Document Detail


Microvascular perfusion 1 week and 6 months after myocardial infarction by first-pass perfusion cardiovascular magnetic resonance imaging.
MedLine Citation:
PMID:  16803939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To characterise the evolution of myocardial perfusion during the first 6 months after myocardial infarction by first-pass perfusion cardiovascular magnetic resonance imaging (CMR) and determine its significance. DESIGN: Prospective cohort design. SETTING: Single-centre study in a teaching hospital in Spain. PATIENTS: 40 patients with a first ST-elevation myocardial infarction, single-vessel disease and thrombolysis in myocardial infarction (TIMI) grade 3 flow (stent in 33 patients) underwent rest and low-dose dobutamine CMR 7 (SD 1) and 184 (SD 11) days after infarction. Microvascular perfusion was assessed at rest by visual assessment and quantitative analysis of first-pass perfusion CMR. Of the 640 segments, 290 segments subtended by the infarct-related artery (IRA) were focused on. RESULTS: Both 1 week and 6 months after infarction, segments with normal perfusion showed more wall thickening, contractile reserve and wall thickness, and less transmural necrosis, p <0.05 in all cases. Of 76 hypoperfused segments at the first week, 47 (62%) normalised perfusion at the sixth month. However, 42 segments (14% of the whole group) showed chronic abnormal perfusion; these segments showed worse CMR indices in the late phase (p<0.05 in all cases). CONCLUSIONS: In patients with an open IRA, more than half of the segments with abnormal perfusion at the first week are normally perfused after six months. First-pass perfusion CMR shows that in a small percentage of segments, abnormal perfusion may become a chronic phenomenon-these areas have a more severe deterioration of systolic function, wall thickness, contractile reserve and the transmural extent of necrosis.
Authors:
V Bodí; J Sanchis; M P López-Lereu; J Núñez; R Sanz; P Palau; C Gómez; D Moratal; F J Chorro; A Llácer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-06-27
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  92     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-19     Completed Date:  2006-12-19     Revised Date:  2010-09-14    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1801-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Hospital Clínico y Universitario de Valencia, Universidad de Valencia, Valencia, Spain. vicentbodi@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Coronary Circulation / physiology*
Diastole
Female
Humans
Magnetic Resonance Angiography
Male
Microcirculation / physiology
Middle Aged
Myocardial Infarction / pathology,  physiopathology*
Myocardium / pathology
Necrosis
Prospective Studies
Systole
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