PMID- 23806080
OWN - NLM
STAT- MEDLINE
DCOM- 20150330
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 15
IP  - 1
DP  - 2013 Jun 27
TI  - The effect of microvascular obstruction and intramyocardial hemorrhage on 
      contractile recovery in reperfused myocardial infarction: insights from 
      cardiovascular magnetic resonance.
PG  - 58
LID - 10.1186/1532-429X-15-58 [doi]
AB  - BACKGROUND: Following acute myocardial infarction (AMI), microvascular 
      obstruction (MO) and intramyocardial hemorrhage (IMH) adversely affect left 
      ventricular remodeling and prognosis independently of infarct size. Whether this 
      is due to infarct zone remodeling, changes in remote myocardium or other factors 
      is unknown. We investigated the role of MO and IMH in recovery of contractility 
      in infarct and remote myocardium. METHODS: Thirty-nine patients underwent 
      cardiovascular magnetic resonance (CMR) with T2-weighted and T2* imaging, late 
      gadolinium enhancement (LGE) and myocardial tagging at 2, 7, 30 and 90 days 
      following primary percutaneous coronary intervention for AMI. Circumferential 
      strain in infarct and remote zones was stratified by presence of MO and IMH. 
      RESULTS: Overall, infarct zone strain recovered with time (p < 0.001). In the 
      presence of MO with IMH and without IMH, epicardial strain recovered (p = 0.03, 
      p < 0.01 respectively), but mid-myocardial or endocardial strain did not 
      (mid-myocardium: p = 0.05, p = 0.12; endocardium: p = 0.27, p = 0.05, 
      respectively). By day 90, infarcts with MO had more attenuated strain in all 
      myocardial layers compared to infarcts without MO (p < 0.01); those with IMH were 
      attenuated further (p < 0.01). Remote myocardial strain was similar across groups 
      at all time-points (p > 0.2). Infarct transmural extent did not correlate with 
      strain (p > 0.05 at each time point). In multivariable logistic regression, MO 
      and IMH were the only significant independent predictors of attenuated 90-day 
      infarct zone strain (p = 0.004, p = 0.011, respectively). CONCLUSIONS: Strain 
      improves within the infarct zone overall following reperfusion with or without MO 
      or IMH. Mid-myocardial and endocardial infarct contractility is diminished in the 
      presence of MO, and further in the presence of IMH. MO and IMH are greater 
      independent predictors of infarct zone contractile recovery than infarct volume 
      or transmural extent.
FAU - Kidambi, Ananth
AU  - Kidambi A
FAU - Mather, Adam N
AU  - Mather AN
FAU - Motwani, Manish
AU  - Motwani M
FAU - Swoboda, Peter
AU  - Swoboda P
FAU - Uddin, Akhlaque
AU  - Uddin A
FAU - Greenwood, John P
AU  - Greenwood JP
FAU - Plein, Sven
AU  - Plein S
LA  - eng
GR  - FS/10/62/28409/BHF_/British Heart Foundation/United Kingdom
GR  - FS/1062/28409/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130627
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Aged
MH  - Biomechanical Phenomena
MH  - Contrast Media
MH  - Coronary Circulation
MH  - England
MH  - Female
MH  - Gadolinium DTPA
MH  - Heart Ventricles/pathology/*physiopathology
MH  - Hemorrhage/diagnosis/etiology/*physiopathology
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Microcirculation
MH  - Middle Aged
MH  - *Myocardial Contraction
MH  - Myocardial Infarction/complications/diagnosis/physiopathology/*therapy
MH  - Myocardial Reperfusion/adverse effects/*methods
MH  - No-Reflow Phenomenon/diagnosis/etiology/*physiopathology
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Recovery of Function
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ventricular Function, Left
MH  - Ventricular Remodeling
PMC - PMC3707770
EDAT- 2013/06/29 06:00
MHDA- 2015/03/31 06:00
PMCR- 2013/06/27
CRDT- 2013/06/29 06:00
PHST- 2013/04/04 00:00 [received]
PHST- 2013/06/19 00:00 [accepted]
PHST- 2013/06/29 06:00 [entrez]
PHST- 2013/06/29 06:00 [pubmed]
PHST- 2015/03/31 06:00 [medline]
PHST- 2013/06/27 00:00 [pmc-release]
AID - S1097-6647(23)00774-3 [pii]
AID - 1532-429X-15-58 [pii]
AID - 10.1186/1532-429X-15-58 [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2013 Jun 27;15(1):58. doi: 10.1186/1532-429X-15-58.