PMID- 29116176
OWN - NLM
STAT- MEDLINE
DCOM- 20190802
LR  - 20210109
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 7
IP  - 1
DP  - 2017 Nov 7
TI  - Redefining viability by cardiovascular magnetic resonance in acute ST-segment 
      elevation myocardial infarction.
PG  - 14676
LID - 10.1038/s41598-017-15353-1 [doi]
LID - 14676
AB  - In chronic myocardial infarction (MI), segments with a transmural extent of 
      infarct (TEI) of </=50% are defined as being viable. However, in the acute phase of 
      an ST-segment elevation myocardial infarction (STEMI), late gadolinium 
      enhancement (LGE) has been demonstrated to overestimate MI size and TEI. We aimed 
      to identify the optimal cut-off of TEI by cardiovascular magnetic resonance (CMR) 
      for defining viability during the acute phase of an MI, using </=50% TEI at 
      follow-up as the reference standard. 40 STEMI patients reperfused by primary 
      percutaneous coronary intervention (PPCI) underwent a CMR at 4 +/- 2 days and 5 +/- 2 
      months. The large majority of segments with 1-25%TEI and 26-50%TEI that were 
      viable acutely were also viable at follow-up (59/59, 100% and 75/82, 96% viable 
      respectively). 56/84(67%) segments with 51-75%TEI but only 4/63(6%) segments with 
      76-100%TEI were reclassified as viable at follow-up. TEI on the acute CMR scan 
      had an area-under-the-curve of 0.87 (95% confidence interval of 0.82 to 0.91) and 
      </=75%TEI had a sensitivity of 98% but a specificity of 66% to predict viability at 
      follow-up. Therefore, the optimal cut-off by CMR during the acute phase of an MI 
      to predict viability was </=75% TEI and this would have important implications for 
      patients undergoing viability testing prior to revascularization during the acute 
      phase.
FAU - Bulluck, Heerajnarain
AU  - Bulluck H
AUID- ORCID: 0000-0002-1985-1783
AD  - The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, 
      University College London, London, UK. h.bulluck@gmail.com.
AD  - National Heart Research Institute Singapore, National Heart Centre Singapore, 
      Singapore, Singapore. h.bulluck@gmail.com.
FAU - Rosmini, Stefania
AU  - Rosmini S
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
FAU - Abdel-Gadir, Amna
AU  - Abdel-Gadir A
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
FAU - Bhuva, Anish N
AU  - Bhuva AN
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
FAU - Treibel, Thomas A
AU  - Treibel TA
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
FAU - Fontana, Marianna
AU  - Fontana M
AD  - The National Institute of Health Research University College London Hospitals 
      Biomedical Research Centre, London, UK.
AD  - National Amyloid Centre, Royal Free Hospital, London, UK.
FAU - Knight, Daniel S
AU  - Knight DS
AD  - National Amyloid Centre, Royal Free Hospital, London, UK.
FAU - Nordin, Sabrina
AU  - Nordin S
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
FAU - Sirker, Alex
AU  - Sirker A
AD  - The National Institute of Health Research University College London Hospitals 
      Biomedical Research Centre, London, UK.
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
FAU - Herrey, Anna S
AU  - Herrey AS
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
FAU - Manisty, Charlotte
AU  - Manisty C
AD  - The National Institute of Health Research University College London Hospitals 
      Biomedical Research Centre, London, UK.
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
FAU - Moon, James C
AU  - Moon JC
AD  - The National Institute of Health Research University College London Hospitals 
      Biomedical Research Centre, London, UK.
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
FAU - Hausenloy, Derek J
AU  - Hausenloy DJ
AD  - The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, 
      University College London, London, UK.
AD  - The National Institute of Health Research University College London Hospitals 
      Biomedical Research Centre, London, UK.
AD  - Barts Heart Centre, St Bartholomew's Hospital, London, UK.
AD  - Cardiovascular and Metabolic Disorders Program, Duke-National University of 
      Singapore, Singapore, Singapore.
AD  - National Heart Research Institute Singapore, National Heart Centre Singapore, 
      Singapore, Singapore.
AD  - Yong Loo Lin School of Medicine, National University Singapore, Singapore, 
      Singapore.
LA  - eng
GR  - CS/14/3/31002/BHF_/British Heart Foundation/United Kingdom
GR  - FS/10/72/28568/BHF_/British Heart Foundation/United Kingdom
GR  - FS/10/039/28270/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20171107
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
MH  - Coronary Artery Bypass
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention
MH  - ST Elevation Myocardial Infarction/*diagnostic imaging/physiopathology/surgery
MH  - Sensitivity and Specificity
PMC - PMC5676975
COIS- The authors declare that they have no competing interests.
EDAT- 2017/11/09 06:00
MHDA- 2019/08/03 06:00
PMCR- 2017/11/07
CRDT- 2017/11/09 06:00
PHST- 2017/06/13 00:00 [received]
PHST- 2017/10/24 00:00 [accepted]
PHST- 2017/11/09 06:00 [entrez]
PHST- 2017/11/09 06:00 [pubmed]
PHST- 2019/08/03 06:00 [medline]
PHST- 2017/11/07 00:00 [pmc-release]
AID - 10.1038/s41598-017-15353-1 [pii]
AID - 15353 [pii]
AID - 10.1038/s41598-017-15353-1 [doi]
PST - epublish
SO  - Sci Rep. 2017 Nov 7;7(1):14676. doi: 10.1038/s41598-017-15353-1.