Baks Timo, van Geuns Robert-Jan, Biagini Elena, Wielopolski Piotr, Mollet Nico R, Cademartiri Filippo, Boersma Eric, van der Giessen Willem J, Krestin Gabriel P, Duncker Dirk J, Serruys Patrick W, de Feyter Pim J
Department of Cardiology (Thoraxcenter), Erasmus MC-University Medical Center Rotterdam, Bd 410, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
Eur Heart J. 2005 Jun;26(11):1070-7. doi: 10.1093/eurheartj/ehi131. Epub 2005 Feb 16.
To study recovery of segmental wall thickening (SWT), ejection fraction (EF), and end-systolic volume (ESV) after acute myocardial infarction (AMI) in patients who underwent primary stenting with drug-eluting stents. Additionally, to evaluate the predictive value of magnetic resonance imaging (MRI)-based myocardial perfusion and delayed enhancement (DE) imaging.
Twenty-two patients underwent cine-MRI, first-pass perfusion, and DE imaging 5 days after successful placement of a drug-eluting stent in the infarct-related coronary artery. Regional myocardial perfusion and the transmural extent of DE were evaluated. A per patient perfusion score was calculated and consisted of a summation of all segmental scores. Myocardial infarct size was quantified by measuring the volume of DE. At 5 months after AMI, cine-MRI was performed and SWT, EF, and ESV were quantified. EF increased from 48+/-11 to 55+/-9% (P<0.01). SWT at 5 months was inversely related to baseline segmental DE scores (P<0.001) and segmental perfusion scores (P<0.001). EF and ESV at 5 months were related to acute infarct size (R(2)=0.65; P<0.001 and R(2)=0.78; P<0.001, respectively) and the calculated perfusion score (R(2)=0.23; P=0.02 and R(2)=0.14; P=0.09, respectively) at baseline.
Marked recovery of left ventricular function was observed in patients receiving a drug-eluting stent for AMI. DE imaging appears to be a better prognosticator than perfusion imaging.
研究接受药物洗脱支架直接置入术的急性心肌梗死（AMI）患者节段性室壁增厚（SWT）、射血分数（EF）和收缩末期容积（ESV）在AMI后的恢复情况。此外，评估基于磁共振成像（MRI）的心肌灌注和延迟强化（DE）成像的预测价值。
22例患者在梗死相关冠状动脉成功置入药物洗脱支架5天后接受电影MRI、首过灌注和DE成像。评估局部心肌灌注和DE的透壁范围。计算每位患者的灌注评分，该评分由所有节段评分相加得到。通过测量DE的体积对心肌梗死面积进行量化。在AMI后5个月，进行电影MRI并对SWT、EF和ESV进行量化。EF从48±11%增加到55±9%（P<0.01）。5个月时的SWT与基线节段DE评分（P<0.001）和节段灌注评分（P<0.001）呈负相关。5个月时的EF和ESV与急性梗死面积（分别为R²=0.65；P<0.001和R²=0.78；P<0.001）以及基线时计算的灌注评分（分别为R²=0.23；P=0.02和R²=0.14；P=0.09）相关。
在接受药物洗脱支架治疗AMI的患者中观察到左心室功能明显恢复。DE成像似乎比灌注成像具有更好的预后价值。
