EpCAM and microvascular obstruction in patients with STEMI: a cardiac magnetic resonance study

Autor: Cesar Rios-Navarro, Vicente Bodi, José M. Vila, Ricardo Oltra, Francisco J. Chorro, Nerea Perez-Sole, Jose Gavara, Elena Revuelta-López, Elena de Dios, Antoni Bayes-Genis, Jose V. Monmeneu, Maria P. Lopez-Lereu, Julio Núñez
Rok vydání: 2022
Předmět:
Male
medicine.medical_specialty
Magnetic Resonance Spectroscopy
medicine.medical_treatment
Magnetic Resonance Imaging
Cine
030204 cardiovascular system & hematology
Ventricular Function
Left
03 medical and health sciences
chemistry.chemical_compound
Percutaneous Coronary Intervention
0302 clinical medicine
Internal medicine
medicine
Humans
In patient
cardiovascular diseases
Myocardial infarction
Ventricular remodeling
End-systolic volume
Aged
Ejection fraction
business.industry
Microcirculation
Percutaneous coronary intervention
Stroke Volume
Epithelial cell adhesion molecule
General Medicine
Middle Aged
Epithelial Cell Adhesion Molecule
medicine.disease
Magnetic Resonance Imaging
chemistry
Cardiology
ST Elevation Myocardial Infarction
Female
business
Cardiac magnetic resonance
human activities
Zdroj: Revista Española de Cardiología (English Edition). 75:384-391
ISSN: 1885-5857
DOI: 10.1016/j.rec.2021.04.006
Popis: Introduction and objectives Microvascular obstruction (MVO) is negatively associated with cardiac structure and worse prognosis after ST-segment elevation myocardial infarction (STEMI). Epithelial cell adhesion molecule (EpCAM), involved in epithelium adhesion, is an understudied area in the MVO setting. We aimed to determine whether EpCAM is associated with the appearance of cardiac magnetic resonance (CMR)-derived MVO and long-term systolic function in reperfused STEMI. Methods We prospectively included 106 patients with a first STEMI treated with percutaneous coronary intervention, quantifying serum levels of EpCAM 24 hours postreperfusion. All patients underwent CMR imaging 1 week and 6 months post-STEMI. The independent correlation of EpCAM with MVO, systolic volume indices, and left ventricular ejection fraction was evaluated. Results The mean age of the sample was 59 ± 13 years and 76% were male. Patients were dichotomized according to median EpCAM (4.48 pg/mL). At 1-week CMR, lower EpCAM was related to extensive MVO (P = .021) and larger infarct size (P = .019). At presentation, EpCAM values were significantly associated with the presence of MVO in univariate (OR, 0.58; 95%CI, 0.38-0.88; P = .011) and multivariate logistic regression models (OR, 0.55; 95%CI, 0.35-0.87; P = .010). Although MVO tends to resolve at chronic phases, decreased EpCAM was associated with worse systolic function: reduced left ventricular ejection fraction (P = .009) and higher left ventricular end-systolic volume (P = .043). Conclusions EpCAM is associated with the occurrence of CMR-derived MVO at acute phases and long-term adverse ventricular remodeling post-STEMI.
Databáze: OpenAIRE
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