A novel index of infarct morphology predicts the presence of microvascular obstruction in patients with acute myocardial
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POSTER PRESENTATION
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A novel index of infarct morphology predicts the presence of microvascular obstruction in patients with acute myocardial infarction Lowie M Van Assche1*, Han W Kim1, Sebastiaan C Bekkers2, Brenda Hayes1, Michele Parker1, Raymond J Kim1 From 15th Annual SCMR Scientific Sessions Orlando, FL, USA. 2-5 February 2012 Background Microvascular obstruction (MO) has been associated with poor LV remodeling and adverse prognosis. Infarct morphology is related to the presence of MO in that patients with MO generally have larger infarct size (IS) and greater mean infarct transmurality. However, neither index is highly predictive on an individual patient basis. In the current study, we investigated the utility of a novel index of infarct morphology, which reflects the circumferential extent of fully transmural infarction extending to the epicardial surface−the epicardial surface area (EpiSA) of infarction−to predict MO. Methods We studied 302 consecutive patients from 2 centers (Duke and Maastricht University) with first AMI. On contrast-enhanced-CMR, early (2-min post-contrast) and late MO (10-min post-contrast) were defined as hypoenhanced regions within hyperenhanced infarction. Infarct size, mean transmurality, and EpiSA were quantified by manual planimetry of the stack of short-axis views. Results Patients were 58±11 years old (71% male). Prevalence of early and late MO was 64% and 55%, respectively. For the population, IS, mean transmurality, and EpiSA were 14% of LV mass (IQR 7-25%), 74% of infarct sector (IQR 57-86%) and 6% of total LV epicardial-surface-area (IQR 1-13%), respectively. All 3 infarct characteristics were significantly larger in patients with MO (all p
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