Time course of infarct healing and left ventricular remodelling in patients with reperfused ST segment elevation myocardial infarction using comprehensive magnetic resonance imaging
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Javier Ganame & Giancarlo Messalli & Pier Giorgio Masci & Steven Dymarkowski & Kayvan Abbasi & Frans Van de Werf & Stefan Janssens & Jan Bogaert
- چاپ و سال / کشور: 2010
Description
Objective To describe the time course of myocardial infarct (MI) healing and left ventricular (LV) remodelling and to assess factors predicting LV remodelling using cardiac MRI. Methods In 58 successfully reperfused MI patients, MRI was performed at baseline, 4 months (4M), and 1 year (1Y) post MI Results Infarct size decreased between baseline and 4M (p<0.001), but not at 1Y; i.e. 18±11%, 12±8%, 11±6% of LV mass respectively; this was associated with LV mass reduction. Infarct and adjacent wall thinning was found at 4M, whereas significant remote wall thinning was measured at 1Y. LVend-diastolic and end-systolic volumes significantly increased at 1Y, p<0.05 at 1Y vs. baseline and vs. 4M; this was associated with increased LV sphericity index. No regional or global LV functional improvement was found at follow-up. Baseline infarct size was the strongest predictor of adverse LV remodelling. Conclusions Infarct healing, with shrinkage of infarcted myocardium and wall thinning, occurs early post-MI as reflected by loss in LV mass and adjacent myocardial remodelling. Longer follow-up demonstrates ongoing remote myocardial and ventricular remodelling. Infarct size at baseline predicts long-term LV remodelling and represents an important parameter for tailoring future post-MI pharmacological therapies designed to prevent heart failure.
Eur Radiol (2011) 21:693–701 DOI 10.1007/s00330-010-1963-8 Received: 10 March 2010 / Revised: 2 August 2010 / Accepted: 3 August 2010 / Published online: 25 September 2010
