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IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2025-02-13 DOI:10.1016/j.jocmr.2025.101850

Lucas de Mello Queiroz, Rafael Almeida Fonseca, Luis Augusto Palma Dallan, Thatiane Facholi Polastri, Ludhmila Abrahao Hajjar, Jose Carlos Nicolau, Roberto Kalil Filho, Karl B Kern, Sergio Timerman, Carlos E Rochitte

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引用次数: 0

摘要

背景：血管内治疗性低温（ETH）对ST段抬高型心肌梗死（STEMI）区域收缩力的影响尚不清楚，其对节段收缩力的影响也尚未评估。我们试图评估经皮冠状动脉介入治疗（PCI）辅助 ETH 后 STEMI 节段心肌应变：我们纳入了在之前的随机试验中急性前壁或下壁 STEMI 后 5 天和 30 天接受 1.5 T 心脏磁共振检查的患者。对梗死心肌、邻近心肌和远端心肌的左心室（LV）应变进行了评估。使用特征追踪成像技术测量了节段圆周应变（CS）和径向应变（RS）。采用重复测量方差分析对时间和治疗方法进行比较：40名患者分为低体温组（ETH，n=29）和对照组（n=11），共5210个左心室节段。在ETH梗死区，与对照组相比，RS（11.2±16 vs. 14.8±15.2，p=0.001）和CS（-5.4±11.1 vs. -8±11.1，p=0.001）在5至30天内出现恢复（11.4±14 vs. 13.1±16.8，p=0.09；-6.5±10.6 vs. -6.4±12.5，p=0.94）。与ETH（28.6±18.6 vs. 29±20，p=0.44；-15.2±10.4 vs. -15.3±10.6，p=0.82）相比，在对照组偏远地区，RS（28±18 vs. 31.7±18.5，p=0.001）和CS（-15.5±10.7 vs. -17.1±9，p=0.001）从5天到30天均有所改善。与对照组相比，ETH跨壁梗死区的RS（11.8±13.2 vs. 8.17±14.7，p=0.001）和CS（-6.1±10.9 vs. -3.1±11.3，p=0.001）均有所改善，30天时收缩力更好：对于前壁或下壁 STEMI 患者，ETH 辅助 PCI 可显著改善梗死区域（包括跨壁节段）的 RS 和 CS，但远端区域没有改善。这可能会进一步增加我们对早期左心室重塑的病理生理学知识，并最终提示潜在的临床价值：本研究中使用和/或分析的数据集可向通讯作者索取。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Hypothermia as an adjunctive therapy to percutaneous intervention after ST-elevation myocardial infarction - Effects on regional myocardial contractility.

Background: The effects of endovascular therapeutic hypothermia (ETH) in ST-elevation myocardial infarction (STEMI) regional contractility are unknown, and its impact on segmental contractility has still not been evaluated. We sought to evaluate segmental myocardial strain after ETH adjuvant to percutaneous coronary intervention (PCI) in STEMI.

Methods: We included patients who underwent 1.5 T cardiac magnetic resonance exams 5 and 30 days after acute anterior or inferior STEMI in a previous randomized trial. Left ventricle (LV) strain was evaluated on infarcted, adjacent, and remote myocardium. Segmental circumferential (CS) and radial strains (RS) were measured using feature-tracking imaging. Repeated-measures of ANOVA was used for comparisons within time and treatment.

Results: Forty patients were divided into hypothermia (ETH, n=29) and control (n=11) groups, with 5210 LV segments. In ETH infarcted areas, RS (11.2±16 vs. 14.8±15.2, p=0.001) and CS (-5.4±11.1 vs. -8±11.1, p=0.001) showed recovery from 5 to 30 days compared to controls (11.4±14 vs. 13.1±16.8, p=0.09; -6.5±10.6 vs. -6.4±12.5, p=0.94). In control remote areas, RS (28±18 vs. 31.7±18.5, p=0.001) and CS (-15.5±10.7 vs. -17.1±9, p=0.001) improved from 5 to 30 days compared to ETH (28.6±18.6 vs. 29±20, p=0.44; -15.2±10.4 vs. -15.3±10.6, p=0.82). Transmural infarcted areas in ETH improved RS (11.8±13.2 vs. 8.17±14.7, p=0.001) and CS (-6.1±10.9 vs. -3.1±11.3, p=0.001) compared to controls, with better contractility at 30 days.

Conclusions: In anterior or inferior STEMI patients, ETH adjuvant to PCI is associated with significant improvement in RS and CS of infarcted areas, including transmural segments, but not in the remote area. This might further increase our pathophysiological knowledge on early LV remodeling and ultimately suggest potential clinical value.

Availability of data and materials: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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来源期刊

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.