Microvascular dysfunction determines infarct characteristics in patients with reperfused ST-segment elevation myocardial infarction: The MICROcirculation in Acute Myocardial Infarction (MICRO-AMI) study

Autor: Andreas Baumbach, Maria Pufulete, Chris Lawton, Julian Strange, Jessica Harris, Thomas W Johnson, Chiara Bucciarelli-Ducci, E McAlindon
Rok vydání: 2018
Předmět:
Male
Critical Care and Emergency Medicine
Adenosine
Physiology
medicine.medical_treatment
Myocardial Infarction
Glycobiology
lcsh:Medicine
Gadolinium
030204 cardiovascular system & hematology
Cardiovascular Physiology
Biochemistry
Hyperaemia
0302 clinical medicine
Mathematical and Statistical Techniques
Medicine and Health Sciences
Medicine
ST segment
030212 general & internal medicine
Myocardial infarction
Prospective Studies
lcsh:Science
Aged
80 and over
Multidisciplinary
biology
Statistics
Nucleosides
Arteries
Middle Aged
Troponin
Glycosylamines
Chemistry
medicine.anatomical_structure
Blood Circulation
Physical Sciences
Cardiology
Regression Analysis
Female
medicine.symptom
Anatomy
TIMI
Research Article
Chemical Elements
Adult
medicine.medical_specialty
Linear Regression Analysis
Research and Analysis Methods
BTC (Bristol Trials Centre)
03 medical and health sciences
Coronary circulation
Percutaneous Coronary Intervention
Internal medicine
Coronary Circulation
Humans
cardiovascular diseases
Statistical Methods
Aged
business.industry
Microcirculation
lcsh:R
Percutaneous coronary intervention
Biology and Life Sciences
Proteins
medicine.disease
Cytoskeletal Proteins
Reperfusion
Vascular resistance
biology.protein
Cardiovascular Anatomy
ST Elevation Myocardial Infarction
Blood Vessels
lcsh:Q
Vascular Resistance
business
human activities
Magnetic Resonance Angiography
Mathematics
Zdroj: PLoS ONE
McAlindon, E, Pufulete, M, Harris, J, Lawton, C, Johnson, T, Strange, J, Baumbach, A & Bucciarelli-Ducci, C 2018, ' Microvascular dysfunction determines infarct characteristics in patients with reperfused ST-segment elevation myocardial infarction : The MICROcirculation in Acute Myocardial Infarction (MICRO-AMI) study ', PLoS ONE, vol. 13, no. 11, e0203750 . https://doi.org/10.1371/journal.pone.0203750
PLoS ONE, Vol 13, Iss 11, p e0203750 (2018)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0203750
Popis: BACKGROUND: In patients with reperfused ST-elevation myocardial infarction (STEMI) both invasive and non-invasive assessments of microvascular dysfunction, the index of microcirculatory resistance (IMR), and microvascular obstruction (MVO) by cardiovascular magnetic resonance (CMR), independently predict poor long-term outcomes.AIMS: The aims of this study were to investigate whether an invasive parameter (IMR), assessed at the time of primary percutaneous intervention (PPCI), could predict the extent of MVO in proportion to infarct size (MVO index).METHODS: 50 patients presenting with STEMI and TIMI flow ≤ I in the infarct related artery were prospectively recruited to the study, before undergoing PPCI. All patients underwent invasive IMR assessment at maximal hyperaemia using adenosine, and following stent insertion. CMR was performed on day 2 following STEMI, MVO was assessed both on first-pass rest perfusion (early MVO) and in the late gadolinium enhancement (LGE) images (late MVO) along with infarct size. The MVO index was calculated as the ratio of late MVO/infarct size. Differences between IMR quartiles and the MVO index were investigated.RESULTS: The median IMR was 38.5 (range 9 to 202). The median size of late MVO was 1.9% LV (range 0 to 21.0% LV). IMR predicted late MVO (pCONCLUSION: IMR measured at the time of PPCI in acutely reperfused STEMI is associated with the presence and severity of infarct damage as measured by the MVO index.TRIAL REGISTRATION: The Microcirculation in Acute Myocardial Infarction (MICRO-AMI). Clinicaltrials.gov NCT01552564. Registered 9th March 2012.
Databáze: OpenAIRE
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