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[PMID]: | 29242240 |
[Au] Autor: | Carberry J; Carrick D; Haig C; Ahmed N; Mordi I; McEntegart M; Petrie MC; Eteiba H; Hood S; Watkins S; Lindsay M; Davie A; Mahrous A; Ford I; Sattar N; Welsh P; Radjenovic A; Oldroyd KG; Berry C |
[Ad] Endereço: | From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (J.C., D.C., N.A., I.M., M.M., M.C.P., H.E., S.H., S.W., M.L., A.D., A.M., N.S., P.W., A.R., K.G.O., C.B.) and Robertson Centre for Biostatistics (C.H., I.F.), University of Glasgow, Scotland; and W |
[Ti] Título: | Persistence of Infarct Zone T2 Hyperintensity at 6 Months After Acute ST-Segment-Elevation Myocardial Infarction: Incidence, Pathophysiology, and Prognostic Implications. |
[So] Source: | Circ Cardiovasc Imaging;10(12), 2017 Dec. | [Is] ISSN: | 1942-0080 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | BACKGROUND: The incidence and clinical significance of persistent T2 hyperintensity after acute ST-segment-elevation myocardial infarction (STEMI) is uncertain. METHODS AND RESULTS: Patients who sustained an acute STEMI were enrolled in a cohort study (BHF MR-MI: NCT02072850). Two hundred eighty-three STEMI patients (mean age, 59±12 years; 75% male) had cardiac magnetic resonance with T2 mapping performed at 2 days and 6 months post-STEMI. Persisting T2 hyperintensity was defined as infarct T2 >2 SDs from remote T2 at 6 months. Infarct zone T2 was higher than remote zone T2 at 2 days (66.3±6.1 versus 49.7±2.1 ms; <0.001) and 6 months (56.8±4.5 versus 49.7±2.3 ms; <0.001). Remote zone T2 did not change over time (mean change, 0.0±2.7 ms; =0.837), whereas infarct zone T2 decreased (-9.5±6.4 ms; <0.001). At 6 months, T2 hyperintensity persisted in 189 (67%) patients, who were more likely to have Thrombus in Myocardial Infarction flow 0 or 1 in the culprit artery ( =0.020), incomplete ST-segment resolution ( =0.037), and higher troponin ( =0.024). Persistent T2 hyperintensity was associated with NT-proBNP (N-terminal pro-B-type natriuretic peptide) concentration (0.57 on a log scale [0.42-0.72]; =0.004) and the likelihood of adverse left ventricular remodeling (>20% change in left ventricular end-diastolic volume; 21.91 [2.75-174.29]; =0.004). Persistent T2 hyperintensity was associated with all-cause death and heart failure, but the result was not significant ( =0.051). ΔT2 was associated with all-cause death and heart failure ( =0.004) and major adverse cardiac events ( =0.013). CONCLUSIONS: Persistent T2 hyperintensity occurs in two thirds of STEMI patients. Persistent T2 hyperintensity was associated with the initial STEMI severity, adverse remodeling, and long-term health outcome. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02072850. |
[Mh] Termos MeSH primário: |
Coração/diagnóstico por imagem Coração/fisiopatologia Imagem por Ressonância Magnética/métodos Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia
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[Mh] Termos MeSH secundário: |
Doença Aguda Feminino Seguimentos Seres Humanos Incidência Estudos Longitudinais Masculino Meia-Idade Prognóstico
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[Pt] Tipo de publicação: | JOURNAL ARTICLE |
[Em] Mês de entrada: | 1712 |
[Cu] Atualização por classe: | 180228 |
[Lr] Data última revisão:
| 180228 |
[Sb] Subgrupo de revista: | IM |
[Da] Data de entrada para processamento: | 171216 |
[St] Status: | MEDLINE |
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