Relationship between CMR-derived parameters of ischemia/reperfusion injury and the timing of CMR after reperfused ST-segment elevation myocardial infarction.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_F184A0673B26
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Relationship between CMR-derived parameters of ischemia/reperfusion injury and the timing of CMR after reperfused ST-segment elevation myocardial infarction.
Journal
Journal of cardiovascular magnetic resonance
Author(s)
Masci P.G., Pavon A.G., Muller O., Iglesias J.F., Vincenti G., Monney P., Harbaoui B., Eeckhout E., Schwitter J.
ISSN
1532-429X (Electronic)
ISSN-L
1097-6647
Publication state
Published
Issued date
23/07/2018
Peer-reviewed
Oui
Volume
20
Number
1
Pages
50
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
To investigate the influence of cardiovascular magnetic resonance (CMR) timing after reperfusion on CMR-derived parameters of ischemia/reperfusion (I/R) injury in patients with ST-segment elevation myocardial infarction (STEMI).
The study included 163 reperfused STEMI patients undergoing CMR during the index hospitalization. Patients were divided according to the time between revascularization and CMR (T <sub>revasc-CMR</sub> : Tertile-1 ≤ 43; 43 < Tertile-2 ≤ 93; Tertile-3 > 93 h). T2-mapping derived area-at-risk (AAR) and intramyocardial-hemorrhage (IMH), and late gadolinium enhancement (LGE)-derived infarct size (IS) and microvascular obstruction (MVO) were quantified. T1-mapping was performed before and > 15 min after Gd-based contrast-agent administration yielding extracellular volume (ECV) of infarct.
Main factors influencing I/R injury were homogenously balanced across T <sub>revasc-CMR</sub> tertiles. T2 values of infarct and remote regions increased with increasing T <sub>revasc-CMR</sub> tertiles (infarct: 60.0 ± 4.9 vs 63.5 ± 5.6 vs 64.8 ± 7.5 ms; P < 0.001; remote: 44.3 ± 2.8 vs 46.1 ± 2.8 vs ± 46.1 ± 3.0; P = 0.001). However, T2 value of infarct largely and significantly exceeded that of remote myocardium in each tertile yielding comparable T2-mapping-derived AAR extent throughout T <sub>revasc-CMR</sub> tertiles (17 ± 9% vs 19 ± 9% vs 18 ± 8% of LV, respectively, P = 0.385). Similarly, T2-mapping-based IMH detection and quantification were independent of T <sub>revasc-CMR</sub> . LGE-derived IS and MVO were not influenced by T <sub>revasc-CMR</sub> (IS: 12 ± 9% vs 12 ± 9% vs 14 ± 9% of LV, respectively, P = 0.646). In 68 patients without MVO, T1-mapping based ECV of infarct region was comparable across T <sub>revasc-CMR</sub> tertiles (P = 0.470).
In STEMI patients, T2 values of infarct and remote myocardium increase with increasing CMR time after revascularization. However, these changes do not give rise to substantial variation of T2-mapping-derived AAR size nor of other CMR-based parameters of I/R.
ISRCTN03522116 . Registered 30.4.2018 (retrospectively registered).
Keywords
Adult, Aged, Contrast Media/administration & dosage, Edema, Cardiac/diagnostic imaging, Edema, Cardiac/etiology, Edema, Cardiac/physiopathology, Female, Humans, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Myocardial Reperfusion/adverse effects, Myocardial Reperfusion Injury/diagnostic imaging, Myocardial Reperfusion Injury/etiology, Myocardial Reperfusion Injury/physiopathology, Organometallic Compounds/administration & dosage, Predictive Value of Tests, Registries, ST Elevation Myocardial Infarction/diagnostic imaging, ST Elevation Myocardial Infarction/physiopathology, ST Elevation Myocardial Infarction/surgery, Time Factors, Treatment Outcome, Cardiovascular magnetic resonance, Extracellular volume, Myocardial edema, Myocardial infarction, T1-mapping, T2-mapping
Pubmed
Web of science
Open Access
Yes
Create date
31/07/2018 11:03
Last modification date
20/08/2019 16:19
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