| Prognostic value of microvascular damage determined by cardiac magnetic resonance in non ST-segment elevation myocardial infarction: comparison between first-pass and late gadolinium-enhanced images. | |
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MedLine Citation:
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PMID: 20562707 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVES: To compare 2 cardiac magnetic resonance (CMR) techniques for the evaluation of the prognostic significance of microvascular damage after non ST-segment elevation myocardial infarction (NSTEMI). MATERIALS AND METHODS: CMR was performed at 3T in 61 patients within the week following their first NSTEMI. A first-pass saturation-recovery gradient-echo perfusion sequence was started during the infusion of contrast material to evaluate the extent of microvascular obstruction (MO) during the first 2 minutes after injection (MO(<2 min)) and between 3 and 5 minutes thereafter (MO(3 min), MO(4 min), MO(5 min)). Ten minutes after injection, late gadolinium-enhanced images were obtained using a phase sensitive inversion recovery sequence to assess persistent MO (PMO) and infarct size. Major adverse cardiac events (MACE) were collected at 1-year follow-up. RESULTS: MO(<2 min) and PMO were found in 28 of 61 and 17 of 61 patients, respectively. About 15 patients had MACE at 1 year, including 4 cardiac deaths. In univariate logistic regression analysis, age (odds ratio [OR], 1.07, P = 0.020), infarct size (OR, 1.08, P = 0.020), multivessel disease (OR, 5.08, P = 0.011), end diastolic volume (OR, 1.04, P = 0.003), end systolic volume (OR, 1.03, P = 0.010), MO from < 2 to 5 minutes postinjection (P < 0.05) and PMO (OR, 18.33, P < 0.001) were significantly associated with the outcome. In multivariate analysis, only PMO remained an independent predictor of MACE. CONCLUSION: Microvascular damage assessed by CMR is associated with a dramatically higher risk of cardiovascular events in NSTEMI patients. Moreover, our data suggest that PMO as assessed on late gadolinium-enhanced images might have a higher prognostic value than MO evaluated on first-pass images. |
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Authors:
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Alexandre Cochet; Alain Lalande; Luc Lorgis; Marianne Zeller; Jean-Claude Beer; Paul M Walker; Claude Touzery; Jean-Eric Wolf; Yves Cottin; François Brunotte |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Investigative radiology Volume: 45 ISSN: 1536-0210 ISO Abbreviation: Invest Radiol Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-05 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0045377 Medline TA: Invest Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 725-32 Citation Subset: IM |
Affiliation:
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MRI Unit, University Hospital, Boulevard du Maréchal de Lattre de Tassigny, Dijon, France. alexandre.cochet@yahoo.fr |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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