Value of Early Cardiovascular Magnetic Resonance for the Prediction of Adverse Arrhythmic Cardiac Events After a First Noncomplicated ST-Segment–Elevation Myocardial Infarction
| Autor: | Vicent Bodí, Jose V. Monmeneu, Cristina Gomez, F. Javier Chorro, Fabian Chaustre, Clara Bonanad, Maite Izquierdo, Pilar M Lopez-Lereu, Julio Núñez, Ricardo Ruiz-Granell, Ángel Ferrero |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Myocardial Infarction Magnetic Resonance Imaging Cine Kaplan-Meier Estimate Ventricular tachycardia Risk Assessment Sudden death Ventricular Function Left Predictive Value of Tests Risk Factors Internal medicine Humans Medicine ST segment Radiology Nuclear Medicine and imaging Prospective Studies cardiovascular diseases Myocardial infarction Aged Proportional Hazards Models Chi-Square Distribution Ejection fraction business.industry Myocardium Hazard ratio Arrhythmias Cardiac Stroke Volume Middle Aged Prognosis medicine.disease Confidence interval Death Sudden Cardiac ROC Curve Area Under Curve Multivariate Analysis Ventricular fibrillation cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation: Cardiovascular Imaging. 6:755-761 |
| ISSN: | 1942-0080 1941-9651 |
| DOI: | 10.1161/circimaging.113.000702 |
| Popis: | Background— Infarct size (IS) determined by cardiac magnetic resonance (CMR) has proven an additional value, on top of left ventricular ejection fraction (LVEF), in prediction of adverse arrhythmic cardiac events (AACEs) in chronic ischemic heart disease. Its value soon after an acute ST-segment–elevation myocardial infarction remains unknown. Our aim was to determine whether early CMR can improve AACE risk prediction after acute ST-segment–elevation myocardial infarction. Methods and Results— Patients admitted for a first noncomplicated ST-segment–elevation myocardial infarction were prospectively followed up. A total of 440 patients were included. All of them underwent CMR 1 week after admission. CMR-derived LVEF and IS (grams per meter squared) were quantified. AACEs included postdischarge sudden death, sustained ventricular tachycardia, and ventricular fibrillation either documented on ECG or recorded via an implantable cardioverter-defibrillator. Within a median follow-up of 2 years, 11 AACEs (2.5%) were detected: 5 sudden deaths (1.1%) and 6 spontaneous ventricular tachycardia/ventricular fibrillation. In the whole group, AACEs associated with more depressed LVEF (adjusted hazard ratio [95% confidence interval], 0.90 [0.83–0.97]; P P =0.01). According to the corresponding area under the receiver operating characteristic curve, LVEF ≤36% and IS ≥23.5 g/m 2 best predicted AACEs. The vast majority of AACEs (10/11) occurred in patients with simultaneous depressed LVEF ≤36% and IS ≥23.5 g/m 2 (n=39). Conclusions— In the era of reperfusion therapies, occurrence of AACEs in patients with an in-hospital noncomplicated first ST-segment–elevation myocardial infarction is low. In this setting, assessment of an early CMR-derived IS could be useful for further optimization of AACE risk prediction. |
| Databáze: | OpenAIRE |
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