PMID- 20943440
OWN - NLM
STAT- MEDLINE
DCOM- 20110425
LR  - 20220410
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 20
IP  - 2
DP  - 2011 Feb
TI  - Dynamic Changes in ST Segment Resolution After Myocardial Infarction and the 
      Association with Microvascular Injury on Cardiac Magnetic Resonance Imaging.
PG  - 111-8
LID - 10.1016/j.hlc.2010.09.006 [doi]
AB  - BACKGROUND: persistent ST elevation after reperfused ST elevation myocardial 
      infarction (STEMI) is believed to be related to poor microvascular perfusion. 
      Cardiac magnetic resonance imaging (CMR) can evaluate microvascular obstruction 
      (MVO) and intramyocardial haemorrhage (IMH) both of which represent severe 
      microvascular damage, have independent prognostic value and are dynamic and 
      evolving over the first 48hours after reperfusion. The aim of this study was to 
      assess whether the development of MVO or IMH has an impact upon ST segment 
      resolution. METHODS: patients undergoing primary percutaneous coronary 
      intervention (PCI) for STEMI had serial 12 lead electrocardiograms (ECG) from one 
      hour after PCI until discharge. Persistent single lead maximal residual ST 
      elevation (maxSTE) at each time point was calculated. ST segment deterioration 
      (re-elevation) was calculated on each ECG until discharge compared with one hour 
      post PCI ECG. CMR was performed within seven days post infarct utilising T2 
      weighted imaging to evaluate culprit artery area at risk (AAR) and IMH. 
      Gadolinium delayed enhancement CMR quantified infarct size and MVO. RESULTS: in 
      the 41 patients studied 58% had MVO and 41% had IMH. ST segment deterioration was 
      more common in those with MVO or IMH (p=0.03 and p=0.008 respectively). MaxSTE 
      was higher at each time point after PCI in those with MVO but only became 
      statistically significant after 24hours. The measurement of maxSTE at 48 or 
      72hours after revascularisation provided the best correlation with the 
      combination of infarct size, AAR, MVO and intramyocardial haemorrhage. 
      CONCLUSION: microvascular injury as defined on CMR is associated with dynamic 
      changes and persistence of ST segment elevation in the first 72hours after 
      reperfusion.
CI  - 2010. Published by Elsevier Inc. on behalf of Australasian Society of Cardiac and 
      Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. All 
      rights reserved.
FAU - Weaver, James C
AU  - Weaver JC
AD  - Department of Cardiology, St. George Hospital, Sydney, Australia. 
      james.weaver@sesiahs.health.nsw.gov.au
FAU - Ramsay, David D
AU  - Ramsay DD
FAU - Rees, David
AU  - Rees D
FAU - Binnekamp, Maurits F
AU  - Binnekamp MF
FAU - Prasan, Ananth M
AU  - Prasan AM
FAU - McCrohon, Jane A
AU  - McCrohon JA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20101012
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
SB  - IM
CIN - Heart Lung Circ. 2011 Feb;20(2):71-2. PMID: 21298819
MH  - Aged
MH  - Angioplasty
MH  - *Coronary Circulation
MH  - *Electrocardiography
MH  - Female
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - *Microcirculation
MH  - Middle Aged
MH  - *Myocardial Infarction/diagnostic imaging/physiopathology/therapy
MH  - *Myocardial Reperfusion
MH  - Radiography
MH  - Time Factors
EDAT- 2010/10/15 06:00
MHDA- 2011/04/26 06:00
CRDT- 2010/10/15 06:00
PHST- 2010/04/25 00:00 [received]
PHST- 2010/09/06 00:00 [accepted]
PHST- 2010/10/15 06:00 [entrez]
PHST- 2010/10/15 06:00 [pubmed]
PHST- 2011/04/26 06:00 [medline]
AID - S1443-9506(10)01506-4 [pii]
AID - 10.1016/j.hlc.2010.09.006 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2011 Feb;20(2):111-8. doi: 10.1016/j.hlc.2010.09.006. Epub 2010 
      Oct 12.