scholarly journals MRI for measuring therapy efficiency after revascularisation in ST-segment elevation myocardial infarction: a systematic review and meta-regression analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034359
Author(s):  
Benjamin Kendziora ◽  
Heli Stier ◽  
Peter Schlattmann ◽  
Marc Dewey
Keyword(s):  
Myocardial Infarction ◽  
Late Gadolinium Enhancement ◽  
Image Interpretation ◽  
Mixed Effects ◽  
Gadolinium Enhancement ◽  
Gender Distribution ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Study Heterogeneity

ObjectiveTo summarise existing data on the relation between the time from symptom onset until revascularisation (time to reperfusion) and the myocardial salvage index (MSI) calculated as proportion of non-necrotic myocardium inside oedematous myocardium on T2-weighted and T1-weighted late gadolinium enhancement MRI after ST-segment elevation myocardial infarction (STEMI).MethodsStudies including patients with revascularised STEMI and stating both the time to reperfusion and the MSI measured by T2-weighted and T1-weighted late gadolinium enhancement MRI were searched in MEDLINE, EMBASE and ISI Web of Science until 16 May 2020. A mixed effects model was used to evaluate the relation between the time to reperfusion and the MSI. The gender distribution and mean age in included patient groups, the timing of MRI, used MRI sequences and image interpretation methodology were included in the mixed effects model to explore between-study heterogeneity.ResultsWe included 38 studies with 5106 patients. The pooled MSI was 42.6% (95% CI: 38.1 to 47.1). The pooled time to reperfusion was 3.8 hours (95% CI: 3.5 to 4.0). Every hour of delay in reperfusion was associated with an absolute decrease of 13.1% (95% CI: 11.5 to 14.6; p<0.001) in the MSI. Between-study heterogeneity was considerable (σ2=167.8). Differences in the gender distribution, timing of MRI and image interpretation among studies explained 45.2% of the between-study heterogeneity.ConclusionsThe MSI on T2-weighted and T1-weighted late gadolinium enhancement MRI correlates inversely with the time to reperfusion, which indicates that cardioprotection achieved by minimising the time to reperfusion leads to a higher MSI. The analysis revealed considerable heterogeneity between studies. The heterogeneity could partly be explained by differences in the gender distribution, timing and interpretation of MRI suggesting that the MRI-assessed MSI is not only influenced by cardioprotective therapy but also by patient characteristics and MRI parameters.

scholarly journals Correlation of Myocardial Strain and Late Gadolinium Enhancement by Cardiac Magnetic Resonance After a First Anterior ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 8 ◽  
Author(s):  
Shiqin Yu ◽  
Jinying Zhou ◽  
Kai Yang ◽  
Xiuyu Chen ◽  
Yucong Zheng ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Left Ventricular ◽  
Adjacent Region ◽  
Remote Region ◽  
Gadolinium Enhancement ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Objectives: To investigate the correlation of cardiac magnetic resonance (CMR) feature-tracking with conventional CMR parameters in patients with a first anterior ST-segment elevation myocardial infarction (STEMI).Methods: This sub-analysis of OCTAMI (Optical Coherence Tomography Examination in Acute Myocardial Infarction) registry included 129 patients who finished a CMR examination 1 month after a first anterior STEMI. Cine images were applied to calculate both global and segmental left ventricular peak strain parameters. The patients were divided into two groups by left ventricular ejection fraction (LVEF) and compared with 42 healthy controls. Segmental late gadolinium enhancement (LGE) was graded according to LGE transmurality as follows: (1) &gt;0 to ≤ 25%; (2) &gt;25 to ≤ 50%; (3) &gt;50 to ≤ 75%; (4) &gt;75%. Left ventricle was divided into infarcted, adjacent, and remote regions to assess regional function.Results: Compared with controls, global radial (28.39 ± 5.08% vs. 38.54 ± 9.27%, p &lt; 0.05), circumferential (−16.91 ± 2.11% vs. −20.77 ± 2.78%, p &lt; 0.05), and longitudinal (−13.06 ± 2.15 vs. −15.52 ± 2.69, p &lt; 0.05) strains were impaired in STEMI patients with normal LVEF (≥55%). Strain parameters were strongly associated with LGE (radial: r = 0.65; circumferential: r = 0.69; longitudinal: r = 0.61; all p &lt; 0.05). A significant and stepwise impairment of global strains was observed in groups divided by LGE tertiles. Furthermore, segmental strain was different in various degrees of LGE transmurality especially for radial and circumferential strain. Strains of adjacent region were better than infarcted region in radial and circumferential directions and worse than remote region in all three directions.Conclusion: Global and regional strain could stratify different extent and transmurality of LGE, respectively. Although without LGE, adjacent region had impaired strains comparing with remote region.

Hospital and long-term prognosis of patients with non-ST-segment elevation myocardial infarction

2008 ◽  
Vol 149 (45) ◽  
pp. 2115-2119 ◽  
Author(s):  
András Jánosi ◽  
Dániel Várnai ◽  
Zsófia Ádám ◽  
Adrienn Surman ◽  
Katalin Vas
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Long Term Prognosis

A szerzők 139, nem ST-elevációs infarktus miatt kezelt betegük adatait elemzik. Vizsgálják a betegek kórházi és késői prognózisát, egyes echokardiográfiás adatok prognózissal való összefüggését, valamint a kórházból elbocsátott betegek esetén a szekunder prevenció szempontjából ajánlott gyógyszeres kezelés gyakoriságát. Az utánkövetés a betegek 98%-ában sikeres volt, a bekövetkezett eseményekről, illetve az utánkövetés idején alkalmazott gyógyszeres kezelésről postai kérdőív útján szereztek adatokat. A nők átlagéletkora 78,6, a férfiaké 71,4 év volt. A kezelt betegeknél gyakori volt a társbetegségek (hypertonia, diabetes mellitus, korábbi ischaemiás szívbetegség) előfordulása. A kórházi kezelés időszakában 30 betegnél (22%) történt koronarográfia, és 29 betegnél revascularisatiós beavatkozásra is sor került. A kórházi halálozás 15% volt, az utánkövetés háromnegyed éve alatt 17%-os halálozást észleltek. A kórházban, illetve az utánkövetési idő alatt meghalt betegek szignifikánsan idősebbek voltak azoknál, akik életben maradtak. Egyes echokardiográfiás adatok (ejekciós frakció, végszisztolés átmérő, szegmentális falmozgászavar és a mitralis insufficientia nagysága) prognosztikus jelentőségűnek bizonyultak, mivel szignifikánsan különböztek az életben maradt és a meghalt betegek esetén. A kórházból elbocsátott betegek igen magas arányban részesültek a másodlagos prevenció szempontjából fontosnak ítélt gyógyszeres kezelésben (aszpirin, béta-blokkoló, ACE-gátló, statin). Az utánkövetés idején sem csökkent ezen gyógyszerek használatának aránya, ami a betegek jó compliance-ét igazolja.

Optical coherence tomography evidence of endothelial erosion as a cause of ST-segment elevation myocardial infarction

2013 ◽  
Vol 14 (5) ◽  
pp. 393-394 ◽  
Author(s):  
Massimo Fineschi ◽  
Vasile Sirbu ◽  
Flavio D’Ascenzi ◽  
Arcangelo Carrera ◽  
Riccardo Barbati ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Optical Coherence ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment
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