Concordance of angiographic and electrocardiographic indexes of microvascular obstruction: myocardial haemorrhage role. Issue 5 (May 2016)

• Record Type: Journal Article
• Authors: Niccoli, Giampaolo; Cosentino, Nicola; Spaziani, Cristina; Loria, Valentina; Fracassi, Francesco; Roberto, Marco; Calvieri, Camilla; Lombardo, Antonella; Natale, Luigi; Napolitano, Carmela; Mandurinoa, Alessandro; Burzotta, Francesco; Leone, Antonio Maria; Porto, Italo; Trani, Carlo; Bonomo, Lorenzo; Crea, Filippo
• Is Part Of: Journal of cardiovascular medicine. Volume 17:Issue 5(2016:May)
• Publication Date: 2016-05
• Subjects: cardiac magnetic resonance -- microvascular obstruction -- primary percutaneous coronary intervention -- ST-elevation myocardial infarction; Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000000178
• Languages: English
• ISSNs: 1558-2027

Abstract

Abstract : 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. Abstract : Supplemental Digital Content is available in the text