PMID- 27550660
OWN - NLM
STAT- MEDLINE
DCOM- 20180404
LR  - 20220316
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Print)
IS  - 2047-2404 (Linking)
VI  - 18
IP  - 6
DP  - 2017 Jun 1
TI  - Prevalence of unrecognized myocardial infarction in a low-intermediate risk 
      asymptomatic cohort and its relation to systemic atherosclerosis.
PG  - 657-662
LID - 10.1093/ehjci/jew155 [doi]
AB  - AIMS: Unrecognized myocardial infarctions (UMIs) have been described in 19-30% of 
      the general population using late gadolinium enhancement (LGE) on cardiac 
      magnetic resonance. However, these studies have focused on an unselected cohort 
      including those with known cardiovascular disease (CVD). The aim of the current 
      study was to ascertain the prevalence of UMIs in a non-high-risk population using 
      magnetic resonance imaging (MRI). METHODS AND RESULTS: A total of 5000 volunteers 
      aged >40 years with no history of CVD and a 10-year risk of CVD of <20%, as 
      assessed by the ATP-III risk score, were recruited to the Tayside Screening for 
      Cardiac Events study. Those with a B-type natriuretic peptide (BNP) level greater 
      than their gender-specific median were invited for a whole-body MR angiogram and 
      cardiac MR including LGE assessment. LGE was classed as absent, UMI, or 
      non-specific. A total of 1529 volunteers completed the imaging study; of these, 
      53 (3.6%) were excluded because of either missing data or inadequate LGE image 
      quality. Ten of the remaining 1476 (0.67%) displayed LGE. Of these, three (0.2%) 
      were consistent with UMI, whereas seven were non-specific occurring in the 
      mid-myocardium (n = 4), epicardium (n = 1), or right ventricular insertion points 
      (n = 2). Those with UMI had a significantly higher BNP [median 116 (range 31-133) 
      vs. 22.6 (5-175) pg/mL, P = 0.015], lower ejection fraction [54.6 (36-62) vs. 
      68.9 (38-89)%, P = 0.007], and larger end-systolic volume [36.3 (27-61) vs. 21.7 
      (5-65) mL/m2, P = 0.014]. Those with non-specific LGE had lower diastolic blood 
      pressure [68 (54-70) vs. 72 (46-98) mmHg, P = 0.013] but no differences in their 
      cardiac function. CONCLUSION: Despite previous reports describing high prevalence 
      of UMI in older populations, in a predominantly middle-aged cohort, those who are 
      of intermediate or low cardiovascular risk have a very low risk of having an 
      unrecognized myocardial infarct.
CI  - (c) The Author 2016. Published by Oxford University Press on behalf of the European 
      Society of Cardiology.
FAU - Weir-McCall, Jonathan R
AU  - Weir-McCall JR
AD  - Department of Cardiovascular and Diabetes Medicine, College of Medicine, 
      Ninewells Hospital, University of Dundee, Level 7, Dundee DD1 9SY, UK.
FAU - Fitzgerald, Kerrie
AU  - Fitzgerald K
AD  - Department of Cardiovascular and Diabetes Medicine, College of Medicine, 
      Ninewells Hospital, University of Dundee, Level 7, Dundee DD1 9SY, UK.
FAU - Papagiorcopulo, Carla J
AU  - Papagiorcopulo CJ
AD  - Department of Cardiovascular and Diabetes Medicine, College of Medicine, 
      Ninewells Hospital, University of Dundee, Level 7, Dundee DD1 9SY, UK.
FAU - Gandy, Stephen J
AU  - Gandy SJ
AD  - NHS Tayside Medical Physics, Ninewells Hospital, Dundee, UK.
FAU - Lambert, Matthew
AU  - Lambert M
AD  - Department of Cardiovascular and Diabetes Medicine, College of Medicine, 
      Ninewells Hospital, University of Dundee, Level 7, Dundee DD1 9SY, UK.
FAU - Belch, Jill J F
AU  - Belch JJF
AD  - Department of Cardiovascular and Diabetes Medicine, College of Medicine, 
      Ninewells Hospital, University of Dundee, Level 7, Dundee DD1 9SY, UK.
FAU - Cavin, Ian
AU  - Cavin I
AD  - NHS Tayside Medical Physics, Ninewells Hospital, Dundee, UK.
FAU - Littleford, Roberta
AU  - Littleford R
AD  - Department of Cardiovascular and Diabetes Medicine, College of Medicine, 
      Ninewells Hospital, University of Dundee, Level 7, Dundee DD1 9SY, UK.
FAU - Macfarlane, Jennifer A
AU  - Macfarlane JA
AD  - NHS Tayside Medical Physics, Ninewells Hospital, Dundee, UK.
FAU - Matthew, Shona Z
AU  - Matthew SZ
AD  - Department of Cardiovascular and Diabetes Medicine, College of Medicine, 
      Ninewells Hospital, University of Dundee, Level 7, Dundee DD1 9SY, UK.
FAU - Nicholas, R Stephen
AU  - Nicholas RS
AD  - NHS Tayside Medical Physics, Ninewells Hospital, Dundee, UK.
FAU - Struthers, Allan D
AU  - Struthers AD
AD  - Department of Cardiovascular and Diabetes Medicine, College of Medicine, 
      Ninewells Hospital, University of Dundee, Level 7, Dundee DD1 9SY, UK.
FAU - Sullivan, Frank M
AU  - Sullivan FM
AD  - Department of Research and Innovation, North York General Hospital, University of 
      Toronto, Toronto, UK.
FAU - Waugh, Shelley A
AU  - Waugh SA
AD  - NHS Tayside Medical Physics, Ninewells Hospital, Dundee, UK.
FAU - White, Richard D
AU  - White RD
AD  - Department of Clinical Radiology, University Hospital of Wales, Cardiff, UK.
FAU - Houston, J Graeme
AU  - Houston JG
AD  - Department of Cardiovascular and Diabetes Medicine, College of Medicine, 
      Ninewells Hospital, University of Dundee, Level 7, Dundee DD1 9SY, UK.
LA  - eng
GR  - MC_PC_13040/MRC_/Medical Research Council/United Kingdom
GR  - MR/K007017/1/MRC_/Medical Research Council/United Kingdom
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Asymptomatic Diseases/*epidemiology
MH  - Atherosclerosis/*diagnostic imaging/epidemiology/physiopathology
MH  - Cohort Studies
MH  - Female
MH  - *Gadolinium
MH  - Healthy Volunteers
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnostic imaging/*epidemiology/pathology
MH  - Prevalence
MH  - Prognosis
MH  - Radiographic Image Enhancement
MH  - Risk Assessment
MH  - Sex Factors
PMC - PMC5439404
OTO - NOTNLM
OT  - atherosclerosis
OT  - cardiac magnetic resonance
OT  - myocardial infarction
OT  - whole-body MRI
EDAT- 2016/08/24 06:00
MHDA- 2018/04/05 06:00
PMCR- 2016/08/22
CRDT- 2016/08/24 06:00
PHST- 2016/01/04 00:00 [received]
PHST- 2016/06/29 00:00 [accepted]
PHST- 2016/08/24 06:00 [pubmed]
PHST- 2018/04/05 06:00 [medline]
PHST- 2016/08/24 06:00 [entrez]
PHST- 2016/08/22 00:00 [pmc-release]
AID - jew155 [pii]
AID - 10.1093/ehjci/jew155 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2017 Jun 1;18(6):657-662. doi: 
      10.1093/ehjci/jew155.