No abstract

Purpose: To assess with cardiac magnetic resonance imaging (CMR) the relationship between treatment delay and improvement of regional left ventricular function after primary percutaneous transluminal coronary angioplasty (p-PTCA) for acute myocardial infarction (AMI). Materials and Methods:We performed cine-and lateenhancement (LE) CMR in 40 patients with first AMI after restoring TIMI 3 flow with p-PTCA and at a follow-up 4 months later. Infarcted segments were determined from LE images. Regional left ventricular function was quantified from cine-CMR images. Segmentation followed the American Heart Association 17-segments model. Patients were divided into groups with delay Ͻ3 hours, 3-6 hours, 6 -12 hours, and a delay Ͼ12 hours.Results: Segmental wall thickening (SWT) significantly iproved only in segments reperfused within 6 hours (P Ͻ 0.001). Follow-up SWT was significantly higher if segments were reperfused early (Ͻ3 hours: 74 Ϯ 4%, 3-6 hours: 57 Ϯ 4%, 6 -12 hours: 48 Ϯ 7%, Ͻ3 to 3-6: P Ͻ 0.003, and Ͻ3 to 6 -12 hours: P Ͻ 0.001). The extent of improvement was greater if delay was Ͻ3 hours compared to segments with a delay of Ͼ3 hours (Ͻ3 hours: ϩ21 Ϯ 3%, 3-6 hours: ϩ8 Ϯ 4%, 6 -12 hours: ϩ6 Ϯ 3%; Ͻ3 hours to 3-6 hours, and 6 -12 h, P Ͻ 0.02). Conclusion:We quantitatively demonstrated that time to p-PTCA treatment significantly influences regional functional recovery of infarcted myocardium at a 4-month follow-up.

No abstract

No abstract