Late microvascular obstruction after acute myocardial infarction: Relation with cardiac and inflammatory markers

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• 作者：Agnes Mayr^a ; ^b ; Gert Klug^a ; Michael Schocke^b ; Thomas Trieb^b ; Johannes Mair^a ; Kathrin Pedarnig^a ; Otmar Pachinger^a ; Werner Jaschke^b ; Bernhard Metzler^a ; ^{Bernhard.Metzler@uki.at}
• 关键词：Acute myocardial infarction ; Microvascular obstruction ; Cardiac marker ; Cardiac magnetic resonance imaging
• 刊名：International Journal of Cardiology
• 出版年：2012
• 期刊代码：128_01675273
• 类别：med
• 出版时间：14 June, 2012
• 卷：157
• 期：3
• 页码：391-396
• 文件大小：448 K

摘要

Objectives

We sought to assess the relation of late microvascular obstruction (l-MVO) size as quantified by cardiac magnetic resonance (CMR) imaging with cardiac and inflammatory marker concentrations after acute myocardial infarction (AMI).

Methods

CMR was performed in 118 consecutive patients within 8 days after successful interventional reperfused first acute ST-elevation AMI. Infarct volumes and l-MVO sizes were calculated from late enhancement (LE) sequences and functional parameters were determined from short-axis cine MR sequences. Creatine kinase (CK) and cardiac troponin T (cTnT), high-sensitivity C-reactive protein (hs-CRP) as well as lactate dehydrogenase (LD) concentrations were determined serially from day 1 to day 4 after symptom onset.

Results

L-MVO was detected in 66/118 patients (55.9%) and comprised 18.2 卤 10%of infarct size and 4.7 卤 3%of left ventricle myocardial mass. Each single-point, peak and cumulative release concentration of cTnT (r = 0.44 to 0.73, p < 0.0001), CK (r = 0.21 to 0.76, p < 0.0001), LD (r = 0.36 to 0.82, all p < 0.0001) as well as hs-CRP single-point values as assessed from day 1 to day 4 and its peak and cumulative release concentrations (r = 0.24 to 0.49, p < 0.003) significantly correlated with l-MVO size. Receiver operating curve (ROC) analysis indicated a cut-off value of 4.7 渭g/l cTnT to best identify the presence of l-MVO (area under the curve (AUC) 0.904; 95%CI: 0.85-0.95; p < 0.0001).

Conclusion

L-MVO sizes significantly correlate with cardiac and inflammatory marker concentrations as determined early after AMI. cTnT concentration of > 4.7 渭g/l could help to identify patients in whom l-MVO is present.