Qifei Xie, Meiling Nie, Feifei Zhang, Xiaoliang Shao, Jianfeng Wang, Juan Song, Yuetao Wang
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MSI was computed as (BARI score-TPD)/BARI score. Long-term cardiac function was assessed via echocardiography.</p><p><strong>Results: </strong>The MSI is notably associated with the long-term cardiac function [EF: Beta = 16 (13, 20), P < 0.00; LVD: Beta = -7.3 (-9.3, -5.3), P < 0.001]. TIMI flow grades 2-3 demonstrate a superior MSI compared to grades 0-1 [0.78 (0.32) vs. 0.61 (0.38), P = 0.002]. TIMI flow grades have an impact on MSI [Beta = 0.08 (0.04, 0.13), P < 0.001]. Compared to patients with a Killip grade of < 2, those with a grade ≥ 2 exhibit a lower MSI [0.69 (0.35) vs. 0.48 (0.42), p = 0.005]. The Killip classification has an impact on MSI [Beta = -0.12(-0.19, -0.04), P = 0.003].</p><p><strong>Discussion: </strong>The study indicates the pivotal role of MSI in predicting long-term cardiac function in STEMI, compares the advantages and limitations of SPECT, CMR, and hybrid SPECT/CAG methods, analyzes the impact of residual blood flow and acute heart failure on MSI, and highlights current technological challenges and future research directions.</p><p><strong>Conclusion: </strong>CAG combining MPI after PCI can be used to obtain MSI. MSI is linked to long-term cardiac function. The amount of antegrade flow before PCI and the initial cardiac function upon admission significantly influence MSI.</p>","PeriodicalId":54215,"journal":{"name":"Current Medical Imaging Reviews","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Novel and Simplified MSI Approach to Predicting the Long-Term Cardiac Function of STEMI.\",\"authors\":\"Qifei Xie, Meiling Nie, Feifei Zhang, Xiaoliang Shao, Jianfeng Wang, Juan Song, Yuetao Wang\",\"doi\":\"10.2174/0115734056375695250707070025\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The Myocardial Salvage Index (MSI) is a valuable indicator in ST-segment Elevation Myocardial Infarction (STEMI) treated with Percutaneous Coronary Intervention (PCI), yet challenges exist in its acquisition. This study aims to calculate MSI using Coronary Angiography (CAG) and myocardial perfusion imaging, and further investigate its correlation with long-term cardiac function.</p><p><strong>Methods: </strong>In 203 STEMI, the myocardium at risk was measured through CAG using the Bypass Angioplasty Revascularization Investigation Myocardial Jeopardy Index (BARI) score. The infarcted myocardium was measured by the Total Perfusion Deficit (TPD) obtained in Myocardial Perfusion Imaging (MPI) after PCI. MSI was computed as (BARI score-TPD)/BARI score. Long-term cardiac function was assessed via echocardiography.</p><p><strong>Results: </strong>The MSI is notably associated with the long-term cardiac function [EF: Beta = 16 (13, 20), P < 0.00; LVD: Beta = -7.3 (-9.3, -5.3), P < 0.001]. TIMI flow grades 2-3 demonstrate a superior MSI compared to grades 0-1 [0.78 (0.32) vs. 0.61 (0.38), P = 0.002]. TIMI flow grades have an impact on MSI [Beta = 0.08 (0.04, 0.13), P < 0.001]. Compared to patients with a Killip grade of < 2, those with a grade ≥ 2 exhibit a lower MSI [0.69 (0.35) vs. 0.48 (0.42), p = 0.005]. The Killip classification has an impact on MSI [Beta = -0.12(-0.19, -0.04), P = 0.003].</p><p><strong>Discussion: </strong>The study indicates the pivotal role of MSI in predicting long-term cardiac function in STEMI, compares the advantages and limitations of SPECT, CMR, and hybrid SPECT/CAG methods, analyzes the impact of residual blood flow and acute heart failure on MSI, and highlights current technological challenges and future research directions.</p><p><strong>Conclusion: </strong>CAG combining MPI after PCI can be used to obtain MSI. MSI is linked to long-term cardiac function. 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引用次数: 0
摘要
心肌挽救指数(MSI)是经皮冠状动脉介入治疗(PCI)治疗st段抬高型心肌梗死(STEMI)的一个有价值的指标,但其获取存在挑战。本研究旨在通过冠状动脉造影(CAG)和心肌灌注显像计算MSI,并进一步探讨其与长期心功能的相关性。方法:在203例STEMI患者中,采用旁路血管成形术重建术心肌危险指数(BARI)评分,通过CAG测量处于危险中的心肌。PCI术后心肌灌注显像(MPI)总灌注赤字(TPD)测量梗死心肌。MSI计算为(BARI评分- tpd)/BARI评分。通过超声心动图评估长期心功能。结果:MSI与长期心功能有显著相关性[EF: Beta = 16 (13,20), P < 0.00;LVD: Beta = -7.3 (-9.3, -5.3), P < 0.001]。与0-1级相比,2-3级TIMI血流表现出更高的MSI[0.78(0.32)比0.61 (0.38),P = 0.002]。TIMI流量等级对MSI有影响[Beta = 0.08 (0.04, 0.13), P < 0.001]。与Killip评分< 2的患者相比,评分≥2的患者的MSI较低[0.69(0.35)比0.48 (0.42),p = 0.005]。Killip分类对MSI有影响[Beta = -0.12(-0.19, -0.04), P = 0.003]。讨论:本研究指出了MSI在预测STEMI患者长期心功能中的关键作用,比较了SPECT、CMR和SPECT/CAG混合方法的优势和局限性,分析了残余血流量和急性心力衰竭对MSI的影响,并强调了当前的技术挑战和未来的研究方向。结论:PCI术后CAG联合MPI可获得MSI。MSI与长期心脏功能有关。PCI术前的顺行血流量和入院时的初始心功能显著影响MSI。
A Novel and Simplified MSI Approach to Predicting the Long-Term Cardiac Function of STEMI.
Introduction: The Myocardial Salvage Index (MSI) is a valuable indicator in ST-segment Elevation Myocardial Infarction (STEMI) treated with Percutaneous Coronary Intervention (PCI), yet challenges exist in its acquisition. This study aims to calculate MSI using Coronary Angiography (CAG) and myocardial perfusion imaging, and further investigate its correlation with long-term cardiac function.
Methods: In 203 STEMI, the myocardium at risk was measured through CAG using the Bypass Angioplasty Revascularization Investigation Myocardial Jeopardy Index (BARI) score. The infarcted myocardium was measured by the Total Perfusion Deficit (TPD) obtained in Myocardial Perfusion Imaging (MPI) after PCI. MSI was computed as (BARI score-TPD)/BARI score. Long-term cardiac function was assessed via echocardiography.
Results: The MSI is notably associated with the long-term cardiac function [EF: Beta = 16 (13, 20), P < 0.00; LVD: Beta = -7.3 (-9.3, -5.3), P < 0.001]. TIMI flow grades 2-3 demonstrate a superior MSI compared to grades 0-1 [0.78 (0.32) vs. 0.61 (0.38), P = 0.002]. TIMI flow grades have an impact on MSI [Beta = 0.08 (0.04, 0.13), P < 0.001]. Compared to patients with a Killip grade of < 2, those with a grade ≥ 2 exhibit a lower MSI [0.69 (0.35) vs. 0.48 (0.42), p = 0.005]. The Killip classification has an impact on MSI [Beta = -0.12(-0.19, -0.04), P = 0.003].
Discussion: The study indicates the pivotal role of MSI in predicting long-term cardiac function in STEMI, compares the advantages and limitations of SPECT, CMR, and hybrid SPECT/CAG methods, analyzes the impact of residual blood flow and acute heart failure on MSI, and highlights current technological challenges and future research directions.
Conclusion: CAG combining MPI after PCI can be used to obtain MSI. MSI is linked to long-term cardiac function. The amount of antegrade flow before PCI and the initial cardiac function upon admission significantly influence MSI.
期刊介绍:
Current Medical Imaging Reviews publishes frontier review articles, original research articles, drug clinical trial studies and guest edited thematic issues on all the latest advances on medical imaging dedicated to clinical research. All relevant areas are covered by the journal, including advances in the diagnosis, instrumentation and therapeutic applications related to all modern medical imaging techniques.
The journal is essential reading for all clinicians and researchers involved in medical imaging and diagnosis.