TY - JOUR
T1 - Concordance of angiographic and electrocardiographic indexes of microvascular obstruction
T2 - Myocardial haemorrhage role
AU - Niccoli, Giampaolo
AU - Cosentino, Nicola
AU - Spaziani, Cristina
AU - Loria, Valentina
AU - Fracassi, Francesco
AU - Roberto, Marco
AU - Calvieri, Camilla
AU - Lombardo, Antonella
AU - Natale, Luigi
AU - Napolitano, Carmela
AU - Mandurinoa, Alessandro
AU - Burzotta, Francesco
AU - Leone, Antonio Maria
AU - Porto, Italo
AU - Trani, Carlo
AU - Bonomo, Lorenzo
AU - Crea, Filippo
PY - 2014/7/31
Y1 - 2014/7/31
N2 - BACKGROUND: Angiographic and electrocardiographic (ECG) indexes of microvascular obstruction (MVO) have been described. We aimed at assessing by cardiac magnetic resonance (CMR) anatomical features underlying concordance between them. METHODS: Forty-one patients were enrolled. Patients presented with neither angiographic nor ECG indexes of MVO (without MVO) (44%), with either angiographic or ECG indexes of MVO (discordant with MVO) (22%) or with both angiographic and ECG indexes of MVO (concordant with MVO) (34%). All patients underwent in-hospital CMR. Echocardiographic data obtained after 6 months were compared with those obtained in hospital. RESULTS: Concordant patients with MVO had larger infarct size, lower myocardial salvage index and higher rate of myocardial haemorrhage (all assessed by CMR) [33% (25-41%), 15% (10-29%) and 88%, respectively] as compared with patients without MVO [12% (9-16%), 66% (52-79%) and 0%; Bonferroni-adjusted P <0.001, Bonferroni-adjusted P <0.001 and P <0.001, respectively], or with discordant ones [25% (21-39%), 35% (20-48%) and 7%; Bonferroni-adjusted P = 0.03, Bonferroni-adjusted P = 0.002 and P = 0.04, respectively]. After 6 months, ejection fraction significantly decreased in concordant patients with MVO (P <0.001) without significant changes in the other groups. CONCLUSIONS: Concordance of angiographic and ECG indexes of MVO reflects more severe myocardial damage translating into unfavourable left ventricular remodelling.
AB - BACKGROUND: Angiographic and electrocardiographic (ECG) indexes of microvascular obstruction (MVO) have been described. We aimed at assessing by cardiac magnetic resonance (CMR) anatomical features underlying concordance between them. METHODS: Forty-one patients were enrolled. Patients presented with neither angiographic nor ECG indexes of MVO (without MVO) (44%), with either angiographic or ECG indexes of MVO (discordant with MVO) (22%) or with both angiographic and ECG indexes of MVO (concordant with MVO) (34%). All patients underwent in-hospital CMR. Echocardiographic data obtained after 6 months were compared with those obtained in hospital. RESULTS: Concordant patients with MVO had larger infarct size, lower myocardial salvage index and higher rate of myocardial haemorrhage (all assessed by CMR) [33% (25-41%), 15% (10-29%) and 88%, respectively] as compared with patients without MVO [12% (9-16%), 66% (52-79%) and 0%; Bonferroni-adjusted P <0.001, Bonferroni-adjusted P <0.001 and P <0.001, respectively], or with discordant ones [25% (21-39%), 35% (20-48%) and 7%; Bonferroni-adjusted P = 0.03, Bonferroni-adjusted P = 0.002 and P = 0.04, respectively]. After 6 months, ejection fraction significantly decreased in concordant patients with MVO (P <0.001) without significant changes in the other groups. CONCLUSIONS: Concordance of angiographic and ECG indexes of MVO reflects more severe myocardial damage translating into unfavourable left ventricular remodelling.
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U2 - 10.2459/JCM.0000000000000178
DO - 10.2459/JCM.0000000000000178
M3 - Article
AN - SCOPUS:84905298741
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
ER -