scholarly journals Cardiovascular Magnetic Resonance for Risk Stratification in Patients With ST-Segment–Elevation Myocardial Infarction

2017 ◽  
Vol 10 (11) ◽  
Author(s):  
Jacob Lønborg ◽  
Thomas Engstrøm
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Risk Stratification ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Early or deferred cardiovascular magnetic resonance after ST-segment-elevation myocardial infarction for effective risk stratification

2019 ◽  
Vol 21 (6) ◽  
pp. 632-639 ◽  
Author(s):  
Pier Giorgio Masci ◽  
Anna Giulia Pavon ◽  
Gianluca Pontone ◽  
Rolf Symons ◽  
Valentina Lorenzoni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Risk Stratification ◽  
Primary Endpoint ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Timi Risk Score

Abstract Aims In ST-segment-elevation myocardial infarction (STEMI), cardiovascular magnetic resonance (CMR) holds the potentiality to improve risk stratification in addition to Thrombolysis in Myocardial Infarction (TIMI) risk score. Nevertheless, the optimal timing for CMR after STEMI remains poorly defined. We aim at comparing the prognostic performance of three stratification strategies according to the timing of CMR after STEMI. Methods and results The population of this prospective registry-based study included 492 reperfused STEMI patients. All patients underwent post-reperfusion (median: 4 days post-STEMI) and follow-up (median: 4.8 months post-STEMI) CMR. Left ventricular (LV) volumes, function, infarct size, and microvascular obstruction extent were quantified. Primary endpoint was a composite of all-death and heart failure (HF) hospitalization. Baseline-to-follow-up percentage increase of LV end-diastolic (EDV; ΔLV-EDV) ≥20% or end-systolic volumes (ESV; ΔLV-ESV) ≥15% were tested against outcome. Three multivariate models were developed including TIMI risk score plus early post-STEMI (early-CMR) or follow-up CMR (deferred-CMR) or both CMRs parameters along with adverse LV remodelling (paired-CMRs). During a median follow-up of 8.3 years, the primary endpoint occurred in 84 patients (47 deaths; 37 HF hospitalizations). Early-CMR, deferred-CMR, and paired-CMR demonstrated similar predictive value for the primary endpoint (C-statistic: 0.726, 0.728, and 0.738, respectively; P = 0.663). ΔLV-EDV ≥20% or ΔLV-ESV ≥15% were unadjusted outcome predictors (hazard ratio: 2.020 and 2.032, respectively; P = 0.002 for both) but lost their predictive value when corrected for other covariates in paired-CMR model. Conclusion In STEMI patients, early-, deferred-, or paired-CMR were equivalent stratification strategies for outcome prediction. Adverse LV remodelling parameters were not independent prognosticators.

scholarly journals 5010Prognostic value of strain assessed by tissue tracking cardiovascular magnetic resonance soon after a first ST-segment elevation myocardial infarction

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
C. Bonanad Lozano ◽  
J.F. Rodriguez-Palomares ◽  
J. Gavara ◽  
F. Valente ◽  
J.V. Monmeneu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Tissue Tracking ◽  
St Segment
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