Relationship of dysglycemia to acute myocardial infarct size and cardiovascular outcome as determined by cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

Research

Gillian Worthy¹  Stephen G Ball²  John P Greenwood²  Adam N Mather²  Sven Plein²  Andrew Crean³  Nik Abidin⁴ 

[1] Clinical Trials Research Unit, University of Leeds, Leeds, UK;Division of Cardiovascular and Neuronal Remodelling, University of Leeds, Leeds, UK;Peter Munk Cardiac Center, Toronto General Hospital, Ontario, Canada;Salford Royal University Teaching Hospital, Manchester, UK;

关键词: Single Photon Emission Compute Tomography;    Cardiovascular Magnetic Resonance;    Infarct Size;    Cardiovascular Magnetic Resonance;    Acute Myocardial Infarction;   

DOI  :  10.1186/1532-429X-12-61

 received in 2010-05-06, accepted in 2010-11-02,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundImproved outcomes for normoglycemic patients suffering acute myocardial infarction (AMI) over the last decade have not been matched by similar improvements in mortality for diabetic patients despite similar levels of baseline risk and appropriate medical therapy. Two of the major determinants of poor outcome following AMI are infarct size and left ventricular (LV) dysfunction.MethodsNinety-three patients with first AMI were studied. 22 patients had diabetes mellitus (DM) based on prior history or admission blood glucose ≥11.1 mmol/l. 13 patients had dysglycemia (admission blood glucose ≥7.8 mmol/l but <11.1 mmol/l) and 58 patients had normoglycemia (admission blood glucose <7.8 mmol/l). Patients underwent cardiac magnetic resonance (CMR) imaging at index presentation and median follow-up of 11 months. Cine imaging assessed LV function and late gadolinium contrast-enhanced imaging was used to quantify infarct size. Clinical outcome data were collected at 18 months median follow-up.ResultsPatients with dysglycemia and DM had larger infarct sizes by CMR than normoglycemic patients; at baseline percentage LV scar (mean (SD)) was 23.0% (10.9), 25.6% (12.9) and 15.8% (10.3) respectively (p = 0.001), and at 11 months percentage LV scar was 17.6% (8.9), 19.1% (9.6) and 12.4% (7.8) (p = 0.017). Patients with dysglycemia and DM also had lower event-free survival at 18 months (p = 0.005).ConclusionsPatients with dysglycemia or diabetes mellitus sustain larger infarct sizes than normoglycemic patients, as determined by CMR. This may, in part, account for their adverse prognosis following AMI.

【 授权许可】

Unknown   
© Mather et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.