- 作者：José ; V. Monmeneu<sup>asup><sup> ; sup><sup>jmonmeneu@eresa.comsup> ; Vicente Bodí ; <sup>bsup> ; Marí ; a P. Ló ; pez-Lereu<sup>asup> ; Juan Sanchis<sup>bsup> ; Julio Nú ; ñ ; ez<sup>bsup> ; Fabiá ; n Chaustre<sup>csup> ; Oliver Husser<sup>bsup> ; Pilar Merlos<sup>bsup> ; Clara Bonanad<sup>bsup> ; Gema Miñ ; ana<sup>bsup> ; Francisco J. Chorro<sup>bsup> ; Angel Llá ; cer<sup>bsup>
- 关键词：IAMCEST ; infarto agudo de miocardio con elevació ; n del ST ; ICP ; intervenció ; n coronaria percutá ; nea ; IMS ; í ; ndice de miocardio salvado ; RMC ; resonancia magné ; tica cardiaca ; STIR ; short tau inversion recovery ; VI ; ventrí
- 刊名：Revista Espa?ola de Cardiolog篓陋a
- 出版年：2012
- 期刊代码：pca308_03008932
- 类别：med
- 出版时间：July, 2012
- 卷：65
- 期：7
- 页码：634-641
- 文件大小：681 K
ss="h4">Introduction and objectives
To evaluate by cardiovascular magnetic resonance those factors related to the amount of salvaged myocardium after a myocardial infarction and its value in predicting adverse ventricular remodeling.
ss="h4">Methods
One hundred eighteen patients admitted for a first ST elevation myocardial infarction (primary angioplasty, 65 patients; a pharmacoinvasive strategy, 53 patients) underwent magnetic resonance (6 [5-8] days and 6 months; n=83). The myocardial salvage index was quantitatively assessed as the percentage of area at risk (T2-weighted sequences) not showing late enhancement.
ss="h4">Results
Myocardial salvage index >31%(median) was associated with a shorter time to reperfusion (153 min vs 258 min), a lower rate of diabetes (12%vs 32%), shorter time to magnetic resonance, and better cardiovascular parameters (P<.05 for all analyses). There were no significant differences depending on the reperfusion method. In a logistic regression analysis, delayed reperfusion (odds ratio=0.42 [0.29-0.63]; P<.0001), diabetes (odds ratio=0.32 [0.11-0.99]; P<.05) and a longer time to the performance of magnetic resonance (odds ratio=0.86 [0.76-0.97]; P<.05) were independently related to a lower probability of a myocardial salvage index >31%. Predictors of increased left ventricular end-systolic volume at 6 months were the number of segments showing an extent of transmural necrosis >50%(odds ratio =1.51 [1.21-1.90]; P<.0001) and left ventricular end-systolic volume at one week (odds ratio=1.12 [1.06-1.18]; P<.0001).
ss="h4">Conclusions
Cardiovascular magnetic resonance enables the quantification of the salvaged myocardium after myocardial infarction. The celerity with which reperfusion therapy is administered constitutes its most important predictor. The possible effect of a delay in the performance of magnetic resonance on myocardial salvage needs to be confirmed. Salvaged myocardium does not improve the value of magnetic resonance for predicting adverse remodeling.
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