Document Detail


Late gadolinium-enhanced cardiovascular magnetic resonance evaluation of infarct size and microvascular obstruction in optimally treated patients after acute myocardial infarction.
MedLine Citation:
PMID:  17891613     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Cardiovascular magnetic resonance (CMR) is considered the standard imaging modality in clinical trials to monitor patients after acute myocardial infarction (AMI). However, limited data is available with respect to infarct size, presence, and extent of microvascular injury (MVO), and changes over time, in relation to cardiac function in these optimally treated patients. In this study, we prospectively investigate the change of infarct size over time, and the incidence and significance of MVO in a uniform, optimally treated patient group after AMI. METHODS: Forty patients underwent cine and late gadolinium-enhanced CMR within 9 days and at 4 months after primary stenting. Left ventricular ejection fraction (LVEF), infarct size (IS) and MVO size were calculated. RESULTS: IS decreased with 19.0% at follow-up (p<0.01). The 23 (57.5%) patients with MVO had larger infarct size, higher left ventricular volumes and lower LVEF and more involution of IS at follow-up. Overall, LVEF improved from 42.3+/-9.8% to 44.0+/-9.8% (p=0.06), irrespective of presence or size of MVO. CONCLUSION: Infarct size reduces over time by 19.0% in optimally treated patients after AMI. Despite optimal reperfusion, MVO was found in the majority of patients. Although patients with MVO had larger infarcts and worse indices of left ventricular remodelling, functional change at follow-up was comparable to patients without MVO.
Authors:
Robin Nijveldt; Aernout M Beek; Mark B M Hofman; Victor A W M Umans; Paul R Algra; Marieke D Spreeuwenberg; Cees A Visser; Albert C van Rossum
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance     Volume:  9     ISSN:  1097-6647     ISO Abbreviation:  J Cardiovasc Magn Reson     Publication Date:  2007  
Date Detail:
Created Date:  2007-09-24     Completed Date:  2008-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815616     Medline TA:  J Cardiovasc Magn Reson     Country:  United States    
Other Details:
Languages:  eng     Pagination:  765-70     Citation Subset:  IM    
Affiliation:
Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. R.Nijveldt@vumc.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation*
Cardiovascular Agents / therapeutic use*
Contrast Media*
Coronary Circulation
Female
Follow-Up Studies
Gadolinium DTPA / diagnostic use*
Humans
Magnetic Resonance Imaging, Cine*
Male
Microcirculation / pathology
Middle Aged
Myocardial Infarction / diagnosis*,  pathology,  physiopathology,  therapy
Prospective Studies
Research Design
Stents*
Stroke Volume
Time Factors
Treatment Outcome
Ventricular Function, Left
Ventricular Remodeling
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 0/Contrast Media; 80529-93-7/Gadolinium DTPA

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