Prognostic value of microvascular occlusion MRI quantification in assessment of reperfused myocardial infarction

Autor: Rana T. M. Khafagy, Wesam El Mozy, Emad Hamed, Yasser Ibrahim Abd ElKhalek, Wahid Tantawy
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: The Egyptian Journal of Radiology and Nuclear Medicine, Vol 51, Iss 1, Pp 1-10 (2020)
Druh dokumentu: article
ISSN: 2090-4762
DOI: 10.1186/s43055-020-00202-5
Popis: Abstract Background Reperfusion therapy in patients with acute myocardial infarction (AMI) can salvage the myocardium; however, successful restoration of the coronary artery patency is not always associated with adequate perfusion at the level of microvasculature, known as the no-reflow or microvascular occlusion (MVO). The primary objective of our prospective study was to assess, by cardiac magnetic resonance (CMR), the prognostic value of MVO size, and its impact on left ventricular (LV) remodeling in cases of reperfused AMI. Thirty-three patients with AMI underwent cardiac MRI at 1.5-T scanner within 7 days (baseline) and 3 months (follow-up) after reperfusion. Patients with MVO were included where early gadolinium enhancement (EGE), late gadolinium enhancement (LGE), and cine sequences were acquired. The impact of MVO size on LV ejection fraction (EF%) and LV volumes was quantitively analyzed. Results There was a significant inverse correlation between the MVO size % of the LV mass (LVM) and the EF% values measured at follow-up with a P value of 0.000, while a significant positive correlation was encountered between the MVO% of LVM and both indexed end-systolic volume (ESVI) and indexed end-diastolic volume (EDVI) values measured at follow-up with P values of 0.438 and 0.389, respectively. MVO size was found to be a significant factor affecting the patient’s outcome (P = 0.000) where MVO size of > 10% of the total LVM can be a predictor of a worse outcome and reduced EF% at follow-up. Conclusion The prognostic value of MVO could be statistically determined with a cut off value to predict a possible good outcome using CMR.
Databáze: Directory of Open Access Journals