007 Predictors of Infarct Size and Microvascular Obstruction Assessed by Cardiac Magnetic Resonance Imaging in patients with Acute ST elevation MI

2010 ◽  
Vol 2 (1) ◽  
pp. 3
Author(s):  
Marc Sirol ◽  
Philippe Malzy ◽  
Georges Sideris ◽  
Victor Stratiev ◽  
Alain Cohen-Solal ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Infarct Size ◽  
Cardiac Magnetic Resonance Imaging ◽  
Microvascular Obstruction ◽  
Resonance Imaging ◽  
St Elevation

scholarly journals Using proximity extension proteomics assay to identify biomarkers associated with infarct size and ejection fraction after ST-elevation myocardial infarction

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Moman A. Mohammad ◽  
Sasha Koul ◽  
Anna Egerstedt ◽  
J. Gustav Smith ◽  
Marko Noc ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Infarct Size ◽  
Cardiac Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
St Elevation ◽  
Inflammatory Proteins

Abstract Plasma concentrations of many cardiovascular and inflammatory proteins are altered after ST-elevation myocardial infarction (STEMI) and may provide prognostic information. We conducted a large-scale proteomic analysis in patients with STEMI, correlating protein levels to infarct size and left ventricular ejection fraction (LVEF) determined with cardiac magnetic resonance imaging. We analysed 131 cardiovascular and inflammatory proteins using a multiplex proximity extension assay and blood samples obtained at baseline, 6, 24, and 96 h from the randomised clinical trial CHILL-MI. Cardiac magnetic resonance imaging data at 4 ± 2 days and 6 months were available as per trial protocol. Using a linear regression model with bootstrap resampling and false discovery rate adjustment we identified five proteins (ST2, interleukin-6, pentraxin-3, interleukin-10, renin, and myoglobin) with elevated values corresponding to larger infarct size or worse LVEF and four proteins (TNF-related apoptosis-inducing ligand, TNF-related activation induced cytokine, interleukin-16, and cystatin B) with values inversely related to LVEF and infarct size, concluding that among 131 circulating inflammatory and cardiovascular proteins in the acute and sub-acute phase of STEMI, nine showed a relationship with infarct size and LVEF post-STEMI, with IL-6 and ST2 exhibiting the strongest association.

scholarly journals In Acute ST-Segment Elevation Myocardial Infarction, Coronary Wedge Pressure Is Associated with Infarct Size and Reperfusion Injury as Evaluated by Cardiac Magnetic Resonance Imaging

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mihaela Ioana Dregoesc ◽  
Raluca Bianca Dumitru ◽  
Sorana Daniela Bolboacă ◽  
Mădălin Constantin Marc ◽  
Simona Manole ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Infarct Size ◽  
Cardiac Magnetic Resonance Imaging ◽  
Reperfusion Injury ◽  
Microvascular Obstruction ◽  
Resonance Imaging ◽  
Wedge Pressure

Background. Coronary collateral flow influences patient prognosis in the setting of acute myocardial infarction. However, few data exist about the relation between coronary collaterals, infarct size, and reperfusion injury. The angiographic Rentrop score is prone to subjectivism and to the inherent limitations of angiographic images. Its prognostic value is controversial in the setting of acute myocardial infarction. The invasive measurement of coronary wedge pressure (CWP) represents an alternative to Rentrop score for the evaluation of coronary collateralization. Our study evaluates pre-revascularization CWP as a predictor of infarct size and reperfusion injury as evaluated by cardiac magnetic resonance imaging. Methods. Patients with acute ST-elevation myocardial infarction underwent preprocedural CWP measurement and primary percutaneous coronary intervention. Infarct size, microvascular obstruction, intramyocardial edema, and intramyocardial hemorrhage were evaluated by cardiac magnetic resonance imaging. Results. Mean CWP was inversely associated with infarct size p=0.01, microvascular obstruction p=0.02, intramyocardial edema p=0.05, and intramyocardial hemorrhage p=0.01. An excellent association was found between mean CWP and an infarct size ≥24% of left ventricular mass (AUC = 0.880, p=0.007), with an optimal cutoff value ≤24.5 mmHg. Both intramyocardial edema p=0.02 and hemorrhage p=0.03 had a larger extent in patients with coronary wedge pressure ≤24.5 mmHg. Rentrop grade <2 was associated with larger infarct size p=0.03, but not with the extent of edema, microvascular obstruction, or intramyocardial hemorrhage. Conclusions. Pre-revascularization CWP was a predictor of infarct size and was significantly associated with a larger extent of intramyocardial edema and intramyocardial hemorrhage. Rentrop grade <2 was associated with a larger infarct size, but had no influence on reperfusion injury. The clinical trial is registered with NCT03371784.

scholarly journals Reperfusion ventricular arrhythmia bursts identify larger infarct size in spite of optimal epicardial and microvascular reperfusion using cardiac magnetic resonance imaging

2017 ◽  
Vol 7 (3) ◽  
pp. 246-256 ◽  
Author(s):  
Kirian van der Weg ◽  
Wichert J Kuijt ◽  
Sebastiaan CAM Bekkers ◽  
Jan GP Tijssen ◽  
Cynthia L Green ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ventricular Arrhythmia ◽  
Infarct Size ◽  
Cardiac Magnetic Resonance Imaging ◽  
Coronary Intervention ◽  
Resonance Imaging ◽  
Additional Cell ◽  
St Elevation

Aims: Ventricular arrhythmia (VA) bursts following recanalisation in acute ST-elevation myocardial infarction (STEMI) are related to larger infarct size (IS). Inadequate microvascular reperfusion, as determined by microvascular obstruction (MVO) using cardiac magnetic resonance imaging (CMR), is also known to be associated with larger IS. This study aimed to test the hypothesis that VA bursts identify larger infarct size in spite of optimal microvascular reperfusion. Methods: All 65 STEMI patients from the Maastricht ST elevation (MAST) study with brisk epicardial flow (TIMI 3), complete ST recovery post-percutaneous coronary intervention and early CMR were included. Using 24-hour Holter registrations from the time of admission, VA bursts were identified against subject-specific Holter background VA rates using a statistical outlier method. MVO and final IS were determined using delayed enhancement CMR. Results: MVO was present in 37/65 (57%) of patients. IS was significantly smaller in the group without MVO (median 9.4% vs. 20.5%; p < 0.001). IS in the group with MVO did not differ depending on VA burst ( n = 28/37; median 20.8% vs. 19.7%; p = 0.64). However, in the group without MVO, VA burst was associated with significantly larger IS ( n = 17/28; median 10.5% vs. 4.1%; p = 0.037). In multivariable analyses, VA burst as well as anterior infarct location remained independent predictors of larger infarct size. Conclusion: In the presence of suboptimal reperfusion with MVO by CMR, VA burst does not further define MI size. However, with optimal TIMI 3 reperfusion and optimal microvascular perfusion (i.e. no MVO), VA burst is associated with larger IS, indicating that VA burst is a marker of additional cell death.

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