Multidetector computed tomography predictors of late ventricular remodeling and function after acute myocardial infarction

被引:8
作者
Lessick, Jonathan [1 ,4 ]
Abadi, Sobhi [2 ]
Agmon, Yoram [1 ,4 ]
Keidar, Zohar [3 ,4 ]
Carasso, Shemi [1 ,4 ]
Aronson, Doron [1 ,4 ]
Ghersin, Eduard [5 ]
Rispler, Shmuel [1 ,4 ]
Sebbag, Anat [1 ]
Israel, Ora [3 ,4 ]
Hammerman, Haim [1 ,4 ]
Roguin, Ariel [1 ,4 ]
机构
[1] Rambam Hlth Care Campus, Dept Cardiol, Haifa, Israel
[2] Rambam Hlth Care Campus, Dept Med Imaging, Haifa, Israel
[3] Rambam Hlth Care Campus, Dept Nucl Med, Haifa, Israel
[4] Technion Israel Inst Technol, Haifa, Israel
[5] Univ Miami, Miller Sch Med, Dept Diagnost Radiol, Miami, FL 33136 USA
关键词
Myocardial infarction; Viability; Remodeling; Perfusion defect; Multidetector CT; MAGNETIC-RESONANCE; MICROVASCULAR OBSTRUCTION; ROW CT; PERFUSION; VIABILITY; IMPROVEMENT; EXPERIENCE; ADENOSINE; REFLOW; SIZE;
D O I
10.1016/j.ejrad.2011.12.016
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Background: Despite advent of rapid arterial revascularization as 1st line treatment for acute myocardial infarction (AMI), incomplete restoral of flow at the microvascular level remains a problem and is associated with adverse prognosis, including pathological ventricular remodeling. We aimed to study the association between multidetector row computed tomography (MDCT) perfusion defects and ventricular remodeling post-AMI. Methods: In a prospective study, 20 patients with ST-elevation AMI, treated by primary angioplasty, underwent arterial and late phase MDCT as well as radionuclide scans to study presence, size and severity of myocardial perfusion defects. Contrast echocardiography was performed at baseline and at 4 months follow-up to evaluate changes in myocardial function and remodeling. Results: Early defects (ED), late defects (LD) and late enhancement (LE) were detected in 15, 7 and 16 patients, respectively and radionuclide defects in 15 patients. The ED area (r = 0.74), and LD area (r = 0.72), and to a lesser extent LE area (r = 0.62) correlated moderately well with SPECT summed rest score. By univariate analysis, follow-up end-systolic volume index and ejection fraction were both significantly related to ED and LD size and severity, but not to LE size or severity. By multivariate analysis, end-systolic volume index was best predicted by LD area (p < 0.05) and ejection fraction by LD enhancement ratio. Conclusions: LD size and severity on MDCT are most closely associated with pathological ventricular remodeling after AMI and may thus play a role in early identification and treatment of this condition. (c) 2011 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:2648 / 2657
页数:10
相关论文
共 24 条
[1]   Detection of Hemodynamically Significant Coronary Artery Stenosis: Incremental Diagnostic Value of Dynamic CT-based Myocardial Perfusion Imaging [J].
Bamberg, Fabian ;
Becker, Alexander ;
Schwarz, Florian ;
Marcus, Roy P. ;
Greif, Martin ;
von Ziegler, Franz ;
Blankstein, Ron ;
Hoffmann, Udo ;
Sommer, Wieland H. ;
Hoffmann, Verena S. ;
Johnson, Thorsten R. C. ;
Becker, Hans-Christoph R. ;
Wintersperger, Bernd J. ;
Reiser, Maximilian F. ;
Nikolaou, Konstantin .
RADIOLOGY, 2011, 260 (03) :689-698
[2]   Adenosine-Stress Dynamic Myocardial CT Perfusion Imaging Initial Clinical Experience [J].
Bastarrika, Gorka ;
Ramos-Duran, Luis ;
Rosenblum, Michael A. ;
Kang, Doo Kyoung ;
Rowe, Garrett W. ;
Schoepf, U. Joseph .
INVESTIGATIVE RADIOLOGY, 2010, 45 (06) :306-313
[3]   Microvascular Obstruction Underlying Pathophysiology and Clinical Diagnosis [J].
Bekkers, Sebastiaan C. A. M. ;
Yazdani, Saami K. ;
Virmani, Renu ;
Waltenberger, Johannes .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2010, 55 (16) :1649-1660
[4]   Assessment of acute myocardial infarction using MDCT after percutaneous coronary intervention: Comparison with MRI [J].
Boussel, Loiec ;
Ribagnac, Michael ;
Bonnefoy, Eric ;
Staat, Patrick ;
Elicker, Brett M. ;
Revel, Didier ;
Douek, Philippe .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2008, 191 (02) :441-447
[5]   Comparison of MDCT and MRI in the detection and sizing of acute and chronic myocardial infarcts [J].
Choe, Yeon Hyeon ;
Choo, Ki Seok ;
Jeon, Eun-Seok ;
Gwon, Hyeon-Cheol ;
Choi, Jin-Ho ;
Park, Jeong-Euy .
EUROPEAN JOURNAL OF RADIOLOGY, 2008, 66 (02) :292-299
[6]   Characterization of acute and chronic myocardial infarcts by multidetector computed tomography - Comparison with contrast-enhanced magnetic resonance [J].
Gerber, BL ;
Belge, B ;
Legros, GJ ;
Lim, P ;
Poncelet, A ;
Pasquet, AS ;
Gisellu, G ;
Coche, E ;
Vanoverschelde, JLJ .
CIRCULATION, 2006, 113 (06) :823-833
[7]   Acute myocardial infarction: Contrast-enhanced multi-detector row CT in a porcine model [J].
Hoffman, U ;
Millea, R ;
Enzweiler, C ;
Ferencik, M ;
Gulick, S ;
Titus, J ;
Achenbach, S ;
Kwait, D ;
Sosnovik, D ;
Brady, TJ .
RADIOLOGY, 2004, 231 (03) :697-701
[8]   Magnetic resonance first pass perfusion imaging for detecting coronary artery disease [J].
Klassen, C ;
Nguyen, M ;
Siuciak, A ;
Wilke, NM .
EUROPEAN JOURNAL OF RADIOLOGY, 2006, 57 (03) :412-416
[9]   ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging - Executive summary - A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to revise the 1995 guidelines for the clinical use of cardiac radionuclide imaging) [J].
Klocke, FJ ;
Baird, MG ;
Lorell, BH ;
Bateman, TM ;
Messer, JV ;
Berman, DS ;
O'Gara, PT ;
Carabello, BA ;
Russell, RO ;
Cerqueira, MD ;
Sutton, MGS ;
DeMaria, AN ;
Udelson, JE ;
Kennedy, JW ;
Verani, MS ;
Williams, KA ;
Antman, EM ;
Smith, SC ;
Alpert, JS ;
Gregoratos, G ;
Anderson, JL ;
Hiratzka, LF ;
Faxon, DP ;
Hunt, SA ;
Fuster, V ;
Jacobs, AK ;
Gibbons, RJ ;
Russell, RO .
CIRCULATION, 2003, 108 (11) :1404-1418
[10]   Assessment of reperfused acute myocardial infarction with two-phase contrast-enhanced helical CT: Prediction of left ventricular function and wall thickness [J].
Koyama, Y ;
Matsuoka, H ;
Mochizuki, T ;
Higashino, H ;
Kawakami, H ;
Nakata, S ;
Aono, J ;
Ito, T ;
Naka, M ;
Ohashi, Y ;
Higaki, J .
RADIOLOGY, 2005, 235 (03) :804-811