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.

Niccoli, G., Cosentino, N., Spaziani, C., Loria, V., Fracassi, F., Roberto, M., Calvieri, C., Lombardo, A., Natale, L., Napolitano, C., Mandurinoa, A., Burzotta, F., Leone, A. M., Porto, I., Trani, C., Bonomo, L., Crea, F., Concordance of angiographic and electrocardiographic indexes of microvascular obstruction: myocardial haemorrhage role, <<JOURNAL OF CARDIOVASCULAR MEDICINE>>, 2016; 17 (5): 382-391. [doi:10.2459/JCM.0000000000000178] [http://hdl.handle.net/10807/73960]

Concordance of angiographic and electrocardiographic indexes of microvascular obstruction: myocardial haemorrhage role

Niccoli, Giampaolo
Primo
;
Cosentino, Nicola
Secondo
;
Spaziani, Cristina;Loria, Valentina;Fracassi, Francesco;Lombardo, Antonella;Natale, Luigi;Napolitano, Carmela;Burzotta, Francesco;Leone, Antonio Maria;Porto, Italo;Trani, Carlo;Bonomo, Lorenzo
Penultimo
;
Crea, Filippo
Ultimo
2016

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.
Inglese
doi: 10.2459/JCM.0000000000000178 Epub 2014
Niccoli, G., Cosentino, N., Spaziani, C., Loria, V., Fracassi, F., Roberto, M., Calvieri, C., Lombardo, A., Natale, L., Napolitano, C., Mandurinoa, A., Burzotta, F., Leone, A. M., Porto, I., Trani, C., Bonomo, L., Crea, F., Concordance of angiographic and electrocardiographic indexes of microvascular obstruction: myocardial haemorrhage role, <<JOURNAL OF CARDIOVASCULAR MEDICINE>>, 2016; 17 (5): 382-391. [doi:10.2459/JCM.0000000000000178] [http://hdl.handle.net/10807/73960]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/73960
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