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

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_F184A0673B26
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Relationship between CMR-derived parameters of ischemia/reperfusion injury and the timing of CMR after reperfused ST-segment elevation myocardial infarction.
Périodique
Journal of cardiovascular magnetic resonance
Auteur(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
Statut éditorial
Publié
Date de publication
23/07/2018
Peer-reviewed
Oui
Volume
20
Numéro
1
Pages
50
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Résumé
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).
Mots-clé
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
Oui
Création de la notice
31/07/2018 12:03
Dernière modification de la notice
20/08/2019 17:19
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