- Oral presentation
- Open Access
Predicting late myocardial recovery and outcomes in the early hours of ST-elevation myocardial infarction: traditional measures compared to microvascular perfusion, salvaged myocardium, and necrosis by cardiovascular magnetic resonance
© Larose et al; licensee BioMed Central Ltd. 2010
- Published: 21 January 2010
- Cardiovascular Magnetic Resonance
- Late Gadolinium Enhancement
- Microvascular Obstruction
- Myocardial Salvage
- Infarct Transmurality
Earlier prediction of poor outcomes following ST-elevation myocardial infarction (STEMI) is desirable as it may allow tailored therapy at the earliest possible time when benefits may be greatest and optimized patient orientation in a managed care setting.
Determine whether a very early imaging strategy may improve the prediction of late systolic dysfunction and poor outcomes in STEMI.
103 patients with acute STEMI were studied by contrast-enhanced cardiovascular magnetic resonance (CE-CMR) within 12 h of primary angioplasty and after infarct healing at 6 months, and followed clinically beyond 2 years. The primary endpoints were LVEF change and LV dysfunction, while poor outcomes were a key secondary endpoint.
During the hyperacute phase of STEMI, LGE volume provides the strongest association and incremental predictive value for late systolic dysfunction and discerns poor late outcomes. Identifying patients at risk for heart failure or MACE very early during STEMI may allow earlier implementation of prognosis-altering therapies in those likely to benefit most and optimize patient management.
This article is published under license to BioMed Central Ltd.