Ya-Nan Zhao , Jia-Ning Cui , Xing-Hua Zhang , Jin-Feng Li , Shi-Min Chen , Xiu-Zheng Yue , Tao Li
{"title":"ST段抬高型心肌梗死后微血管阻塞与心磁共振测定的整体和局部心肌功能的关系","authors":"Ya-Nan Zhao , Jia-Ning Cui , Xing-Hua Zhang , Jin-Feng Li , Shi-Min Chen , Xiu-Zheng Yue , Tao Li","doi":"10.24920/004120","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the impact of microvascular obstruction (MVO) on the global and regional myocardial function by cardiac magnetic resonance feature-tracking (CMR-FT) in ST-segment-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention.</p></div><div><h3>Methods</h3><p>Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1 - 7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective study. Based on the presence or absence of MVO on late gadolinium enhancement images, patients were divided into groups with MVO and without MVO. The infarct zone, adjacent zone, and remote zone were determined based on a myocardial 16-segment model. The radial strain (RS), circumferential strain (CS), and longitudinal strain (LS) of the global left ventricle (LV) and the infarct, adjacent, and remote zones were measured by CMR-FT from cine images and compared between patients with and without MVO using independent-samples <em>t</em>-test. Logistic regression analysis was used to assess the association of MVO with the impaired LV function.</p></div><div><h3>Results</h3><p>A total of 157 STEMI patients (mean age 56.66 ± 11.38 years) were enrolled. MVO was detected in 37.58% (59/157) of STEMI patients, and the mean size of MVO was 3.00 ±3.76 mL. Compared with patients without MVO (<em>n</em> = 98), the MVO group had significantly reduced LV global RS (<em>t</em> = −4.30, <em>P</em> < 0.001), global CS (<em>t</em> = 4.99, <em>P</em> < 0.001), and global LS (<em>t</em> = 3.51, <em>P</em> = 0.001). The RS and CS of the infarct zone in patients with MVO were significantly reduced (<em>t</em> = −3.38, <em>P</em> = 0.001; <em>t</em> = 2.64, <em>P</em> = 0.01; respectively) and the infarct size was significantly larger (<em>t</em> = 8.37, <em>P</em> < 0.001) than that of patients without MVO. The presence of LV MVO [<em>OR</em> = 4.10, 95%<em>CI</em>: 2.05 – 8.19, <em>P</em> < 0.001) and its size [<em>OR</em> = 1.38, 95% <em>CI</em>: 1.10–1.72, <em>P</em>=0.01], along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis, while only heart rate (<em>OR</em>=1.08, 95%<em>CI</em>: 1.03 – 1.13, <em>P</em>=0.001) and LV infarct size (<em>OR</em>=1.10, 95%<em>CI</em>: 1.03 - 1.16, <em>P</em>=0.003) were independent influencing factors for the impaired LV global CS in multivariable Logistic regression analysis.</p></div><div><h3>Conclusion</h3><p>The infarct size was larger in STEMI patients with MVO, and MVO deteriorates the global and regional LV myocardial function.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction\",\"authors\":\"Ya-Nan Zhao , Jia-Ning Cui , Xing-Hua Zhang , Jin-Feng Li , Shi-Min Chen , Xiu-Zheng Yue , Tao Li\",\"doi\":\"10.24920/004120\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To investigate the impact of microvascular obstruction (MVO) on the global and regional myocardial function by cardiac magnetic resonance feature-tracking (CMR-FT) in ST-segment-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention.</p></div><div><h3>Methods</h3><p>Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1 - 7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective study. Based on the presence or absence of MVO on late gadolinium enhancement images, patients were divided into groups with MVO and without MVO. The infarct zone, adjacent zone, and remote zone were determined based on a myocardial 16-segment model. The radial strain (RS), circumferential strain (CS), and longitudinal strain (LS) of the global left ventricle (LV) and the infarct, adjacent, and remote zones were measured by CMR-FT from cine images and compared between patients with and without MVO using independent-samples <em>t</em>-test. Logistic regression analysis was used to assess the association of MVO with the impaired LV function.</p></div><div><h3>Results</h3><p>A total of 157 STEMI patients (mean age 56.66 ± 11.38 years) were enrolled. MVO was detected in 37.58% (59/157) of STEMI patients, and the mean size of MVO was 3.00 ±3.76 mL. Compared with patients without MVO (<em>n</em> = 98), the MVO group had significantly reduced LV global RS (<em>t</em> = −4.30, <em>P</em> < 0.001), global CS (<em>t</em> = 4.99, <em>P</em> < 0.001), and global LS (<em>t</em> = 3.51, <em>P</em> = 0.001). The RS and CS of the infarct zone in patients with MVO were significantly reduced (<em>t</em> = −3.38, <em>P</em> = 0.001; <em>t</em> = 2.64, <em>P</em> = 0.01; respectively) and the infarct size was significantly larger (<em>t</em> = 8.37, <em>P</em> < 0.001) than that of patients without MVO. The presence of LV MVO [<em>OR</em> = 4.10, 95%<em>CI</em>: 2.05 – 8.19, <em>P</em> < 0.001) and its size [<em>OR</em> = 1.38, 95% <em>CI</em>: 1.10–1.72, <em>P</em>=0.01], along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis, while only heart rate (<em>OR</em>=1.08, 95%<em>CI</em>: 1.03 – 1.13, <em>P</em>=0.001) and LV infarct size (<em>OR</em>=1.10, 95%<em>CI</em>: 1.03 - 1.16, <em>P</em>=0.003) were independent influencing factors for the impaired LV global CS in multivariable Logistic regression analysis.</p></div><div><h3>Conclusion</h3><p>The infarct size was larger in STEMI patients with MVO, and MVO deteriorates the global and regional LV myocardial function.</p></div>\",\"PeriodicalId\":35615,\"journal\":{\"name\":\"Chinese Medical Sciences Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Chinese Medical Sciences Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1001929423000147\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chinese Medical Sciences Journal","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1001929423000147","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction
Objective
To investigate the impact of microvascular obstruction (MVO) on the global and regional myocardial function by cardiac magnetic resonance feature-tracking (CMR-FT) in ST-segment-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention.
Methods
Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1 - 7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective study. Based on the presence or absence of MVO on late gadolinium enhancement images, patients were divided into groups with MVO and without MVO. The infarct zone, adjacent zone, and remote zone were determined based on a myocardial 16-segment model. The radial strain (RS), circumferential strain (CS), and longitudinal strain (LS) of the global left ventricle (LV) and the infarct, adjacent, and remote zones were measured by CMR-FT from cine images and compared between patients with and without MVO using independent-samples t-test. Logistic regression analysis was used to assess the association of MVO with the impaired LV function.
Results
A total of 157 STEMI patients (mean age 56.66 ± 11.38 years) were enrolled. MVO was detected in 37.58% (59/157) of STEMI patients, and the mean size of MVO was 3.00 ±3.76 mL. Compared with patients without MVO (n = 98), the MVO group had significantly reduced LV global RS (t = −4.30, P < 0.001), global CS (t = 4.99, P < 0.001), and global LS (t = 3.51, P = 0.001). The RS and CS of the infarct zone in patients with MVO were significantly reduced (t = −3.38, P = 0.001; t = 2.64, P = 0.01; respectively) and the infarct size was significantly larger (t = 8.37, P < 0.001) than that of patients without MVO. The presence of LV MVO [OR = 4.10, 95%CI: 2.05 – 8.19, P < 0.001) and its size [OR = 1.38, 95% CI: 1.10–1.72, P=0.01], along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis, while only heart rate (OR=1.08, 95%CI: 1.03 – 1.13, P=0.001) and LV infarct size (OR=1.10, 95%CI: 1.03 - 1.16, P=0.003) were independent influencing factors for the impaired LV global CS in multivariable Logistic regression analysis.
Conclusion
The infarct size was larger in STEMI patients with MVO, and MVO deteriorates the global and regional LV myocardial function.
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