TY - JOUR
T1 - 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
AU - Demirkiran, Ahmet
AU - van der Hoeven, Nina W.
AU - Janssens, Gladys N.
AU - Lemkes, Jorrit S.
AU - Everaars, Henk
AU - van de Ven, Peter M.
AU - van Pouderoijen, Nikki
AU - van Cauteren, Yvonne J. M.
AU - van Leeuwen, Maarten A. H.
AU - Nap, Alexander
AU - Teunissen, Paul F.
AU - Hopman, Luuk H. G. A.
AU - Bekkers, Sebastiaan C. A. M.
AU - Smulders, Martijn W.
AU - van Royen, Niels
AU - van Rossum, Albert C.
AU - Robbers, Lourens F. H. J.
AU - Nijveldt, Robin
N1 - Funding Information: A.D. has received a research grant from The European Association of Cardiovascular Imaging (EACVI) in relation with this research project. The REDUCE-MVI study was funded by AstraZeneca to M.v.L. and N.v.R. The TRANSIENT trial was supported by unrestricted research grants from AstraZeneca and Biotronik to N.v.R. The PREDICT-MVI trial was funded in part by unrestricted research grants from Volcano Corporation and Biotronik to N.v.R. The project that enrolled NSTEMI patients at the Maastricht UMC+ site was supported in part by the Netherlands Heart Foundation to M.S. (grant 2014T05). Publisher Copyright: © 2021 The Author(s).
PY - 2022/6/1
Y1 - 2022/6/1
N2 - 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.
AB - 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.
KW - cardiovascular magnetic resonance imaging
KW - infarct size
KW - myocardial tissue characteristics
KW - strain
KW - transient ST-segment elevation myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=85131268551&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ehjci/jeab114
DO - https://doi.org/10.1093/ehjci/jeab114
M3 - Article
C2 - 34195800
SN - 2047-2404
VL - 23
SP - 836
EP - 845
JO - European heart journal cardiovascular Imaging
JF - European heart journal cardiovascular Imaging
IS - 6
ER -