Left ventricular function, strain, and infarct characteristics in patients with transient ST-segment elevation myocardial infarction compared to ST-segment and non-ST-segment elevation myocardial infarctions

Ahmet Demirkiran, Nina W. van der Hoeven, Gladys N. Janssens, Jorrit S. Lemkes, Henk Everaars, Peter M. van de Ven, Nikki van Pouderoijen, Yvonne J. M. van Cauteren, Maarten A. H. van Leeuwen, Alexander Nap, Paul F. Teunissen, Luuk H. G. A. Hopman, Sebastiaan C. A. M. Bekkers, Martijn W. Smulders, Niels van Royen, Albert C. van Rossum, Lourens F. H. J. Robbers, Robin Nijveldt

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Aims: This study aims to explore cardiovascular magnetic resonance (CMR)-derived left ventricular (LV) function, strain, and infarct size characteristics in patients with transient ST-segment elevation myocardial infarction (TSTEMI) compared to patients with ST-segment and non-ST-segment elevation myocardial infarctions (STEMI and NSTEMI, respectively). Methods and results: In total, 407 patients were enrolled in this multicentre observational prospective cohort study. All patients underwent CMR examination 2-8 days after the index event. CMR cine imaging was performed for functional assessment and late gadolinium enhancement to determine infarct size and identify microvascular obstruction (MVO). TSTEMI patients demonstrated the highest LV ejection fraction and the most preserved global LV strain (longitudinal, circumferential, and radial) across the three groups (overall P ≤ 0.001). The CMR-defined infarction was less frequently observed in TSTEMI than in STEMI patients [77 (65%) vs. 124 (98%), P < 0.001] but was comparable with NSTEMI patients [77 (65%) vs. 66 (70%), P = 0.44]. A remarkably smaller infarct size was seen in TSTEMI compared to STEMI patients [1.4 g (0.0-3.9) vs. 13.5 g (5.3-26.8), P < 0.001], whereas infarct size was not significantly different from that in NSTEMI patients [1.4 g (0.0-3.9) vs. 2.1 g (0.0-8.6), P = 0.06]. Whilst the presence of MVO was less frequent in TSTEMI compared to STEMI patients [5 (4%) vs. 53 (31%), P < 0.001], no significant difference was seen compared to NSTEMI patients [5 (4%) vs. 5 (5%), P = 0.72]. Conclusion: TSTEMI yielded favourable cardiac LV function, strain, and infarct-related scar mass compared to STEMI and NSTEMI. LV function and infarct characteristics of TSTEMI tend to be more similar to NSTEMI than STEMI.

Original languageEnglish
Pages (from-to)836-845
Number of pages10
JournalEuropean Heart Journal Cardiovascular Imaging
Volume23
Issue number6
DOIs
Publication statusPublished - 1 Jun 2022

Keywords

  • cardiovascular magnetic resonance imaging
  • infarct size
  • myocardial tissue characteristics
  • strain
  • transient ST-segment elevation myocardial infarction

Cite this