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

Abstract

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.

Impact of Bivalirudin on Ischemia/Reperfusion Injury in Patients with Reperfused STEMI Assessed by Cardiac Magnetic Resonance

“…Bivalirudin yielded a lower incidence of IMH coinciding with decreased edema at the acute phase and one-month follow-up, which could herald an improved outcome after STEMI. The reduction in IMH could be attributed to bivalirudin’s direct thrombin inhibition, considering the role of thrombin-induced microvascular damage in IMH pathogenesis [ 37 ]. Our findings were consistent with other observations.…”

“…Studies have shown that MVO are associated with adverse LV remodeling in reperfused STEMI patients [ 37 ]. IMH, a severe MVO outcome, has also been significantly linked with a decrease in LVEF in STEMI patients post-PCI [ 36 ].…”