Document Detail

Reperfusion haemorrhage as determined by cardiovascular MRI is a predictor of adverse left ventricular remodelling and markers of late arrhythmic risk.
MedLine Citation:
PMID:  21051455     Owner:  NLM     Status:  In-Data-Review    
Background Interstitial haemorrhage due to reperfusion of severely ischaemic myocardium can be detected in vivo by T2-weighted (T2W) and T2* cardiovascular magnetic resonance (CMR). The clinical implications of myocardial haemorrhage following primary percutaneous coronary intervention (PPCI) remain undetermined. Objectives To assess whether the presence of myocardial haemorrhage influences ventricular remodelling and risk of late ventricular arrhythmia following PPCI for acute myocardial infarction (AMI). Methods Forty-eight patients with first ST-elevation AMI, treated successfully with PPCI, underwent CMR at day 2 and 3 months. Left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were determined from cine-CMR, infarct size and microvascular obstruction (MVO) from gadolinium-enhanced images and area at risk (AAR) from T2W CMR. Myocardial haemorrhage was defined as hypointense signal within the AAR on both T2W and T2* images. All patients had a signal-averaged electrocardiogram at 3 months. Results 30/48 (63%) patients had MVO and 12 of these showed myocardial haemorrhage. Patients with haemorrhagic myocardial infarction (MI) had significantly larger LVEDV and LVESV, lower LVEF and larger infarcts than those with non-haemorrhagic MI at baseline and at 3 months. The presence of haemorrhage was an independent predictor of adverse remodelling defined as increased LVESV on follow-up (p=0.001, OR 1.6) and prolonged filtered QRS (fQRS) on signal-averaged ECG at 3 months (p=0.020, OR 1.176). Conclusions Reperfusion haemorrhage following AMI is associated with larger infarct size, diminished myocardial salvage and lower LVEF. The presence of haemorrhage is the strongest independent predictor of adverse ventricular remodelling and is also associated with prolonged fQRS duration, which is a marker of arrhythmic risk.
Adam N Mather; Timothy A Fairbairn; Stephen G Ball; John P Greenwood; Sven Plein
Related Documents :
19046785 - Improvement of cardiac function and remodeling by transplanting adipose tissue-derived ...
7501195 - A review of united states air force aeromedical evacuation of acute myocardial infarcti...
18651485 - The prognostic role of electrocardiographic left ventricular mass assessment for identi...
1539875 - Accuracy of 22-lead ecg analysis for diagnosis of acute myocardial infarction and coron...
25081355 - Electrocardiographic difference between ventricular arrhythmias from the right ventricu...
2055935 - Evaluation of proposed standards for runoff in femoropopliteal arterial reconstructions...
Publication Detail:
Type:  Journal Article     Date:  2010-11-04
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  97     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  453-9     Citation Subset:  AIM; IM    
Division of Cardiovascular and Neuronal Remodelling, University of Leeds, G-floor, Jubilee Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK;
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  Oxidative stress induces distinct physiological responses in the two Trebouxia phycobionts of the li...
Next Document:  Optical coherence evaluation of everolimus-eluting stents 8 months after implantation.