Introduction
Methods
Patient population
CMR image acquisition
CMR image analysis
Statistical analysis
Results
Characteristic | n = 71 |
---|---|
Age (years) | 57 ± 10 |
Male gender | 57 (80%) |
Body mass index (kg/m2) | 27 ± 3 |
Risk factors | |
Family history of CAD | 32 (45%) |
Hypertension | 17 (24%) |
Hypercholesterolemia | 9 (13%) |
Diabetes mellitus | 24 (34%) |
Smoking | 57 (80%) |
Maximum CK-MB (U/l) | 212 ± 224 |
Time to reperfusion (h) | 2.4 [1.5-3.6] |
TIMI flow grade 3 post PCI | 67 (94%) |
GP IIb/IIIa inhibitor used | 24 (34%) |
Infarct related artery | |
LAD | 45 (63%) |
LCx | 6 (8%) |
RCA | 20 (28%) |
Medication at discharge | |
ACE inhibitor or ATII antagonist | 65 (92%) |
Aspirin | 71 (100%) |
Beta-blocker | 70 (99%) |
P2Y12 inhibitor | 71 (100%) |
Statin | 71 (100%) |
LV volumes and LV function | |
LV ED volume (ml/m2)* | 93 ± 15 |
LV ES volume (ml/m2)* | 49 ± 14 |
LV EF (%) | 49 ± 8 |
Microvascular obstruction | 37 (52%) |
Discriminating between infarcted and non-infarcted myocardium
Characteristic | Hyperenhanced (n = 418) | Non-enhanced (n = 678) | p value |
---|---|---|---|
Wall thickening | |||
absWT (mm) | 1.9 ± 1.7 | 4.0 ± 1.8 | < 0.001 |
relWT (%) | 27 ± 31 | 65 ± 41 | < 0.001 |
Circumferential strain | |||
CS (%) | -6.6 ± 3.8 | -12.7 ± 4.5 | < 0.001 |
Systolic CSR (%/ms) | -4.6 ± 2.6 | -7.6 ± 3.1 | < 0.001 |
Diastolic CSR (%/ms) | 5.0 ± 6.1 | 9.1 ± 4.6 | < 0.001 |
Radial strain | |||
RS (%) | 7.4 ± 6.5 | 15.6 ± 10.6 | < 0.001 |
Systolic RSR (%/ms) | 5.8 ± 5.0 | 9.4 ± 5.2 | < 0.001 |
Diastolic RSR (%/ms) | -6.6 ± 4.0 | -10.7 ± 6.0 | < 0.001 |
Discriminating between infarcted myocardium with and without MVO
Characteristic | MVO (n = 145) | No MVO (n = 273) | Uncorrected p value | Corrected p value |
---|---|---|---|---|
Wall thickening | ||||
absWT (mm) | 1.4 ± 1.4 | 2.3 ± 1.7 | < 0.001 | 0.657 |
relWT (%) | 17 ± 22 | 34 ± 34 | < 0.001 | 0.148 |
Circumferential strain | ||||
CS (%) | -5.3 ± 3.4 | -7.6 ± 3.7 | < 0.001 | <0.001 |
Systolic CSR (%/ms) | -4.0 ± 2.7 | -5.1 ± 2.4 | < 0.001 | <0.001 |
Diastolic CSR (%/ms) | 4.0 ± 4.2 | 5.8 ± 7.1 | < 0.001 | 0.019 |
Radial strain | ||||
RS (%) | 4.9 ± 4.6 | 9.3 ± 7.0 | < 0.001 | 0.152 |
Systolic RSR (%/ms) | 4.6 ± 4.0 | 6.8 ± 5.5 | < 0.001 | 0.011 |
Diastolic RSR (%/ms) | -5.4 ± 3.5 | -7.5 ± 4.2 | < 0.001 | 0.024 |
Transmural extent of infarction (%) | 64.9 [42.3-84.7] | 13.9 [4.7-34.8] | < 0.001 |
Optimal cutoff values and diagnostic accuracies
Characteristic | Hyperenhancement | MVO | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Optimal cut-off | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Accuracy (%) | Optimal cut-off | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Accuracy (%) | |
Wall thickening
| ||||||||||||
absWT | 2.7 mm | 72 | 79 | 68 | 82 | 76 | 2.1 mm | 75 | 61 | 51 | 82 | 65 |
relWT | 48 % | 81 | 70 | 63 | 86 | 74 | 31 % | 79 | 60 | 51 | 84 | 66 |
Circumferential strain
| ||||||||||||
CS | -9.6 % | 81 | 76 | 68 | 87 | 78 | -6.2 % | 75 | 74 | 60 | 85 | 74 |
Systolic CSR | -5.9 %/ms | 72 | 78 | 67 | 82 | 76 | -4.7 %/ms | 71 | 68 | 54 | 82 | 69 |
Diastolic CSR | 5.5 %/ms | 68 | 84 | 72 | 81 | 77 | 3.5 %/ms | 61 | 77 | 58 | 79 | 71 |
Radial strain
| ||||||||||||
RS | 8.1 % | 68 | 80 | 67 | 80 | 75 | 5.7 % | 68 | 74 | 58 | 81 | 72 |
Systolic RSR | 5.8 %/ms | 64 | 74 | 61 | 77 | 70 | 5.0 %/ms | 70 | 65 | 51 | 80 | 66 |
Diastolic RSR | -6.8 %/ms | 63 | 76 | 62 | 77 | 71 | -4.7 %/ms | 50 | 82 | 59 | 75 | 70 |