The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarction

Aim. To study the relationship between the presence and size of microvascular obstruction (MVO) and the prognosis of patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) within one year.Material and methods. The study inc...

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Main Authors: M. A. Terenicheva, R. M. Shakhnovich, O. V. Stukalova, D. V. Pevzner, I. S. Yavelov, Yu. O. Shalaginova, S. K. Ternovoy
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2024-04-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/5603
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author M. A. Terenicheva
R. M. Shakhnovich
O. V. Stukalova
D. V. Pevzner
I. S. Yavelov
Yu. O. Shalaginova
S. K. Ternovoy
author_facet M. A. Terenicheva
R. M. Shakhnovich
O. V. Stukalova
D. V. Pevzner
I. S. Yavelov
Yu. O. Shalaginova
S. K. Ternovoy
author_sort M. A. Terenicheva
collection DOAJ
description Aim. To study the relationship between the presence and size of microvascular obstruction (MVO) and the prognosis of patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) within one year.Material and methods. The study included 50 patients with a first STEMI who underwent PPCI on the infarct-related artery. After 3-7 days and 12 months, contrast-enhanced cardiac magnetic resonance imaging was performed to assess left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), and MVOs. After 12 months, patients were rehospitalized and prognosis was assessed based on data on cardiovascular events.Results. Patients with MVO had a significantly lower LVEF in the acute period of MI (44,1±10,6%) compared to patients without MVO (52,9±10,5%), p=0,0209, as well as during reassessment after a year (44,8±11,1%) compared with patients without MVO (58,9±8,0%), p=0,0004. A significant inverse correlation was found between LVEF in the initial and repeat examination and MVO size in the initial examination as follows: ρ=-0,42 (95% confidence interval (CI): -0,66 — -0,12, p=0,008) and ρ=-0,61 (95% CI: -0,78 — -0,34, p=0,0001). There was also a significant inverse correlation between LVEF and MVO size at reassessment, ρ=-0,40 (95% CI: -0,65 — -0,07, p=0,0205). A significant direct correlation was identified between MVO size in the acute MI period and LVEDV one year later, ρ=0,35 (95% CI: 0,02-0,62, p=0,0409). The development of a left ventricular (LV) aneurysm was registered in 40% of patients with MVO during the initial study and was not registered among patients without MVO (p=0,0039).Conclusion. MVOs was associated with post-infarction LV aneurysm. An increase in MVO size correlated with a decrease in LVEF and an increase in LVEDV both in the acute period and one year after MI.
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spelling doaj-art-4086ac85691c464cbf65ff7aa99a4af12025-08-20T03:57:22Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202024-04-0129310.15829/1560-4071-2024-56034015The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarctionM. A. Terenicheva0R. M. Shakhnovich1O. V. Stukalova2D. V. Pevzner3I. S. Yavelov4Yu. O. Shalaginova5S. K. Ternovoy6E.I. Chazov National Medical Research Center, A. L. Myasnikov Institute of Clinical CardiologyE.I. Chazov National Medical Research Center, A. L. Myasnikov Institute of Clinical CardiologyE.I. Chazov National Medical Research Center, A. L. Myasnikov Institute of Clinical CardiologyE.I. Chazov National Medical Research Center, A. L. Myasnikov Institute of Clinical CardiologyNational Medical Research Center for Therapy and Preventive MedicineE.I. Chazov National Medical Research Center, A. L. Myasnikov Institute of Clinical CardiologyE.I. Chazov National Medical Research Center, A. L. Myasnikov Institute of Clinical Cardiology; I.M. Sechenov First Moscow State Medical UniversityAim. To study the relationship between the presence and size of microvascular obstruction (MVO) and the prognosis of patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) within one year.Material and methods. The study included 50 patients with a first STEMI who underwent PPCI on the infarct-related artery. After 3-7 days and 12 months, contrast-enhanced cardiac magnetic resonance imaging was performed to assess left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), and MVOs. After 12 months, patients were rehospitalized and prognosis was assessed based on data on cardiovascular events.Results. Patients with MVO had a significantly lower LVEF in the acute period of MI (44,1±10,6%) compared to patients without MVO (52,9±10,5%), p=0,0209, as well as during reassessment after a year (44,8±11,1%) compared with patients without MVO (58,9±8,0%), p=0,0004. A significant inverse correlation was found between LVEF in the initial and repeat examination and MVO size in the initial examination as follows: ρ=-0,42 (95% confidence interval (CI): -0,66 — -0,12, p=0,008) and ρ=-0,61 (95% CI: -0,78 — -0,34, p=0,0001). There was also a significant inverse correlation between LVEF and MVO size at reassessment, ρ=-0,40 (95% CI: -0,65 — -0,07, p=0,0205). A significant direct correlation was identified between MVO size in the acute MI period and LVEDV one year later, ρ=0,35 (95% CI: 0,02-0,62, p=0,0409). The development of a left ventricular (LV) aneurysm was registered in 40% of patients with MVO during the initial study and was not registered among patients without MVO (p=0,0039).Conclusion. MVOs was associated with post-infarction LV aneurysm. An increase in MVO size correlated with a decrease in LVEF and an increase in LVEDV both in the acute period and one year after MI.https://russjcardiol.elpub.ru/jour/article/view/5603microvascular obstructionheart failureacute st-segment elevation myocardial infarctioncardiac magnetic resonance imaging
spellingShingle M. A. Terenicheva
R. M. Shakhnovich
O. V. Stukalova
D. V. Pevzner
I. S. Yavelov
Yu. O. Shalaginova
S. K. Ternovoy
The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarction
Российский кардиологический журнал
microvascular obstruction
heart failure
acute st-segment elevation myocardial infarction
cardiac magnetic resonance imaging
title The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarction
title_full The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarction
title_fullStr The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarction
title_full_unstemmed The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarction
title_short The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarction
title_sort value of microvascular obstruction according to contrast enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute st segment elevation myocardial infarction
topic microvascular obstruction
heart failure
acute st-segment elevation myocardial infarction
cardiac magnetic resonance imaging
url https://russjcardiol.elpub.ru/jour/article/view/5603
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