Prognostic significance of non-infarcted myocardium correlated with microvascular impairment evaluated dynamically by native T1 mapping

Insights into Imaging

Original Article

Jun Pu¹  Jian-Rong Xu²  Dong-Aolei An²  Lian-Ming Wu²  Chong-Wen Wu²  Ting Yue²  Yan Zhou²  Bing-Hua Chen²  Jiani Hu³  Matthew Bautista³  Erika Ouchi³ 

[1] Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, 200127, Shanghai, P. R. China;Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, 200127, Shanghai, P. R. China;Department of Radiology, Wayne State University, 48201, Detroit, MI, USA;

关键词: Myocardial infarction;    Magnetic resonance imaging;    Ventricular remodeling;    Fibrosis;    T1 mapping;   

DOI  :  10.1186/s13244-022-01360-y

 received in 2022-10-24, accepted in 2022-12-19,  发布年份 2022

来源: Springer

【 摘 要 】

ObjectivesThis study aimed to investigate the influence of microvascular impairment on myocardial characteristic alterations in remote myocardium at multiple time points, and its prognostic significance after acute ST-segment elevation myocardial infarction (STEMI).MethodsPatients were enrolled prospectively and performed CMR at baseline, 30 days, and 6 months. The primary endpoint was major adverse cardiac events (MACE): death, myocardial reinfarction, malignant arrhythmia, and hospitalization for heart failure. Cox proportional hazards regression modeling was analyzed to estimate the correlation between T1 mapping of remote myocardium and MACE in patients with and without microvascular obstruction (MVO).ResultsA total of 135 patients (mean age 60.72 years; 12.70% female, median follow-up 510 days) were included, of whom 86 (63.70%) had MVO and 26 (19.26%) with MACE occurred in patients. Native T1 values of remote myocardium changed dynamically. At 1 week and 30 days, T1 values of remote myocardium in the group with MVO were higher than those without MVO (p = 0.030 and p = 0.001, respectively). In multivariable cox regression analysis of 135 patients, native1w T1 (HR 1.03, 95%CI 1.01–1.04, p = 0.002), native30D T1 (HR 1.05, 95%CI 1.03–1.07, p < 0.001) and LGE (HR 1.10, 95%CI 1.05–1.15, p < 0.001) were joint independent predictors of MACE. In multivariable cox regression analysis of 86 patients with MVO, native30D T1 (HR 1.05, 95%CI 1.04–1.07, p < 0.001) and LGE (HR 1.10, 95%CI 1.05–1.15, p < 0.001) were joint independent predictors of MACE.ConclusionsThe evolution of native T1 in remote myocardium was associated with the extent of microvascular impairment after reperfusion injury. In patients with MVO, native30D T1 and LGE were joint independent predictors of MACE.

【 授权许可】

CC BY   
© The Author(s) 2023

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