Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction
Abstract Background The acute coronary syndrome diagnosis includes different classifications of myocardial infarction, which have been shown to differ in their pathology, as well as their early and late prognosis. These differences may relate to the underlying extent of infarction and/or residual my...
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crspringernat:10.1186/1532-429x-10-47 2023-05-15T18:15:16+02:00 Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction Plein, Sven Younger, John F Sparrow, Patrick Ridgway, John P Ball, Stephen G Greenwood, John P 2008 http://dx.doi.org/10.1186/1532-429x-10-47 https://link.springer.com/content/pdf/10.1186/1532-429X-10-47.pdf en eng Springer Science and Business Media LLC Journal of Cardiovascular Magnetic Resonance volume 10, issue 1 ISSN 1532-429X Cardiology and Cardiovascular Medicine Radiology Nuclear Medicine and imaging Radiological and Ultrasound Technology journal-article 2008 crspringernat https://doi.org/10.1186/1532-429x-10-47 2022-01-04T14:57:06Z Abstract Background The acute coronary syndrome diagnosis includes different classifications of myocardial infarction, which have been shown to differ in their pathology, as well as their early and late prognosis. These differences may relate to the underlying extent of infarction and/or residual myocardial ischemia. The study aim was to compare scar and ischemia mass between acute non-ST elevation myocardial infarction (NSTEMI), ST-elevation MI with Q-wave formation (Q-STEMI) and ST-elevation MI without Q-wave formation (Non-Q STEMI) in-vivo, using cardiovascular magnetic resonance (CMR). Methods and results This was a prospective cohort study of twenty five consecutive patients with NSTEMI, 25 patients with thrombolysed Q-STEMI and 25 patients with thrombolysed Non-Q STEMI. Myocardial function (cine imaging), ischemia (adenosine stress first pass myocardial perfusion) and scar (late gadolinium enhancement) were assessed by CMR 2–6 days after presentation and before any invasive revascularisation procedure. All subjects gave written informed consent and ethical committee approval was obtained. Scar mass was highest in Q-STEMI, followed by Non-Q STEMI and NSTEMI (24.1%, 15.2% and 3.8% of LV mass, respectively; p < 0.0001). Ischemia mass showed the reverse trend and was lowest in Q-STEMI, followed by Non-Q STEMI and NSTEMI (6.9%, 14.7% and 19.9% of LV mass, respectively; p = 0.012). The combined mass of scar and ischemia was similar between the three groups (p = 0.17). The ratio of scar to ischemia was 3.5, 1.0 and 0.2 for Q-STEMI, Non-Q STEMI and NSTEMI, respectively. Conclusion Prior to revascularisation, the ratio of scar to ischemia differs between NSTEMI, Non-Q STEMI and Q-STEMI, whilst the combined scar and ischemia mass is similar between these three types of MI. These results provide in-vivo confirmation of the diverse pathophysiology of different types of acute myocardial infarction and may explain their divergent early and late prognosis. Article in Journal/Newspaper SCAR Springer Nature (via Crossref) Journal of Cardiovascular Magnetic Resonance 10 1 |
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Springer Nature (via Crossref) |
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Cardiology and Cardiovascular Medicine Radiology Nuclear Medicine and imaging Radiological and Ultrasound Technology |
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Cardiology and Cardiovascular Medicine Radiology Nuclear Medicine and imaging Radiological and Ultrasound Technology Plein, Sven Younger, John F Sparrow, Patrick Ridgway, John P Ball, Stephen G Greenwood, John P Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction |
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Cardiology and Cardiovascular Medicine Radiology Nuclear Medicine and imaging Radiological and Ultrasound Technology |
description |
Abstract Background The acute coronary syndrome diagnosis includes different classifications of myocardial infarction, which have been shown to differ in their pathology, as well as their early and late prognosis. These differences may relate to the underlying extent of infarction and/or residual myocardial ischemia. The study aim was to compare scar and ischemia mass between acute non-ST elevation myocardial infarction (NSTEMI), ST-elevation MI with Q-wave formation (Q-STEMI) and ST-elevation MI without Q-wave formation (Non-Q STEMI) in-vivo, using cardiovascular magnetic resonance (CMR). Methods and results This was a prospective cohort study of twenty five consecutive patients with NSTEMI, 25 patients with thrombolysed Q-STEMI and 25 patients with thrombolysed Non-Q STEMI. Myocardial function (cine imaging), ischemia (adenosine stress first pass myocardial perfusion) and scar (late gadolinium enhancement) were assessed by CMR 2–6 days after presentation and before any invasive revascularisation procedure. All subjects gave written informed consent and ethical committee approval was obtained. Scar mass was highest in Q-STEMI, followed by Non-Q STEMI and NSTEMI (24.1%, 15.2% and 3.8% of LV mass, respectively; p < 0.0001). Ischemia mass showed the reverse trend and was lowest in Q-STEMI, followed by Non-Q STEMI and NSTEMI (6.9%, 14.7% and 19.9% of LV mass, respectively; p = 0.012). The combined mass of scar and ischemia was similar between the three groups (p = 0.17). The ratio of scar to ischemia was 3.5, 1.0 and 0.2 for Q-STEMI, Non-Q STEMI and NSTEMI, respectively. Conclusion Prior to revascularisation, the ratio of scar to ischemia differs between NSTEMI, Non-Q STEMI and Q-STEMI, whilst the combined scar and ischemia mass is similar between these three types of MI. These results provide in-vivo confirmation of the diverse pathophysiology of different types of acute myocardial infarction and may explain their divergent early and late prognosis. |
format |
Article in Journal/Newspaper |
author |
Plein, Sven Younger, John F Sparrow, Patrick Ridgway, John P Ball, Stephen G Greenwood, John P |
author_facet |
Plein, Sven Younger, John F Sparrow, Patrick Ridgway, John P Ball, Stephen G Greenwood, John P |
author_sort |
Plein, Sven |
title |
Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction |
title_short |
Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction |
title_full |
Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction |
title_fullStr |
Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction |
title_full_unstemmed |
Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction |
title_sort |
cardiovascular magnetic resonance of scar and ischemia burden early after acute st elevation and non-st elevation myocardial infarction |
publisher |
Springer Science and Business Media LLC |
publishDate |
2008 |
url |
http://dx.doi.org/10.1186/1532-429x-10-47 https://link.springer.com/content/pdf/10.1186/1532-429X-10-47.pdf |
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SCAR |
genre_facet |
SCAR |
op_source |
Journal of Cardiovascular Magnetic Resonance volume 10, issue 1 ISSN 1532-429X |
op_doi |
https://doi.org/10.1186/1532-429x-10-47 |
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Journal of Cardiovascular Magnetic Resonance |
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10 |
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1 |
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1766188382071816192 |