Hemorrhagic Myocardial Infarction After Coronary Reperfusion Detected In Vivo by Magnetic Resonance Imaging in Humans: Prevalence and Clinical Implications
| Autor: | Toshio Shimada, Kazuya Sano, Shin-ichi Inoue, Yo Murakami, Hideaki Kawamitsu, Kazuro Sugimura, Rinji Murakami, Koichi Ochiai, Yutaka Ishibashi, Jun Kitamura |
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| Rok vydání: | 1999 |
| Předmět: |
Male
medicine.medical_specialty Myocardial Infarction Hemorrhage Myocardial Reperfusion Autopsy Coronary Angiography Scintigraphy Statistics Nonparametric In vivo Internal medicine Humans Medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Myocardial infarction Angioplasty Balloon Coronary Aged Tomography Emission-Computed Single-Photon Analysis of Variance Ejection fraction Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Intensity (physics) medicine.anatomical_structure Case-Control Studies Cardiology Female Cardiomyopathies Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Journal of Cardiovascular Magnetic Resonance. 1:247-256 |
| ISSN: | 1097-6647 |
| Popis: | With the advent of thrombolytic therapy, hemorrhagic myocardial infarction (HMI) has been observed in experimental and human autopsy studies. However, its clinical implications remain undetermined, because of the absence of a reliable method to detect its presence in vivo. This study was designed to evaluate the clinical implications of HMI detected by magnetic resonance (MR) imaging in vivo after coronary reperfusion. Thirty-nine patients with acute myocardial infarction (AMI) were studied. Percutaneous transluminal coronary angioplasty (PTCA) was used to reopen the occluded coronary artery. Electrocardiogram (ECG)-gated T2*-weighted gradient-echo MR imaging was performed to detect intramyocardial hemorrhage, using a 1.5-T magnet within 2 weeks after coronary reperfusion (average, 5.7 days). Thirteen patients (33%) showed intramyocardial hemorrhage as a distinct hypointense zone by gradient-echo MR imaging and 26 patients showed homogeneous intensity consistent with absence of intramyocardial hemorrhage. Coronary angiograms showed lesser development of collateral flow in the patients with HMI than in those without (81% vs. 37%). Infarct size, estimated 1 month after coronary reperfusion by thallium-201 scintigraphy, was larger among patients with HMI than in those without (37 +/- 14% vs. 21 +/- 14%, respectively, p < 0.05). Left ventricular ejection fraction at 1 month follow-up showed less recovery in patients with HMI than in those without (47 +/- 9 to 51 +/- 10%; p = 0.47, vs. 53 +/- 10 to 60 +/- 9%, respectively, p < 0.05). ECG-gated T2*-weighted gradient-echo MR imaging offers a noninvasive means of detection of intramyocardial hemorrhage in patients with reperfused AMI. HMI occurred even after primary PTCA and may be a common finding associated with severely injured myocardium. |
| Databáze: | OpenAIRE |
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