PS 08-65 IMPACT OF HYPERTENSION ON MYOCARDIAL SALVAGE ASSESSED BY CARDIAC MAGNETIC RESONANCE IN PATIENTS WITH REPERFUSED ACUTE MYOCARDIAL INFARCTION. (September 2016)

• Record Type: Journal Article
• Authors: Omori, Taku; Dohi, Kaoru; Nakamori, Shiro; Kumagai, Naoto; Ishida, Masaki; Fujimoto, Naoki; Ichikawa, Yasutaka; Kitagawa, Kakuya; Yamada, Norikazu; Sakuma, Hajime; Ito, Masaaki
• Is Part Of: Journal of hypertension. Volume 34:(2016) Supplement 1
• Publication Date: 2016-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000500759.97529.01
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Controversy exists on whether hypertension has a cardioprotective effect in patients with acute myocardial infarction (MI). We sought to assess the influence of hypertension on cardioprotective effects, measured as myocardial salvage index (MSI) by using cardiac magnetic resonance (CMR), in patients with reperfused acute MI. Design and Method: A total of 31 patients with acutely reperfused first ST-segment elevation MI caused by proximal coronary culprit lesions and pre-procedual Thrombolysis in Myocardial Infarction (TIMI) flow 0/1 underwent CMR within 2 weeks. Area at risk (AAR), MI size and MSI were determined by T2-weighted and late gadolinium enhanced CMR. Results: AAR, MI size normalized by LV mass was 36 ± 14% and 27 ± 15%, respectively (P < 0.05), yielding a mean MSI of 28 ± 20% (range 0–69%). Seventeen patients (55%) had hypertension. Hypertensive patients had significantly lower MSI than non-hypertensive patients (20 ± 16% vs 38 ± 20%, p < 0.05). However, there was no significant differences in AAR and MI size between both groups (37 ± 15% vs 35 ± 15%, p = 0.7, 30 ± 15% vs 23 ± 14%, p = 0.2). Univariate analysis demonstrated that MSI was associated with MI size, TIMI flow, LV mass index (LVMI) and peak CPK level (r = −0.38, 0.62, −0.40, −0.46, respectively, all p < 0.05). The presence of hypertension was a significant predictor of lower MSI (B coefficient = −0.34, p < 0.05). Conclusions: The current results demonstrated that myocardial salvage was attenuated in hypertensive patients with acute MI and inversely related with LVMI. Thus, cardioprotective effects may be impaired in patients with hypertension through increased LV mass.