Novel insights into myocardial fibrosis in patients with new onset ST-elevation myocardial infarction following percutaneous coronary intervention through enhanced cardiac magnetic resonance imaging: a prospective cohort study

Abstract Background Myocardial fibrosis is a prevalent pathological hallmark of a diverse range of chronic and acute cardiovascular disorders. However, the relevant literature currently provides limited evidence regarding the determinants of myocardial fibrosis severity in patients with new-onset ST...

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Main Authors: Temilola J. Oketunbi, Jun Wang, Bin Ding, Xilong Song, Yao Li, Hongwei Song, Xiaojun Shi, Sigang Hu, Dasheng Gao, Hongju Wang, Miaonan Li
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-04719-3
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author Temilola J. Oketunbi
Jun Wang
Bin Ding
Xilong Song
Yao Li
Hongwei Song
Xiaojun Shi
Sigang Hu
Dasheng Gao
Hongju Wang
Miaonan Li
author_facet Temilola J. Oketunbi
Jun Wang
Bin Ding
Xilong Song
Yao Li
Hongwei Song
Xiaojun Shi
Sigang Hu
Dasheng Gao
Hongju Wang
Miaonan Li
author_sort Temilola J. Oketunbi
collection DOAJ
description Abstract Background Myocardial fibrosis is a prevalent pathological hallmark of a diverse range of chronic and acute cardiovascular disorders. However, the relevant literature currently provides limited evidence regarding the determinants of myocardial fibrosis severity in patients with new-onset ST-elevation myocardial infarction (STEMI) following successful emergent percutaneous coronary intervention (PCI) utilizing contrast-enhanced cardiac magnetic resonance imaging (CE-CMR). Methods We prospectively enrolled a cohort of 78 patients who presented with new-onset ST-segment elevation myocardial infarction and who underwent successful emergent PCI within 12 h from the onset of symptoms. Late gadolinium-enhanced LGE (LGE) was quantified via CE-CMR, and patients were categorized into two groups on the basis of the median LGE value. Results The median LGE was 16% (IQR 12 to 24). Compared with patients with LGE below the median (n = 37), those with LGE above the median (n = 41) presented significantly reduced left ventricular global radial strain(GRS), global circumferential strain(GCS), and global longitudinal strain(GLS) (all p < 0.05). The infarcted radial segment (IRS), infarcted circumferential segment (ICS) and infarcted longitudinal segment (ILS) were significantly reduced in patients with greater LGE (all p < 0.05). The occurrence rates of microvascular obstruction (MVO) (p < 0.001) and wall motion abnormality (WMA) (p < 0.01) were significantly greater in patients with a greater extent of LGE, despite successful reperfusion therapy. LGE exhibited a moderate negative correlation with the global circumferential segment (r=-0.547, p < 0.001) and a weak negative correlation with both the global radial segment and the global longitudinal segment (r=-0.434, p < 0.001; r=-0.437, p < 0.001). In the multivariable linear regression analysis model, the Gensini score (β = 0.258; p < 0.01), LVEF% (β=-0.269; p < 0.05), MVO (β = 0.343; p < 0.001) and GRS (β = 0.227; p < 0.05) emerged as robust predictors of myocardial fibrosis. Conclusion The present study revealed a correlation of cardiac pathological structure, microcirculation, and myocardial fibrosis in the context of acute myocardial infarction. Therefore, this study provides theoretical evidence from a pathological perspective regarding the progression of myocardial fibrosis in patients with new-onset STEMI following successful PCI. Trial registration The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2400080282; January 25th, 2024).
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spelling doaj-art-6342c6d76d734e5abff77ba8f893837d2025-08-20T02:11:51ZengBMCBMC Cardiovascular Disorders1471-22612025-04-0125111210.1186/s12872-025-04719-3Novel insights into myocardial fibrosis in patients with new onset ST-elevation myocardial infarction following percutaneous coronary intervention through enhanced cardiac magnetic resonance imaging: a prospective cohort studyTemilola J. Oketunbi0Jun Wang1Bin Ding2Xilong Song3Yao Li4Hongwei Song5Xiaojun Shi6Sigang Hu7Dasheng Gao8Hongju Wang9Miaonan Li10Department of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityDepartment of Cardiovascular Diseases, The First Affiliated Hospital of Bengbu Medical UniversityAbstract Background Myocardial fibrosis is a prevalent pathological hallmark of a diverse range of chronic and acute cardiovascular disorders. However, the relevant literature currently provides limited evidence regarding the determinants of myocardial fibrosis severity in patients with new-onset ST-elevation myocardial infarction (STEMI) following successful emergent percutaneous coronary intervention (PCI) utilizing contrast-enhanced cardiac magnetic resonance imaging (CE-CMR). Methods We prospectively enrolled a cohort of 78 patients who presented with new-onset ST-segment elevation myocardial infarction and who underwent successful emergent PCI within 12 h from the onset of symptoms. Late gadolinium-enhanced LGE (LGE) was quantified via CE-CMR, and patients were categorized into two groups on the basis of the median LGE value. Results The median LGE was 16% (IQR 12 to 24). Compared with patients with LGE below the median (n = 37), those with LGE above the median (n = 41) presented significantly reduced left ventricular global radial strain(GRS), global circumferential strain(GCS), and global longitudinal strain(GLS) (all p < 0.05). The infarcted radial segment (IRS), infarcted circumferential segment (ICS) and infarcted longitudinal segment (ILS) were significantly reduced in patients with greater LGE (all p < 0.05). The occurrence rates of microvascular obstruction (MVO) (p < 0.001) and wall motion abnormality (WMA) (p < 0.01) were significantly greater in patients with a greater extent of LGE, despite successful reperfusion therapy. LGE exhibited a moderate negative correlation with the global circumferential segment (r=-0.547, p < 0.001) and a weak negative correlation with both the global radial segment and the global longitudinal segment (r=-0.434, p < 0.001; r=-0.437, p < 0.001). In the multivariable linear regression analysis model, the Gensini score (β = 0.258; p < 0.01), LVEF% (β=-0.269; p < 0.05), MVO (β = 0.343; p < 0.001) and GRS (β = 0.227; p < 0.05) emerged as robust predictors of myocardial fibrosis. Conclusion The present study revealed a correlation of cardiac pathological structure, microcirculation, and myocardial fibrosis in the context of acute myocardial infarction. Therefore, this study provides theoretical evidence from a pathological perspective regarding the progression of myocardial fibrosis in patients with new-onset STEMI following successful PCI. Trial registration The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2400080282; January 25th, 2024).https://doi.org/10.1186/s12872-025-04719-3Acute ST-segment elevation myocardial infarctionLate gadolinium enhancementMyocardial fibrosisCardiac magnetic resonance
spellingShingle Temilola J. Oketunbi
Jun Wang
Bin Ding
Xilong Song
Yao Li
Hongwei Song
Xiaojun Shi
Sigang Hu
Dasheng Gao
Hongju Wang
Miaonan Li
Novel insights into myocardial fibrosis in patients with new onset ST-elevation myocardial infarction following percutaneous coronary intervention through enhanced cardiac magnetic resonance imaging: a prospective cohort study
BMC Cardiovascular Disorders
Acute ST-segment elevation myocardial infarction
Late gadolinium enhancement
Myocardial fibrosis
Cardiac magnetic resonance
title Novel insights into myocardial fibrosis in patients with new onset ST-elevation myocardial infarction following percutaneous coronary intervention through enhanced cardiac magnetic resonance imaging: a prospective cohort study
title_full Novel insights into myocardial fibrosis in patients with new onset ST-elevation myocardial infarction following percutaneous coronary intervention through enhanced cardiac magnetic resonance imaging: a prospective cohort study
title_fullStr Novel insights into myocardial fibrosis in patients with new onset ST-elevation myocardial infarction following percutaneous coronary intervention through enhanced cardiac magnetic resonance imaging: a prospective cohort study
title_full_unstemmed Novel insights into myocardial fibrosis in patients with new onset ST-elevation myocardial infarction following percutaneous coronary intervention through enhanced cardiac magnetic resonance imaging: a prospective cohort study
title_short Novel insights into myocardial fibrosis in patients with new onset ST-elevation myocardial infarction following percutaneous coronary intervention through enhanced cardiac magnetic resonance imaging: a prospective cohort study
title_sort novel insights into myocardial fibrosis in patients with new onset st elevation myocardial infarction following percutaneous coronary intervention through enhanced cardiac magnetic resonance imaging a prospective cohort study
topic Acute ST-segment elevation myocardial infarction
Late gadolinium enhancement
Myocardial fibrosis
Cardiac magnetic resonance
url https://doi.org/10.1186/s12872-025-04719-3
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