Impella effects on reverse myocardial remodeling in anterior ST-elevation myocardial infarction: insights from a comprehensive analysis of acute and chronic MRI findings.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Expert Review of Cardiovascular Therapy Pub Date : 2025-03-11 DOI:10.1080/14779072.2025.2476129

Daisuke Fukamachi, Akimasa Yamada, Kurara Takahashi, Ran Sumida, Yudai Tanaka, Shohei Migita, Saki Mizobuchi, Masatsugu Miyagawa, Hidesato Fujito, Yutaka Koyama, Akihito Oogaku, Katsunori Fukumoto, Riku Arai, Yasunari Ebuchi, Masaki Monden, Tomoyuki Morikawa, Takashi Mineki, Keisuke Kojima, Nobuhiro Murata, Mitsumasa Sudo, Daisuke Kitano, Naoya Matsumoto, Yasuo Okumura

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Abstract

Background: Late adverse myocardial remodeling after ST elevation myocardial infarction (STEMI) is strongly associated with cardiac death. Global Longitudinal strain (GLS) and circumferential diastolic strain rate (CDSR) derived cardiovascular magnetic resonance imaging (CMRI) is a powerful predictor of late myocardial remodeling. However, the Impella's effects on CMRI after STEMI are not fully understood.

Research design and methods: We retrospectively compared the CMRI in the acute (18 [14-22] vs. 14 [6-22] days, p = 0.43) and chronic phases (118 [102-242] vs. 117 [101-202] days, p = 1.0) after anterior STEMI.

Results: Five patients received Impella before percutaneous coronary intervention (PCI), and seven underwent intra-aortic balloon pumping (IABP). There were no significant differences in the peak creatine kinase levels (2595 [2069 -12,932] vs. 4372 [2941-5601] IU/L, p = 0.76) and LVEF upon admission (51 ± 11 vs. 50 ± 9%, p = 1.0). The Impella group had significantly better acute CMRI-derived LVEF (49 ± 10 vs. 35 ± 7%, p = 0.02) and CDSR (0.9 ± 0.2 vs. 0.5 ± 0.3 s^{- 1}, p = 0.018). In the chronic phase, the CMRI-derived LVEF and GLS were significantly higher in the Impella group (54 ± 9 vs. 39 ± 5%, p = 0.01; -9.9 ± 1.3 vs. -6.5 ± 2.2%, p = 0.01).

Conclusions: The Impella implantation led to better LVEF and CDSR in the acute phase than IABP and better maintenance of both the LVEF and GLS through the chronic phase.

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来源期刊

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

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0.00%

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期刊介绍： Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.