Impact of microvascular obstruction on left ventricular local remodeling after reperfused myocardial infarction

Zhang, Lin; Mandry, Damien; Chen, Bailiang; Huttin, Olivier; Hossu, Gabriela; Wang, Hairong; Beaumont, Marine; Girerd, Nicolas; Felblinger, Jacques; Odille, Freddy

doi:10.1002/jmri.25780

Cited by 13 publications

(7 citation statements)

References 42 publications

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“…our results showed that patients with MVO had larger LV ESVI and LV myocardial mass index and more impaired LVEF, WTR, and global peak strains. However, limited data reported the relationship between MVO and regional dysfunction in patients with STEMI in previous studies [24,25] . In the present study, we compared the strain characteristics of infarct zone, adjacent zone, and remote zone in patients with and without MVO.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction

Zhao,

Cui,

Zhang

et al. 2023

Chinese Medical Sciences Journal

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Objective: To investigate the impact of microvascular obstruction (MVO) on the global and regional myocardial function by cardiac magnetic resonance feature-tracking (CMR-FT) in ST-segment-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention. Methods:Acute STEMI patients who underwent cardiac magnetic resonance at 1-7 days after successfully reperfusion were included in this retrospective study. Based on the presence or absence of MVO on late gadolinium enhancement images, the STEMI patients were divided into the group with MVO and without MVO. The infarct zone, adjacent zone and remote zone were determined based on a myocardial 16-segment model on late gadolinium enhancement images. The radial strain (RS), circumferential strain (CS) and longitudinal strain (LS) of the global left ventricle and infarct, adjacent and remote zone strains were measured by CMR-FT from cine images. The global and regional strains in patients with and without MVO were compared using independent-samples t-test. Logistic regression analysis was used to assay the association of MVO with the reduced left ventricular function.

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Section: Discussionmentioning

confidence: 99%

Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction

Zhao,

Cui,

Zhang

et al. 2023

Chinese Medical Sciences Journal

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“…An animal experiment deduced that with the occurrence of CMVO, the myocardial elasticity in the infarcted area decreased, resulting in the increase of local wall stress [ 40 ]. Moreover, the CMVO was allied to an increased size of reduced ventricular wall thickness and minor improvement of ventricular wall thickening [ 41 ]. The above mechanisms may joint participation in the potential effect of CMVO on ALVR.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a predictive model for adverse left ventricular remodeling in NSTEMI patients after primary percutaneous coronary intervention

Wang

Liu

Wang

et al. 2022

BMC Cardiovasc Disord

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Introduction To develop and validate clinical evaluators that predict adverse left ventricular remodeling (ALVR) in non-ST-elevation myocardial infarction (NSTEMI) patients after primary percutaneous coronary intervention (PCI). Methods The retrospective study analyzed the clinical data of 507 NSTEMI patients who were treated with primary PCI from the Affiliated Hospital of Xuzhou Medical University and the Second Affiliated Hospital of Xuzhou Medical University, between January 1, 2019 and September 31, 2021. The training cohort consisted of patients admitted before June 2020 (n = 287), and the remaining patients (n = 220) were assigned to an external validation cohort. The endpoint event was the occurrence of ALVR, which was described as an increase ≥ 20% in left ventricular end-diastolic volume (LVEDV) at 3–4 months follow-up CMR compared with baseline measurements. The occurrence probability of ALVR stemmed from the final model, which embodied independent predictors recommended by logistic regression analysis. The area under the receiver operating characteristic curve (AUC), Calibration plot, Hosmer–Lemeshow method, and decision curve analysis (DCA) were applied to quantify the performance. Results Independent predictors for ALVR included age (odds ratio (OR): 1.040; 95% confidence interval (CI): 1.009–1.073), the level of neutrophil to lymphocyte ratio (OR: 4.492; 95% CI: 1.906–10.582), the cardiac microvascular obstruction (OR: 3.416; 95% CI: 1.170–9.970), peak global longitudinal strain (OR: 1.131; 95% CI: 1.026–1.246), infarct size (OR: 1.082; 95% CI: 1.042–1.125) and left ventricular ejection fraction (OR: 0.925; 95% CI: 0.872–0.980), which were screened by regression analysis then merged into the nomogram model. Both internal validation (AUC: 0.805) and external validation (AUC: 0.867) revealed that the prediction model was capable of good discrimination. Calibration plot and Hosmer–Lemeshow method showed high consistency between the probabilities predicted by the nomogram (P = 0.514) and the validation set (P = 0.762) and the probabilities of actual occurrence. DCA corroborated the clinical utility of the nomogram. Conclusions In this study, the proposed nomogram model enabled individualized prediction of ALVR in NSTEMI patients after reperfusion and conduced to guide clinical therapeutic schedules.

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“…после ОИМ [26]. Другие исследователи получили аналогичные данные об участии МВО в патогенезе неблагоприятного постинфарктного ремоделирования сердца [27,28]. Однако M.I.…”

Section: микроваскулярная обструкция и неблагоприятное постинфарктное...unclassified

Reperfusion cardiac injury. The role of microvascular obstruction

Ryabov

Popov

Вышлов

et al. 2023

SJCEM

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Microvascular obstruction (MVO) of coronary arteries increases the mortality rate and major adverse cardiac events in patients with acute myocardial infarction (AMI) and percutaneous coronary intervention (PCI). According to preliminary data platelets, inflammation, Ca2+ overload, neuropeptide Y, and endothelin-1 could be involved in the pathogenesis of MVO. Many questions related to the pathogenesis of MVO remain unanswered. The role of endothelial cell damage in the formation of MVO in patients with AMI and PCI is unknown. It is unclear whether nitric oxide (NO) production reduces or decreases sensitivity of smooth muscle cells of coronary arteries to NO in patients with MVO. It was obtained only indirect evidence on the involvement of inflammation in the development of MVO. The role of ROS in the pathogenesis of MVO is not studied. The role of necroptosis and pyroptosis in the pathogenesis of MVO in patients with AMI and PCI is also not studied.The significance of thromboxane A, vasopressin, angiotensin II, and prostacyclin in the formation of MVO is unknown before. It was not obtained conclusive evidence on the involvement of coronary artery spasm in the development of MVO. Correlation analysis of the neuropeptide Y, endothelin-1 levels and the MVO size in patients with AMI and PCI was not performed. It is not clear whether endogenous adrenaline exacerbates MVO or, conversely, prevents MVO.

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Impact of microvascular obstruction on left ventricular local remodeling after reperfused myocardial infarction

Abstract: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:499-510.

Cited by 13 publications

References 42 publications

Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction

Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction

Development and validation of a predictive model for adverse left ventricular remodeling in NSTEMI patients after primary percutaneous coronary intervention

Reperfusion cardiac injury. The role of microvascular obstruction

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