Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction
Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction
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DOI：
10.1161/01.cir.97.8.765
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发表时间：
1998-03-03
期刊：
影响因子：
37.8
通讯作者：
Lima, JAC
中科院分区：
文献类型：
--
作者：
Wu, KC;Zerhouni, EA;Lima, JAC
背景--急性冠脉闭塞期间微血管阻塞的程度可能决定心肌损伤的最终程度，从而决定患者在梗死后的预后。增强MRI显示梗死灶中心深部微血管梗阻区域呈低强化，与心肌损伤程度较大相对应。方法和结果：44例患者在梗死后10+/-6天行MRI检查。微血管阻塞定义为注射对比剂后1-2分钟出现的低强化。心肌梗死面积以造影剂后5至10分钟左室心肌质量增加的百分比进行评估，并对患者进行16+/-5个月的临床随访。17例患者于梗死后6个月复查MRI。有微血管阻塞的患者(n=11)比无微血管阻塞的患者心血管事件更多(45%比9%；P=.016)。事实上，微血管状态预示着心血管并发症的发生(X~(2)=6.46，P
Background-The extent of microvascular obstruction during acute coronary occlusion may determine the eventual magnitude of myocardial damage and thus, patient prognosis after infarction. By contrast-enhanced MRI, regions of profound microvascular obstruction at the infarct core are hypoenhanced and correspond to greater myocardial damage acutely. We investigated whether profound microvascular obstruction after infarction pr-edicts 2-year cardiovascular morbidity and mortality.Methods and Results-Forty-four patients underwent MRI 10+/-6 days after infarction. Microvascular obstruction was defined as hypoenhancement seen 1 to 2 minutes after contrast injection. Infarct size was assessed as percent left ventricular mass hyperenhanced 5 to 10 minutes alter contrast, Patients were followed clinically for 16+/-5 months. Seventeen patients returned 6 months after infarction for repeat MRI. Patients with microvascular obstruction (n=11) had more cardiovascular events than those without (45% versus 9%; P=.016). In fact, microvascular status predicted occurrence of cardiovascular complications (chi(2)=6.46, P