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Myocardial salvage index

Adam Ali Ghotbi, Andreas Kjaer, Lars Nepper-Christensen, Kiril Aleksov Ahtarovski, Jacob Thomsen Lønborg, Niels Vejlstrup, Kasper Kyhl, Thomas Emil Christensen, Thomas Engstrøm, Henning Kelbæk, Lene Holmvang, Lia E Bang, Rasmus Sejersten Ripa, Philip Hasbak
BACKGROUND: Determining infarct size and myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) is important when assessing the efficacy of new reperfusion strategies. We investigated whether rest (82)Rb-PET myocardial perfusion imaging can estimate area at risk, final infarct size, and myocardial salvage index when compared to cardiac SPECT and magnetic resonance (CMR). METHODS: Twelve STEMI patients were injected with (99m)Tc-Sestamibi intravenously immediate prior to reperfusion...
October 14, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Burak Turan, Tolga Daşli, Ayhan Erkol, İsmail Erden, Yelda Başaran
BACKGROUND: Incidence of diastolic dyssynchrony (DD) and its impact on functional recovery of left ventricle (LV) after ST segment elevation myocardial infarction (STEMI) is not known. METHODS: Consecutive patients with STEMI who underwent successful revascularization were prospectively enrolled. Echocardiography with tissue Doppler imaging was performed within 48 hours of admission and at 6 months. LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), ejection fraction (EF), and left atrial volume index (LAVI) were calculated...
September 2016: Journal of Cardiovascular Ultrasound
Alexander Joost, Thomas Stiermaier, Charlotte Eitel, Georg Fuernau, Suzanne de Waha, Steffen Desch, Holger Thiele, Ingo Eitel
Data on the impact of initial Thrombolysis In Myocardial Infarction (TIMI) flow in the culprit coronary artery on myocardial damage after ST-elevation myocardial infarction (STEMI) are limited. Aim of this multicenter study was, therefore, to elucidate the impact of TIMI flow grade before percutaneous coronary intervention (PCI) on infarct size (IS), myocardial salvage index (MSI), and microvascular obstruction (MVO) assessed by cardiac magnetic resonance (CMR) imaging in patients with STEMI. We enrolled 738 patients with STEMI reperfused by primary PCI within 12 hours after symptom onset at 8 centers...
August 13, 2016: American Journal of Cardiology
Raffaele Piccolo, Ingo Eitel, Gennaro Galasso, Alberto Dominguez-Rodriguez, Allan Zeeberg Iversen, Pedro Abreu-Gonzalez, Stephan Windecker, Holger Thiele, Federico Piscione
BACKGROUND: Diabetic patients are at increased risk for future cardiovascular events after ST-segment elevation myocardial infarction (STEMI). Administration of an intracoronary abciximab bolus during primary percutaneous coronary intervention (PCI) may be beneficial in this high-risk subgroup. OBJECTIVES: This study sought to report the 1-year clinical outcomes and cardiac magnetic resonance (CMR) findings in STEMI patients with and without diabetes randomized to intracoronary or intravenous abciximab bolus at the time of primary PCI...
August 16, 2016: Journal of the American College of Cardiology
Soonuk Choi, Woo Jin Jang, Young Bin Song, Joao A C Lima, Eliseo Guallar, Yeon Hyeon Choe, Jin Kyung Hwang, Eun Kyoung Kim, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Sang-Chol Lee, Sang Hoon Lee, Hyeon-Cheol Gwon
OBJECTIVES: Elevated D-dimer levels on admission predict prognosis in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI), but the association of D-dimer levels with structural markers of myocardial injury in these patients is unknown. METHODS: We performed cardiac magnetic resonance (CMR) imaging in 208 patients treated with primary PCI for STEMI. CMR was performed a median of 3 days after the index procedure...
2016: PloS One
M Lisy, E Schmid, J Kozok, P Rosenberger, U A Stock, G Kalender
AIM: Intraoperative allogeneic blood product transfusion (ABPT) in cardiac surgery is associated with worse overall outcome, including mortality. The objective of this study was to evaluate the ABPTs in minimalized extracorporeal cardiopulmonary (MECC(TM)) compared with standard open system on-pump coronary revascularization. METHODS: Data of 156 patients undergoing myocardial revascularization between September 2008 and September 2010 were reviewed. 83 patients were operated by the MECC technique and 73 were treated by standard extracorporeal circulation (sECC)...
2016: Open Cardiovascular Medicine Journal
Chaoyi Cui, Xintian Huang, Xiaobing Liu, Weimin Li, Xinwu Lu, Min Lu, Mier Jiang, Minyi Yin
OBJECTIVE: To evaluate efficacy, safety, and midterm patency of endovascular treatment of obstructive popliteal artery (PA) disease. METHODS: A retrospective evaluation of patients with atherosclerotic PA disease who underwent percutaneous transluminal balloon angioplasty and provisional stent, based on both conventional and dynamic angiographies, was conducted from June 2011 to June 2014. Forty-three patients were included in the study, and most patients had limited surgical revascularization options...
August 3, 2016: Journal of Vascular Surgery
Heerajnarain Bulluck, Stefania Rosmini, Amna Abdel-Gadir, Steven K White, Anish N Bhuva, Thomas A Treibel, Marianna Fontana, Esther Gonzalez-Lopez, Patricia Reant, Manish Ramlall, Ashraf Hamarneh, Alex Sirker, Anna S Herrey, Charlotte Manisty, Derek M Yellon, Peter Kellman, James C Moon, Derek J Hausenloy
BACKGROUND: Whether the remote myocardium of reperfused ST-segment elevation myocardial infarction (STEMI) patients plays a part in adverse left ventricular (LV) remodeling remains unclear. We aimed to use automated extracellular volume fraction (ECV) mapping to investigate whether changes in the ECV of the remote (ECVR emote) and infarcted myocardium (ECVI nfarct) impacted LV remodeling. METHODS AND RESULTS: Forty-eight of 50 prospectively recruited reperfused STEMI patients completed a cardiovascular magnetic resonance at 4±2 days and 40 had a follow-up scan at 5±2 months...
July 2016: Journal of the American Heart Association
Yazan Daaboul, Serge Korjian, W Douglas Weaver, Robert A Kloner, Robert P Giugliano, Jim Carr, Brandon J Neal, Gerald Chi, Madeleine Cochet, Laura Goodell, Nathan Michalak, Luke Rusowicz-Orazem, Turky Alkathery, Haytham Allaham, Sujit Routray, Donald Szlosek, Purva Jain, C Michael Gibson
Biomarker measures of infarct size and myocardial salvage index (MSI) are important surrogate measures of clinical outcomes after a myocardial infarction. However, there is variability in infarct size unaccounted for by conventional adjustment factors. This post hoc analysis of Evaluation of Myocardial Effects of Bendavia for Reducing Reperfusion Injury in Patients With Acute Coronary Events (EMBRACE) ST-Segment Elevation Myocardial Infarction (STEMI) trial evaluates the association between left ventricular (LV) mass and infarct size as assessed by areas under the curve for creatine kinase-MB (CK-MB) and troponin I release over the first 72 hours (CK-MB area under the curve [AUC] and troponin I [TnI] AUC) and the MSI...
September 1, 2016: American Journal of Cardiology
Jamal N Khan, Sheraz A Nazir, Anvesha Singh, Abhishek Shetye, Florence Y Lai, Charles Peebles, Joyce Wong, John P Greenwood, Gerry P McCann
BACKGROUND: Late gadolinium-enhanced cardiovascular magnetic resonance imaging overestimates infarct size and underestimates recovery of dysfunctional segments acutely post ST-segment-elevation myocardial infarction. We assessed whether cardiovascular magnetic resonance imaging-derived segmental myocardial strain and markers of myocardial injury could improve the accuracy of late gadolinium-enhancement in predicting functional recovery after ST-segment-elevation myocardial infarction...
June 2016: Circulation. Cardiovascular Imaging
Jacob Lønborg, Henning Kelbæk, Lene Holmvang, Steffen Helqvist, Niels Vejlstrup, Erik Jørgensen, Kari Saunamäki, Nadia P Dridi, Lene Kløvgaard, Anne Kaltoft, Hans-Erik Bøtker, Jens F Lassen, Peter Clemmensen, Christian Juhl Terkelsen, Thomas Engstrøm
Some patients presenting with ST-segment elevation myocardial infarction (STEMI) have complete ST resolution in the electrocardiogram, which may be clinical useful in the triage of patients with STEMI. However, the importance of complete ST resolution in these patients remains uncertain. Thus, the purpose was to describe the prognosis of patients with complete ST resolution before primary percutaneous coronary intervention (PCI). Continuous ST monitoring from arrival until 90 minutes after PCI was performed in 933 patients with STEMI...
June 1, 2016: American Journal of Cardiology
Tuncay Yetgin, Matthijs van Kranenburg, Tim Ten Cate, Dirk J Duncker, Menko-Jan de Boer, Roberto Diletti, Robert-Jan M van Geuns, Felix Zijlstra, Olivier C Manintveld
BACKGROUND: Whether ischemic postconditioning (IPOC) immediately after routine thrombus aspiration (TA) reduces infarct size (IS) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) has not been established. STUDY DESIGN: The POstconditioning Rotterdam Trial (PORT) is a dual-center, prospective, open-label, randomized trial with blinded endpoint evaluation enrolling 72 subjects with first-time STEMI, and an occluded infarct-related artery (IRA) without collaterals undergoing PPCI...
September 10, 2015: Catheterization and Cardiovascular Interventions
Masaomi Gohbara, Noriaki Iwahashi, Eiichi Akiyama, Nobuhiko Maejima, Kengo Tsukahara, Kiyoshi Hibi, Masami Kosuge, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura
BACKGROUND: Epicardial adipose tissue (EAT), defined as the adipose tissue between the visceral pericardium and the outer margin of the myocardium, is associated with coronary artery disease in the general population. However, the clinical implications of EAT in patients with ST-segment elevation myocardial infarction (STEMI) remain unclear. METHODS: A total of 142 patients with a first STEMI, who received reperfusion therapy within 12h from symptom onset, were enrolled...
March 19, 2016: Journal of Cardiology
Sebastian J Reinstadler, Charlotte Eitel, Georg Fuernau, Suzanne de Waha, Steffen Desch, Meinhard Mende, Bernhard Metzler, Gerhard Schuler, Holger Thiele, Ingo Eitel
AIMS: There is evidence suggesting a positive effect of cigarette smoking on myocardial tissue reperfusion and clinical outcomes in patients with myocardial infarction ('smoker's paradox'). We aimed to evaluate the relationship of smoking with cardiac magnetic resonance (CMR)-determined myocardial salvage and damage as well as clinical outcomes in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: This multicentre study included 727 consecutive STEMI patients reperfused within 12 h after symptom onset...
March 13, 2016: European Heart Journal Cardiovascular Imaging
Helle Søholm, Jacob Lønborg, Mads J Andersen, Niels Vejlstrup, Thomas Engstrøm, Christian Hassager, Jacob Eifer Møller
OBJECTIVES: Left ventricular (LV) diastolic dysfunction is a predictor of increased morbidity and mortality; however, little is known about diastolic function and the degree of myocardial damage after myocardial infarction (MI). The aim was to assess the association between diastolic dysfunction by echocardiography and myocardial salvage assessed with cardiac magnetic resonance (CMR) imaging in patients with ST-segment elevation MI (STEMI). DESIGN: In a prospective study, echocardiography and CMR were performed in STEMI patients in the early post-MI phase assessing diastolic dysfunction according to E/A and E/e'average and area at risk, and after three months with measurement of final infarct size and salvage index...
June 2016: Scandinavian Cardiovascular Journal: SCJ
Sebastian Johannes Reinstadler, Charlotte Eitel, Merle Thieme, Bernhard Metzler, Janine Poess, Steffen Desch, Holger Thiele, Ingo Eitel
It is unknown whether the occurrence of ST-elevation myocardial infarction (STEMI) at a younger age is associated with differences in myocardial damage compared with older patients. We aimed to compare the infarct characteristics (area at risk [AAR], myocardial salvage index [MSI], infarct size [IS], microvascular obstruction [MVO]) and clinical outcome in patients aged ≤45 years and >45 years. We analyzed 795 patients with STEMI treated with primary percutaneous coronary intervention. All patients completed 12-month follow-up for the assessment of major adverse cardiac events (MACE)...
May 1, 2016: American Journal of Cardiology
Henrik Engblom, Einar Heiberg, David Erlinge, Svend Eggert Jensen, Jan Erik Nordrehaug, Jean-Luc Dubois-Randé, Sigrun Halvorsen, Pavel Hoffmann, Sasha Koul, Marcus Carlsson, Dan Atar, Håkan Arheden
BACKGROUND: Cardiac magnetic resonance (CMR) can quantify myocardial infarct (MI) size and myocardium at risk (MaR), enabling assessment of myocardial salvage index (MSI). We assessed how MSI impacts the number of patients needed to reach statistical power in relation to MI size alone and levels of biochemical markers in clinical cardioprotection trials and how scan day affect sample size. METHODS AND RESULTS: Controls (n=90) from the recent CHILL-MI and MITOCARE trials were included...
March 2016: Journal of the American Heart Association
Yama Fakhri, Martin Busk, Mikkel Malby Schoos, Christian Juhl Terkelsen, Steen D Kristensen, Galen S Wagner, Maria Sejersten, Peter Clemmensen, Jens Kastrup
BACKGROUND: Primary percutaneous coronary intervention (pPCI) is recommended in patients with ST Elevation Myocardial Infarction (STEMI) and symptom duration <12hours. However, a considerable amount of myocardium might still be salvaged in STEMI patients with symptom durations >12hours (late-presenters). The Anderson-Wilkin's score (AW-score) estimates the acuteness of myocardial ischemia from the electrocardiogram (ECG) in STEMI patients. We hypothesized that the AW-score is superior to symptom duration in identifying substantial salvage potential in late-presenters...
May 2016: Journal of Electrocardiology
Jane Tufvesson, Marcus Carlsson, Anthony H Aletras, Henrik Engblom, Jean-François Deux, Sasha Koul, Peder Sörensson, John Pernow, Dan Atar, David Erlinge, Håkan Arheden, Einar Heiberg
BACKGROUND: Efficacy of reperfusion therapy can be assessed as myocardial salvage index (MSI) by determining the size of myocardium at risk (MaR) and myocardial infarction (MI), (MSI = 1-MI/MaR). Cardiovascular magnetic resonance (CMR) can be used to assess MI by late gadolinium enhancement (LGE) and MaR by either T2-weighted imaging or contrast enhanced SSFP (CE-SSFP). Automatic segmentation algorithms have been developed and validated for MI by LGE as well as for MaR by T2-weighted imaging...
2016: BMC Medical Imaging
Kasper Pryds, Christian Juhl Terkelsen, Astrid Drivsholm Sloth, Kim Munk, Søren Steen Nielsen, Michael Rahbek Schmidt, Hans Erik Bøtker
OBJECTIVE: We investigated influence of remote ischaemic conditioning (RIC) on the detrimental effect of healthcare system delay on myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). METHODS: A post-hoc analysis of a randomised controlled trial in patients with STEMI randomised to treatment with pPCI or RIC+pPCI. RIC was performed as four cycles of intermittent 5 min upper arm ischaemia and reperfusion...
July 1, 2016: Heart: Official Journal of the British Cardiac Society
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