Document Detail

Late cardiac remodeling after primary percutaneous coronary intervention-five-year cardiac magnetic resonance imaging follow-up.
MedLine Citation:
PMID:  23018679     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Primary percutaneous coronary intervention (PPCI) preserves function and improves survival. The late effects of PPCI on left ventricular remodeling, however, have not yet been investigated on cardiac magnetic resonance imaging (CMRI).
METHODS AND RESULTS: Twenty-five patients with acute myocardial infarction (AMI) treated with PPCI underwent CMRI within 10 days, at 4 months and at 5 years. Left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume were quantified on cine images. Infarct mass and transmural extent of infarction were quantified on contrast-enhanced imaging. In all patients EDV increased significantly in the early phase (192 ± 40 ml to 211 ± 49 ml, P ≤ 0.01) and LVEF improved significantly (42 ± 9% to 46 ± 9%, P=0.02). In the late phase (>4 months) no significant changes were observed (LVEF 44 ± 9%, P=0.07; EDV 216 ± 68 ml, P=0.38). Three different groups could be identified. One-third (32%) had no dilatation at all; one-third (32%) had limited dilatation at 4 months without progression later; and 36% had progressive dilatation both at 4 months and at late follow-up. This third group had an average increase in EDV of 20% in the acute phase followed by an additional 13%. The strongest predictor for progressive dilatation was infarct mass.
CONCLUSIONS: Even in the era of PPCI for AMI followed by optimal medical therapy, one-third of patients had progressive dilatation, which was best predicted by infarct mass.
Tirza Springeling; Sharon W Kirschbaum; Alexia Rossi; Timo Baks; Yusuf Karamermer; Carl Schulz; Mohammed Ouhlous; Dirk J Duncker; Adriaan Moelker; Gabriel P Krestin; Patrick W J C Serruys; Pim de Feyter; Robert-Jan M van Geuns
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2012-09-27
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  77     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-07     Completed Date:  2013-06-13     Revised Date:  2013-07-08    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  81-8     Citation Subset:  IM    
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Dilatation, Pathologic / etiology,  physiopathology,  radiography
Follow-Up Studies
Hypertrophy, Left Ventricular / etiology,  physiopathology*,  radiography
Magnetic Resonance Imaging
Middle Aged
Myocardial Infarction / physiopathology*,  radiography,  surgery*
Percutaneous Coronary Intervention / adverse effects*
Postoperative Complications / physiopathology*,  radiography
Stroke Volume
Ventricular Remodeling*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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