, 62)).
Conclusion Both TnI and SS correlate with acute infarct size by ceMRI and this correlation improves when they are used in combination. Ho
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