Mitral regurgitation quantified by CMR 4D-flow is associated with microvascular obstruction post reperfused ST-segment elevation myocardial infarction
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Published:2022-05-15
Issue:1
Volume:15
Page:
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ISSN:1756-0500
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Container-title:BMC Research Notes
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language:en
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Short-container-title:BMC Res Notes
Author:
Assadi HosamadinORCID, Grafton-Clarke Ciaran, Demirkiran Ahmet, van der Geest Rob J., Nijveldt Robin, Flather Marcus, Swift Andrew J., Vassiliou Vass S., Swoboda Peter P., Dastidar Amardeep, Greenwood John P., Plein Sven, Garg Pankaj
Abstract
Abstract
Objectives
Mitral regurgitation (MR) and microvascular obstruction (MVO) are common complications of myocardial infarction (MI). This study aimed to investigate the association between MR in ST-elevation MI (STEMI) subjects with MVO post-reperfusion. STEMI subjects undergoing primary percutaneous intervention were enrolled. Cardiovascular magnetic resonance (CMR) imaging was performed within 48-hours of initial presentation. 4D flow images of CMR were analysed using a retrospective valve tracking technique to quantify MR volume, and late gadolinium enhancement images of CMR to assess MVO.
Results
Among 69 patients in the study cohort, 41 had MVO (59%). Patients with MVO had lower left ventricular (LV) ejection fraction (EF) (42 ± 10% vs. 52 ± 8%, P < 0.01), higher end-systolic volume (98 ± 49 ml vs. 73 ± 28 ml, P < 0.001) and larger scar volume (26 ± 19% vs. 11 ± 9%, P < 0.001). Extent of MVO was associated with the degree of MR quantified by 4D flow (R = 0.54, P = 0.0003). In uni-variate regression analysis, investigating the association of CMR variables to the degree of acute MR, only the extent of MVO was associated (coefficient = 0.27, P = 0.001). The area under the curve for the presence of MVO was 0.66 (P = 0.01) for MR > 2.5 ml. We conclude that in patients with reperfused STEMI, the degree of acute MR is associated with the degree of MVO.
Publisher
Springer Science and Business Media LLC
Subject
General Biochemistry, Genetics and Molecular Biology,General Medicine
Reference24 articles.
1. Garg P, Kidambi A, Foley JRJ, Musa TA, Ripley DP, Swoboda PP, Erhayiem B, Dobson LE, McDiarmid AK, Greenwood JP, Plein S. Ventricular longitudinal function is associated with microvascular obstruction and intramyocardial haemorrhage. Open Heart. 2016;3(1): e000337. 2. Garg P, Kidambi A, Swoboda PP, Foley JRJ, Musa TA, Ripley DP, Erhayiem B, Dobson LE, McDiarmid AK, Fent GJ, Haaf P, Greenwood JP, Plein S. The role of left ventricular deformation in the assessment of microvascular obstruction and intramyocardial haemorrhage. Int J Cardiovasc Imaging. 2017;33(3):361–70. 3. Haaf P, Garg P, Messroghli DR, Broadbent DA, Greenwood JP, Plein S. Cardiac T1 mapping and extracellular volume (ECV) in clinical practice: a comprehensive review. J Cardiovasc Magn Reson. 2016;18(1):89. 4. Garg P, Saunders LC, Swift AJ, Wild JM, Plein S. Role of cardiac T1 mapping and extracellular volume (ECV) in the assessment of myocardial infarction. Anatol J Cardiol. 2018;19(6):404. 5. Pellizzon GG, Grines CL, Cox DA, Stuckey T, Tcheng JE, Garcia E, Guagliumi G, Turco M, Lansky AJ, Griffin JJ, Cohen DJ, Aymong E, Mehran R, O’Neill WW, Stone GW. Importance of mitral regurgitation inpatients undergoing percutaneous coronary intervention for acute myocardial infarction: the controlled abciximab and device investigation to lower late angioplasty complications (CADILLAC) trial. J Am Coll Cardiol. 2004;43(8):1368–74.
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