| Impact of primary coronary angioplasty delay on myocardial salvage, infarct size, and microvascular damage in patients with ST-segment elevation myocardial infarction: insight from cardiovascular magnetic resonance. | |
| | |
MedLine Citation:
|
PMID: 19942086 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: We investigated the extent and nature of myocardial damage by using cardiovascular magnetic resonance (CMR) in relation to different time-to-reperfusion intervals. BACKGROUND: Previous studies evaluating the influence of time to reperfusion on infarct size (IS) and myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) have yielded conflicting results. METHODS: Seventy patients with STEMI successfully treated with primary percutaneous coronary intervention within 12 h from symptom onset underwent CMR 3 +/- 2 days after hospital admission. Patients were subcategorized into 4 time-to-reperfusion (symptom onset to balloon) quartiles: < or =90 min (group I, n = 19), >90 to 150 min (group II, n = 17), >150 to 360 min (group III, n = 17), and >360 min (group IV, n = 17). T2-weighted short tau inversion recovery and late gadolinium enhancement CMR were used to characterize reversible and irreversible myocardial injury (area at risk and IS, respectively); salvaged myocardium was defined as the normalized difference between extent of T2-weighted short tau inversion recovery and late gadolinium enhancement. RESULTS: Shorter time-to-reperfusion (group I) was associated with smaller IS and microvascular obstruction and larger salvaged myocardium. Mean IS progressively increased overtime: 8% (group I), 11.7% (group II), 12.7% (group III), and 17.9% (group IV), p = 0.017; similarly, MVO was larger in patients reperfused later (0.5%, 1.5%, 3.7%, and 6.6%, respectively, p = 0.047). Accordingly, salvaged myocardium markedly decreased when reperfusion occurred >90 min of coronary occlusion (8.5%, 3.2%, 2.4%, and 2.1%, respectively, p = 0.004). CONCLUSIONS: In patients with STEMI treated with primary percutaneous coronary intervention, time to reperfusion determines the extent of reversible and irreversible myocardial injury assessed by CMR. In particular, salvaged myocardium is markedly reduced when reperfusion occurs >90 min of coronary occlusion. |
| | |
Authors:
|
Marco Francone; Chiara Bucciarelli-Ducci; Iacopo Carbone; Emanuele Canali; Raffaele Scardala; Francesca A Calabrese; Gennaro Sardella; Massimo Mancone; Carlo Catalano; Francesco Fedele; Roberto Passariello; Jan Bogaert; Luciano Agati |
Related Documents
:
|
1801796 - Immediate functional benefits after controlled reperfusion during surgical revasculariz... 1718696 - Local myocardial biochemical and ionic alterations during myocardial ischaemia and repe... 9323086 - Amelioration of ischemia- and reperfusion-induced myocardial injury by 17beta-estradiol... 2153476 - Sustained limitation of myocardial reperfusion injury by a monoclonal antibody that alt... 7151086 - Effects of tiapamil on myocardial performance in coronary artery disease. 21933586 - Relationship between coronary atherosclerosis plaque characteristics and high sensitivi... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 54 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2009 Dec |
Date Detail:
|
Created Date: 2009-11-27 Completed Date: 2010-01-05 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 2145-53 Citation Subset: AIM; IM |
Affiliation:
|
Cardiovascular Magnetic Resonance Unit, Department of Radiology Sciences, Sapienza University of Rome, Rome 00161, Italy. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Angioplasty, Transluminal, Percutaneous Coronary
/
methods* Coronary Circulation / physiology* Electrocardiography* Female Follow-Up Studies Humans Magnetic Resonance Imaging / methods* Male Microcirculation* Middle Aged Myocardial Infarction / diagnosis, physiopathology, therapy* Myocardial Reperfusion Injury / diagnosis*, etiology, physiopathology Prognosis Prospective Studies Time Factors |
| Comments/Corrections | |
Comment In:
|
J Am Coll Cardiol. 2009 Dec 1;54(23):2154-6
[PMID:
19942087
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A Half Century of Selective Coronary Arteriography.
Next Document: Microemboli and Microvascular Obstruction in Acute Coronary Thrombosis and Sudden Coronary Death Rel...