TY - JOUR
T1 - Microvascular dysfunction following ST-elevation myocardial infarction and its recovery over time
AU - Hassell, Mariëlla E. C. J.
AU - Bax, Matthijs
AU - van Lavieren, Martijn A.
AU - Nijveldt, Robin
AU - Hirsch, Alexander
AU - Robbers, Lourens
AU - Marques, Koen M.
AU - Tijssen, Jan G. P.
AU - Zijlstra, Felix
AU - van Rossum, Albert C.
AU - Piek, Jan J.
AU - Delewi, Ronak
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Aims: It is unclear whether microvascular dysfunction following ST-elevation myocardial infarction (STEMI) is prognostic for long-term left ventricular function (LVF), and whether recovery of the microvasculature status is associated with LVF improvement. The aim of this study was to assess whether microvascular dysfunction in the infarct-related artery (IRA), as assessed by coronary flow reserve (CFR) within one week after PPCI, was associated with LVF at both four months and two years. Methods and results: In 62 patients, CFR and hyperaemic microvascular resistance index (HMRI) in the IRA were assessed by intracoronary Doppler flow measurements within one week and at four months. CMR was performed at the same time points and also at two years. CFR at baseline was associated with left ventricular ejection fraction (LVEF) at four months (beta=4.66, SE=2.10, p=0.03) and at two-year follow-up (beta=5.84, SE=2.45, p=0.02). HMRI was not associated with LVF. In large infarcts, absolute improvement of CFR in the first four months was associated with LVEF improvement (beta=5.09, SE=1.86, p=0.01). Conclusions: Microvascular dysfunction, assessed by CFR, in the subacute phase of STEMI is prognostic for LVEF at four months and two years. This underlines the pivotal role of microvascular dysfunction following STEMI
AB - Aims: It is unclear whether microvascular dysfunction following ST-elevation myocardial infarction (STEMI) is prognostic for long-term left ventricular function (LVF), and whether recovery of the microvasculature status is associated with LVF improvement. The aim of this study was to assess whether microvascular dysfunction in the infarct-related artery (IRA), as assessed by coronary flow reserve (CFR) within one week after PPCI, was associated with LVF at both four months and two years. Methods and results: In 62 patients, CFR and hyperaemic microvascular resistance index (HMRI) in the IRA were assessed by intracoronary Doppler flow measurements within one week and at four months. CMR was performed at the same time points and also at two years. CFR at baseline was associated with left ventricular ejection fraction (LVEF) at four months (beta=4.66, SE=2.10, p=0.03) and at two-year follow-up (beta=5.84, SE=2.45, p=0.02). HMRI was not associated with LVF. In large infarcts, absolute improvement of CFR in the first four months was associated with LVEF improvement (beta=5.09, SE=1.86, p=0.01). Conclusions: Microvascular dysfunction, assessed by CFR, in the subacute phase of STEMI is prognostic for LVEF at four months and two years. This underlines the pivotal role of microvascular dysfunction following STEMI
KW - Depressed left ventricular function
KW - Myocardial infarction
KW - ST-elevation myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=85027230205&partnerID=8YFLogxK
U2 - https://doi.org/10.4244/EIJ-D-16-00818
DO - https://doi.org/10.4244/EIJ-D-16-00818
M3 - Article
C2 - 28218606
SN - 1774-024X
VL - 13
SP - 578
EP - 584
JO - Eurointervention
JF - Eurointervention
IS - 5
ER -