TY - JOUR
T1 - Multidetector computed tomography predictors of late ventricular remodeling and function after acute myocardial infarction
AU - Lessick, Jonathan
AU - Abadi, Sobhi
AU - Agmon, Yoram
AU - Keidar, Zohar
AU - Carasso, Shemi
AU - Aronson, Doron
AU - Ghersin, Eduard
AU - Rispler, Shmuel
AU - Sebbag, Anat
AU - Israel, Ora
AU - Hammerman, Haim
AU - Roguin, Ariel
PY - 2012/10
Y1 - 2012/10
N2 - 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.
AB - 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.
KW - Multidetector CT
KW - Myocardial infarction
KW - Perfusion defect
KW - Remodeling
KW - Viability
UR - http://www.scopus.com/inward/record.url?scp=84865249285&partnerID=8YFLogxK
U2 - 10.1016/j.ejrad.2011.12.016
DO - 10.1016/j.ejrad.2011.12.016
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 22209631
AN - SCOPUS:84865249285
SN - 0720-048X
VL - 81
SP - 2648
EP - 2657
JO - European Journal of Radiology
JF - European Journal of Radiology
IS - 10
ER -