PMID- 27741939 OWN - NLM STAT- MEDLINE DCOM- 20170626 LR - 20181113 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 16 IP - 1 DP - 2016 Oct 14 TI - Assessment of the longitudinal changes in infarct heterogeneity post myocardial infarction. PG - 198 LID - 198 AB - BACKGROUND: Infarct heterogeneity, as assessed by determination of the peri-infarct zone (PIZ) by cardiac magnetic resonance imaging, has been shown to be an independent predictor for the development of cardiac arrhythmias and mortality post myocardial infarction (MI). The temporal evolution of the PIZ post MI is currently unknown. Thus, the main objective of our study was to describe the temporal evolution of the PIZ over a 6 month time period in contemporarily managed ST elevation myocardial infarction (STEMI) patients. Further, given the poor prognosis associated with microvascular obstruction (MVO) post STEMI, we sought to compare the temporal evolution of the PIZ in patients with and without MVO. We hypothesized that patients with MVO would show a relative persistence of PIZ over time when compared to those without MVO. METHODS: Twenty-one patients post primary percutaneous coronary intervention were enrolled and treated with evidence based therapy. Each patient had three cardiac MRI scans at 48 h, 3 weeks and 6 months post infarction. Repeated Measures Analysis of Variance (ANOVA) was used to assess the evolution of core infarct size and peri-infarct zone size across the three time frames. RESULTS: The patients in this study were predominantly male, with ~40 % LAD territory infarction and a mean LVEF of 46 +/- 7 %. Core infarct size and PIZ size both decreased significantly across the three time frames. The presence of microvascular obstruction (MVO), a known adverse prognostic factor, influenced PIZ size. Both patients with and without MVO had a significant reduction in core infarct size over time. Patients with MVO did not have a significant change in PIZ size over time (11.9 +/- 6.8 %, 12.2 +/- 7.5 %, 10.7 +/- 6.6 % p = 0.77). In contrast, non-MVO patients did have a significant decrease in PIZ size over time (7.0 +/- 5.5 %, 7.1 +/- 6.5 %, 2.7 +/- 2.6 %, p = 0.01). CONCLUSIONS: Peri-infarct zone size, like core infarct size, varies depending upon the timing of measurement. Patients with MVO displayed a persistence of the PIZ over time. FAU - Roifman, Idan AU - Roifman I AD - Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada. idan.roifman@utoronto.ca. FAU - Ghugre, Nilesh R AU - Ghugre NR AD - Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada. AD - Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, ON, Canada. AD - Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada. FAU - Vira, Tasnim AU - Vira T AD - Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada. FAU - Zia, Mohammad I AU - Zia MI AD - Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada. FAU - Zavodni, Anna AU - Zavodni A AD - Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada. AD - Division of Cardiothoracic Imaging, Department of Medical Imaging, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, ON, Canada. FAU - Pop, Mihaela AU - Pop M AD - Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada. AD - Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, ON, Canada. AD - Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada. FAU - Connelly, Kim A AU - Connelly KA AD - Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael's Hospital, The University of Toronto, Toronto, ON, Canada. FAU - Wright, Graham A AU - Wright GA AD - Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada. AD - Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, ON, Canada. AD - Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada. LA - eng GR - CIHR/Canada PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20161014 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Coronary Circulation/*physiology MH - Coronary Vessels/*diagnostic imaging/physiopathology MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Humans MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - Microcirculation MH - Middle Aged MH - Myocardium/*pathology MH - Percutaneous Coronary Intervention MH - Prospective Studies MH - ST Elevation Myocardial Infarction/*diagnosis/physiopathology/surgery MH - Severity of Illness Index MH - Time Factors PMC - PMC5064965 OTO - NOTNLM OT - Cardiac magnetic resonance imaging OT - Gray zone/Peri-infarct zone OT - Infarct heterogeneity OT - ST elevation myocardial infarction (STEMI) EDAT- 2016/10/16 06:00 MHDA- 2017/06/27 06:00 PMCR- 2016/10/14 CRDT- 2016/10/16 06:00 PHST- 2016/03/03 00:00 [received] PHST- 2016/09/30 00:00 [accepted] PHST- 2016/10/16 06:00 [entrez] PHST- 2016/10/16 06:00 [pubmed] PHST- 2017/06/27 06:00 [medline] PHST- 2016/10/14 00:00 [pmc-release] AID - 10.1186/s12872-016-0373-5 [pii] AID - 373 [pii] AID - 10.1186/s12872-016-0373-5 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2016 Oct 14;16(1):198. doi: 10.1186/s12872-016-0373-5.