Bodi, Vicente and Husser, Oliver and Sanchis, Juan and Nunez, Julio and Lopez-Lereu, Maria P. and Monmeneu, Jose V. and Mainar, Luis and Chaustre, Fabian and Riegger, Guenter A. J. and Bosch, Maria J. and Chorro, Francisco J. and Llacer, Angel (2010) Contractile Reserve and Extent of Transmural Necrosis in the Setting of Myocardial Stunning: Comparison at Cardiac MR Imaging. RADIOLOGY, 255 (3). pp. 755-763. ISSN 0033-8419,
Full text not available from this repository. (Request a copy)Abstract
Purpose: To perform a comparison of cardiac magnetic resonance (MR) imaging-derived ejection fraction (EF) during low-dose dobutamine infusion (EF(D)) with the extent of segments with transmural necrosis in more than 50% of their wall thickness (ETN) for the prediction of major adverse cardiac events (MACEs) and late systolic recovery soon after a first ST-segment elevation myocardial infarction (STEMI). Materials and Methods: Institutional ethics committee approval and written informed consent were obtained. One hundred nineteen consecutive patients with a first STEMI, a depressed left ventricular EF, and an open infarct-related artery underwent MR imaging at 1 week after infarction. EF D and ETN (by using a 17-segment model) were determined, and the prediction of MACEs and systolic recovery at follow-up was assessed by using area under the receiver operating characteristic curve (AUC) and multivariable regression analysis. Results: During follow-up (median, 613 days; range, 312-1243 days), 18 MACEs (five cardiac deaths, six myocardial infarctions, seven readmissions for heart failure) occurred. MACEs were associated with a lower EF D (43% +/- 12 [standard deviation] vs 49% +/- 10, P = .02) and a larger ETN (seven segments +/- three vs four segments +/- three, P < .001). Patients with systolic recovery (increase in EF of > 5% at follow-up compared with baseline EF, n = 44) displayed a higher EF(D) (51% +/- 10 vs 47% +/- 9, P = .04) and a smaller ETN (three segments +/- two vs five segments +/- three, P = .002) at 1 week. ETN and EF D both related to MACEs (AUC: 0.78 vs 0.67, respectively, P = .1) and systolic recovery (AUC: 0.68 vs 0.62, respectively, P = .3). According to multivariable analysis, ETN was the only MR variable associated with time to MACEs (hazard ratio, 1.38; 95% confidence interval: 1.19, 1.60; P < .001) and systolic recovery (odds ratio, 0.76; 95% confidence interval: 0.64, 0.92; P = .004) independent of baseline characteristics. Conclusion: ETN is as useful as EF D for the prediction of MACEs and systolic recovery soon after STEMI.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CARDIOVASCULAR MAGNETIC-RESONANCE; CORONARY-ARTERY-DISEASE; FUNCTIONAL RECOVERY; PROGNOSTIC VALUE; INFARCTION; PREDICTION; VIABILITY; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 30 Jul 2020 07:16 |
| Last Modified: | 30 Jul 2020 07:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/24679 |
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