Portal de investigación
Impact of Persistent Microvascular Obstruction Late After STEMI on Adverse LV Remodeling A CMR Study
Fecha de publicación:
Fecha Ahead of Print:
Autores de INCLIVA
Participantes ajenos a INCLIVA
- Gavara, Jose
- Lopez-Lereu, Maria P
- Monmeneu, Jose V
- Perez-Sole, Nerea
- Moratal, David
- Rodriguez-Palomares, Jose F
- Freixa, Andrea
- Borras, Roger
- Ortiz-Perez, Jose T
Grupos y Plataformas de I+D+i
Abstract
BACKGROUND Little is known about the occurrence and implications of persistent microvascular obstruction (MVO) after reperfused ST-segment elevation myocardial infarction (STEMI). OBJECTIVES The authors used cardiac magnetic resonance (CMR) to characterize the impact of persistent MVO on adverse left ventricular remodeling (ALVR). METHODS A prospective registry of 471 STEMI patients underwent CMR 7 (IQR: 5-10) days and 198 (IQR: 167-231) days after infarction. MVO (>= 1 segment) and ALVR (relative increase >15% at follow-up CMR) of left ventricular end-diastolic index (LVEDVI) and left ventricular end-systolic volume index (LVESVI) were determined. RESULTS One-week MVO occurred in 209 patients (44%) and persisted in 30 (6%). The extent of MVO (P = 0.026) and intramyocardial hemorrhage (P = 0.001) at 1 week were independently associated with the magnitude of MVO at follow-up CMR. Compared with patients without MVO (n = 262, 56%) or with MVO only at 1 week (n =179, 38%), those with persistent MVO at follow-up (n = 30, 6%) showed higher rates of ALVR-LVEDVI (22%, 27%, and 50%; P = 0.003) and ALVR-LVESVI (20%, 21%, and 53%; P < 0.001). After adjustment, persistent MVO at follow-up (>= 1 segment) was independently associated with Delta LVEDVI (relative increase, %) (P < 0.001) and ?LVESVI (P < 0.001). Compared with a 1:1 propensity score-matched population on CMR variables made up of 30 patients with MVO only at 1 week, patients with persistent MVO more frequently displayed ALVR-LVEDVI (12% vs 50%; P = 0.003) and ALVR-LVESVI (12% vs 53%; P = 0.001). CONCLUSIONS MVO persists in a small percentage of patients in chronic phase after STEMI and exerts deleterious effects in terms of LV remodeling. These findings fuel the need for further research on microvascular injury repair. (c) 2023 by the American College of Cardiology Foundation.
Datos de la publicación
- ISSN/ISSNe:
- 1936-878X, 1876-7591
- Tipo:
- Article
- Páginas:
- 919-930
- PubMed:
- 37052556
JACC-CARDIOVASCULAR IMAGING ELSEVIER SCIENCE INC
Citas Recibidas en Web of Science: 16
Documentos
- No hay documentos
Filiaciones
Keywords
- cardiac magnetic resonance; microvascular obstruction; myocardial infarction
Financiación
Proyectos y Estudios Clínicos
Resolution of microvascular obstruction after myocardial infarction. A multidisciplinary approach to assess the structural and clinical consequences and to evaluate new therapeutic options.
Investigador Principal: VICENT BODÍ PERIS
PI20/00637 . INSTITUTO SALUD CARLOS III . 2021
A multidisciplinary study to advance in the understanding of the basic mechanisms and clinical implications of microvascular obstruction after acute myocardial infarction. Exploration of novel diagnostic and therapeutic opportunities.
Investigador Principal: VICENT BODÍ PERIS
PROMETEO/2021/008 . CONSELLERIA EDUCACION/INNOVACION,UNIVERSIDADES, CIENCIA Y SOCIEDAD DIGITAL/EMPLEO . 2021
Cita
Impact of Persistent Microvascular Obstruction Late After STEMI on Adverse LV Remodeling A CMR Study. Bodi V, Gavara J, Lopez MP, Monmeneu JV, de Dios E, Perez N, Bonanad C et al. JACC-CARDIOVASCULAR IMAGING. 2023 julio 01. 16 (7):919-930. DOI:10.1016/j.jcmg.2023.01.021. PMID:37052556.
