TY - JOUR
T1 - Computer-Assisted Quantification of Myocardial Reperfusion After Primary Percutaneous Coronary Intervention Predicts Functional and Contrast-Enhanced Cardiovascular Magnetic Resonance Outcomes in Patients With ST-Segment Elevation Myocardial Infarction
AU - Gu, Youlan L.
AU - Haeck, Joost D. E.
AU - Vogelzang, Mathijs
AU - Bilodeau, Luc
AU - Krucoff, Mitchell W.
AU - Tijssen, Jan G. P.
AU - de Winter, Robbert J.
AU - Zijlstra, Felix
AU - Koch, Karel T.
PY - 2011
Y1 - 2011
N2 - Objective. We investigated whether the Quantitative Blush Evaluator (QuBE) value predicts functional and contrast-enhanced cardiovascular magnetic resonance (CMR) outcomes at 4-6 months after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Background. QuBE is a computer-assisted open source program to quantify myocardial reperfusion. Although a higher QuBE value is associated with improved myocardial reperfusion measures and lower 1-year mortality, the association with intermediate functional parameters after STEMI has not yet been investigated. Methods. QuBE values were quantified retrospectively on angiograms of patients enrolled in the ancillary CMR study of the proximal embolic protection in acute myocardial infarction and resolution of ST-elevation trial. QuBE en CMR outcomes were independently assessed by reviewers blinded to clinical data. Results. A higher QuBE value was significantly associated with a smaller left ventricular (LV) end-diastolic and end-systolic volume, a higher LV ejection fraction and systolic wall thickening in the infarct area, and a smaller final infarct size and extent of transmural segments (P <= 0.008). In a multivariable model, including age, gender, infarct location, time to treatment, history of myocardial infarction, and postprocedural thrombolysis in myocardial infarction flow grade, only the QuBE value and infarct location remained as independent predictors of LV ejection fraction (P = 0.018 for QuBE value). Conclusion. Higher QuBE values are independently associated with improved functional and contrast-enhanced CMR outcomes including LV ejection fraction at 4-6 months after primary PCI and may therefore aid in identifying high-risk patients who benefit most from adjunctive therapies sustaining myocardial function after PCI. (C) 2010 Wiley-Liss, Inc
AB - Objective. We investigated whether the Quantitative Blush Evaluator (QuBE) value predicts functional and contrast-enhanced cardiovascular magnetic resonance (CMR) outcomes at 4-6 months after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Background. QuBE is a computer-assisted open source program to quantify myocardial reperfusion. Although a higher QuBE value is associated with improved myocardial reperfusion measures and lower 1-year mortality, the association with intermediate functional parameters after STEMI has not yet been investigated. Methods. QuBE values were quantified retrospectively on angiograms of patients enrolled in the ancillary CMR study of the proximal embolic protection in acute myocardial infarction and resolution of ST-elevation trial. QuBE en CMR outcomes were independently assessed by reviewers blinded to clinical data. Results. A higher QuBE value was significantly associated with a smaller left ventricular (LV) end-diastolic and end-systolic volume, a higher LV ejection fraction and systolic wall thickening in the infarct area, and a smaller final infarct size and extent of transmural segments (P <= 0.008). In a multivariable model, including age, gender, infarct location, time to treatment, history of myocardial infarction, and postprocedural thrombolysis in myocardial infarction flow grade, only the QuBE value and infarct location remained as independent predictors of LV ejection fraction (P = 0.018 for QuBE value). Conclusion. Higher QuBE values are independently associated with improved functional and contrast-enhanced CMR outcomes including LV ejection fraction at 4-6 months after primary PCI and may therefore aid in identifying high-risk patients who benefit most from adjunctive therapies sustaining myocardial function after PCI. (C) 2010 Wiley-Liss, Inc
U2 - https://doi.org/10.1002/ccd.22665
DO - https://doi.org/10.1002/ccd.22665
M3 - Article
C2 - 20518003
SN - 1522-1946
VL - 77
SP - 174
EP - 181
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 2
ER -