Impact of Early ST-Segment Changes on Cardiac Magnetic Resonance-Verified Intramyocardial Haemorrhage and Microvascular Obstruction in ST-Elevation Myocardial Infarction Patients

Medicine
Song DingJun Pu

Abstract

The aim of this study was to explore the significance of different ST-segment changes before and after percutaneous coronary intervention (PCI), in relation to cardiac magnetic resonance (CMR)-verified microvascular obstruction (MVO) along with intramyocardial hemorrhage (IMH) in ST-elevation myocardial infarction (STEMI) patients.This study enrolled 108 STEMI patients who received primary PCI and had no contraindication of CMR investigation. Sum ST-segment elevation (STE), maximal STE on admission and sum ST-segment resolution (STR), and single-lead STR and residual STE at 60 minutes after primary PCI were assessed. MVO and IMH were determined by contrast-enhanced CMR.Patients were classified into 3 groups: 30 patients with MVO(-)/IMH(-), 25 with MVO(+)/IMH(-), and 53 with MVO(+)/IMH(+). Sum STE (P = 0.001), maximal STE (P < 0.001), and residual STE (P = 0.025) were highest and single-lead STR was lowest (P = 0.044) in the MVO(+)/IMH(+) group. Receiver operator characteristics curve analysis revealed that maximal STE was the most powerful factor for distinguishing between MVO(+) and MVO(-) patients (optimal threshold = 0.5 mV, area under the curve, AUC = 0.718, P < 0.001), or IMH(+) and IMH(-) patients (optimal threshold = 0.5...Continue Reading

References

Oct 24, 2007·Circulation·Kristian ThygesenNawwar Al-Attar
Aug 30, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Jung-Sun KimYangsoo Jang
Jul 25, 2009·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·J VicenteD Revel
Sep 17, 2009·The International Journal of Cardiovascular Imaging·A M BeekA C van Rossum
Oct 17, 2009·JACC. Cardiovascular Imaging·Robin NijveldtFelix Zijlstra
Dec 5, 2009·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Song DingBen He
Aug 23, 2011·European Heart Journal·Cheuk-Kit WongUNKNOWN HERO-2 Investigators
Jun 29, 2013·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Ananth KidambiSven Plein

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Software Mentioned

MedCalc
SPSS
QMass MR

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