Impact of hyperglycemia at admission in patients with acute ST-segment elevation myocardial infarction as assessed by contrast-enhanced MRI

Jensen, Christoph J; Eberle, Holger C; Naßenstein, Kai; Schlosser, Thomas; Farazandeh, Mani; Naber, Christoph; Sabin, Georg; Bruder, Oliver

doi:10.1007/s00392-011-0290-7

Cited by 60 publications

(45 citation statements)

References 46 publications

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“…However, apart from 4 studies (69–71,80,81), most have demonstrated increasing LMVO size to correlate with MACE (51,57,66,78,82–84) on multivariate analysis. A study by Jensen et al (82) suggested a cutoff of LMVO >3.9% of LV volume to predict MACE. Compared with the other measurements of size, the MVO/IS ratio was noted to have the strongest impact on MACE in a study by de Waha et al (63).…”

Section: Resultsmentioning

confidence: 98%

Effect of Microvascular Obstruction and Intramyocardial Hemorrhage by CMR on LV Remodeling and Outcomes After Myocardial Infarction

Hamirani

Wong

Kramer

et al. 2014

JACC: Cardiovascular Imaging

221

138

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The goal of this systematic analysis is to provide a comprehensive review of the current cardiac magnetic resonance data on microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH). Data related to the association of MVO and IMH in patients with acute myocardial infarction (MI) with left ventricular (LV) function, volumes, adverse LV remodeling, and major adverse cardiac events (MACE) were critically analyzed. MVO is associated with a lower ejection fraction, increased ventricular volumes and infarct size, and a greater risk of MACE. Late MVO is shown to be a stronger prognostic marker for MACE and cardiac death, recurrent MI, congestive heart failure/heart failure hospitalization, and follow-up LV end-systolic volumes than early MVO. IMH is associated with LV remodeling and MACE on pooled analysis, but because of limited data and heterogeneity in study methodology, the effects of IMH on remodeling require further investigation.

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Section: Resultsmentioning

confidence: 98%

Effect of Microvascular Obstruction and Intramyocardial Hemorrhage by CMR on LV Remodeling and Outcomes After Myocardial Infarction

Hamirani

Wong

Kramer

et al. 2014

JACC: Cardiovascular Imaging

221

138

View full text Add to dashboard Cite

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“…Experimental and clinical studies suggest that rapid increases in serum glucose increases infarct size (Esposito et al 2002;Williams et al 1998), impairs left ventricular function, and microvascular obstruction (Jensen et al 2011). This could be because hyperglycemia increases interstitial fibrosis and myocyte apoptosis that exaggerate left ventricular remodelling (Shiomi et al 2003).…”

Section: Discussionmentioning

confidence: 99%

Myocardial potency of Bio-tea against Isoproterenol induced myocardial damage in rats

Lobo

Shenoy

2014

J Food Sci Technol

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Kombucha (Bio-tea) is a beverage produced by the fermentation of sugared black tea using a symbiotic association of bacteria and yeasts. Traditional claims about Kombucha report beneficial effects such as antibiotic properties, gastric regulation, relief from joint rheumatism and positive influence on the cholesterol level, arteriosclerosis, diabetes, and aging problems. The present investigation was carried out to understand the preventive effect of Kombucha on heart weight, blood glucose, total protein, lipid profile and cardiac markers in rats with myocardial damage induced using Isoproterenol. As Bio-tea is produced by fermenting tea, the parameters were compared in rats pre-treated with normal black tea and Bio-tea for 30 days followed by subcutaneous injection of Isoproterenol (85 mg/kg body weight). Normal rats as well as Isoproterenol induced myocardial infarcted rats were also used, which served as controls. Isoproterenol induced myocardial infarcted control rats showed a significant increase in heart weight, blood glucose and cardiac markers and a decrease in plasma protein. Increased levels of cholesterol, triglycerides, low density lipids (LDL) and very low density lipids (VLDL) were also observed, while the high density lipid (HDL) content decreased. Bio-tea showed a higher preventive effect against myocardial infarction when compared to tea, as was observed by the significant reduction in heart weight, and blood glucose and increase in plasma albumin levels. Bio-tea significantly decreased cholesterol, triglycerides, LDL and VLDL while simultaneously increasing the levels of HDL. Similarly a decrease in leakage of cardiac markers from the myocardium was also observed.

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“…[18][19][20] To date, this imaging technique has only been applied in a limited number of patients to assess the relationship between hyperglycemia and myocardial damage in MI. 21,22 Particularly CMRI data from large unselected, consecutive patient series with evolving STEMI including patients with and without established DM treated by contemporary acute MI management are lacking.…”

Section: Clinical Perspective On P 718mentioning

confidence: 99%

Prognostic Impact of Hyperglycemia in Nondiabetic and Diabetic Patients With ST-Elevation Myocardial Infarction

Eitel

Hintze

Waha

et al. 2012

Circ: Cardiovascular Imaging

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Background-Hyperglycemia on admission is associated with increased mortality rates in patients with ST-elevation myocardial infarction (STEMI). However, data regarding the relationship between hyperglycemia and myocardial damage in STEMI are scarce. The aim of this study was to determine the relationship of diabetes mellitus status and hyperglycemia on myocardial damage assessed by cardiovascular magnetic resonance imaging and to evaluate the longterm prognostic significance of hyperglycemia in a high-risk STEMI population. Methods and Results-Glucose levels were determined on admission in 411 consecutive STEMI patients reperfused by primary angioplasty. Patients were categorized on the basis of diabetes mellitus status and admission glucose level. Magnetic resonance imaging was performed for assessment of infarct size and microvascular obstruction. The primary clinical end point was the occurrence of major adverse cardiovascular events at long-term follow-up. STEMI patients with pre-existing diabetes mellitus were at greater risk for major adverse cardiovascular events (32% versus 11%; P<0.001) despite having similar infarct sizes and extent of reperfusion injury than nondiabetic patients. Glycemic status on admission was associated with greater myocardial damage and an increased risk for major adverse cardiovascular events (P<0.001). In nondiabetic patients, the risk of severe myocardial injury started to rise once admission glucose exceeded 7.8 mmol/L, whereas the threshold was higher among patients with diabetes mellitus (≥11.1 mmol/L). Conclusions-The higher mortality rate in diabetic versus nondiabetic STEMI patients is not explained by more pronounced myocardial damage. Hyperglycemia on admission is associated with greater myocardial injury and an increased risk of major adverse cardiovascular events at long-term follow-up. However, hyperglycemia has a stronger relationship to myocardial injury in nondiabetic compared with diabetic patients. Eitel et al Hyperglycemia and Prognosis in STEMI 709unselected, high-risk STEMI population treated by primary percutaneous coronary intervention (PCI), and (3) to compare the hyperglycemia-associated risk at long-term follow-up in patients without antecedent DM versus those with DM. Methods Study PopulationThis study was conducted at a single tertiary care center between February 2006 and August 2008. The study protocol was approved by the local ethics committee, and all patients gave written informed consent. Patients with STEMI undergoing primary PCI were eligible if the onset of symptoms was <12 hours before PCI and if they had ST-segment elevation of at least 0.1 mV in ≥2 extremity leads or at least 0.2 mV in ≥2 precordial leads. Exclusion criteria were previous fibrinolysis, emergency coronary artery bypass surgery, and contraindications to CMRI at study entry, such as implanted pacemakers, defibrillators, claustrophobia, or metallic intracranial implants. Primary PCI and Subsequent TreatmentPrimary PCI was performed according to standard clinical practice. The ...

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Impact of hyperglycemia at admission in patients with acute ST-segment elevation myocardial infarction as assessed by contrast-enhanced MRI

Cited by 60 publications

References 46 publications

Effect of Microvascular Obstruction and Intramyocardial Hemorrhage by CMR on LV Remodeling and Outcomes After Myocardial Infarction

Effect of Microvascular Obstruction and Intramyocardial Hemorrhage by CMR on LV Remodeling and Outcomes After Myocardial Infarction

Myocardial potency of Bio-tea against Isoproterenol induced myocardial damage in rats

Prognostic Impact of Hyperglycemia in Nondiabetic and Diabetic Patients With ST-Elevation Myocardial Infarction

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