Prognostic implication of global myocardial blood flow in patients with ST-segment elevation myocardial infarction
The prognostic implications of cardiovascular magnetic resonance imaging (CMR)-derived hyperemic myocardial blood flow (MBF) in patients with ST-elevation myocardial infarction (STEMI) are unknown. This study sought to investigate the incremental prognostic value of hyperemic MBF over conventional CMR markers to identify patients with high risk of future incidence of patient-oriented composite outcomes (POCO) and major adverse cardiac events (MACE) after STEMI. A total of 237 patients who presented with STEMI were prospectively enrolled. The CMR protocol included left-ventricular ejection fraction (LVEF), late gadolinium enhancement (LGE) and microvascular obstruction (MVO) measurement, and volumetric MBF assessment. During a median follow-up of 2.6 years, 47 patients experienced POCO (primary outcome) and 21 patients had MACE. In a multivariable model, multivessel disease, LGE, MVO, and hyperemic MBF were independently associated with POCO. Addition of hyperemic MBF to the model consisting of GRACE score, multivessel disease, LVEF, LGE, and MVO significantly improved the predictive efficacy (integrated discrimination improvement 0.020, p = 0.021). Patients with low hyperemic MBF had significantly higher incidence of MACE compared to those with high hyperemic MBF in propensity score matching analysis (p = 0.018). In conclusion, CMR-derived hyperemic MBF could provide independent and incremental prognostic value over LVEF, LGE, and MVO in patients with STEMI.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
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| Enthalten in: |
Heart and vessels - 35(2020), 7 vom: 31. Juli, Seite 936-945 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hamaya, Rikuta [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiovascular magnetic resonance imaging |
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| Anmerkungen: |
Date Completed 07.12.2020 Date Revised 14.12.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00380-020-01570-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM306956411 |
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| 520 | |a The prognostic implications of cardiovascular magnetic resonance imaging (CMR)-derived hyperemic myocardial blood flow (MBF) in patients with ST-elevation myocardial infarction (STEMI) are unknown. This study sought to investigate the incremental prognostic value of hyperemic MBF over conventional CMR markers to identify patients with high risk of future incidence of patient-oriented composite outcomes (POCO) and major adverse cardiac events (MACE) after STEMI. A total of 237 patients who presented with STEMI were prospectively enrolled. The CMR protocol included left-ventricular ejection fraction (LVEF), late gadolinium enhancement (LGE) and microvascular obstruction (MVO) measurement, and volumetric MBF assessment. During a median follow-up of 2.6 years, 47 patients experienced POCO (primary outcome) and 21 patients had MACE. In a multivariable model, multivessel disease, LGE, MVO, and hyperemic MBF were independently associated with POCO. Addition of hyperemic MBF to the model consisting of GRACE score, multivessel disease, LVEF, LGE, and MVO significantly improved the predictive efficacy (integrated discrimination improvement 0.020, p = 0.021). Patients with low hyperemic MBF had significantly higher incidence of MACE compared to those with high hyperemic MBF in propensity score matching analysis (p = 0.018). In conclusion, CMR-derived hyperemic MBF could provide independent and incremental prognostic value over LVEF, LGE, and MVO in patients with STEMI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cardiovascular magnetic resonance imaging | |
| 650 | 4 | |a Coronary flow reserve | |
| 650 | 4 | |a Myocardial blood flow | |
| 650 | 4 | |a ST-segment elevation myocardial infarction | |
| 700 | 1 | |a Kanaji, Yoshihisa |e verfasserin |4 aut | |
| 700 | 1 | |a Hada, Masahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Kanno, Yoshinori |e verfasserin |4 aut | |
| 700 | 1 | |a Usui, Eisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Hoshino, Masahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Yamaguchi, Masao |e verfasserin |4 aut | |
| 700 | 1 | |a Sumino, Yohei |e verfasserin |4 aut | |
| 700 | 1 | |a Horie, Tomoki |e verfasserin |4 aut | |
| 700 | 1 | |a Hirano, Hidenori |e verfasserin |4 aut | |
| 700 | 1 | |a Sugiyama, Tomoyo |e verfasserin |4 aut | |
| 700 | 1 | |a Kakuta, Tsunekazu |e verfasserin |4 aut | |
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