ST段抬高型心肌梗死超急性期的对比增强心血管磁共振成像
Contrast-enhanced cardiovascular magnetic resonance in the hyperacute phase of ST-elevation myocardial infarction.
作者信息
Larose Eric, Côté Julie, Rodés-Cabau Josep, Noël Bernard, Barbeau Gerald, Bordeleau Edith, Miró Santiago, Brochu Bernard, Delarochellière Robert, Bertrand Olivier F
机构信息
Département multidisciplinaire de cardiologie, Institut universitaire de cardiologie et de pneumologie de Québec and Faculté de médecine de l'Université Laval, 2725 chemin Ste-Foy, Quebec, QC, Canada.
出版信息
Int J Cardiovasc Imaging. 2009 Jun;25(5):519-27. doi: 10.1007/s10554-009-9451-4. Epub 2009 Mar 15.
Cardiovascular magnetic resonance (CMR) very early after primary percutaneous coronary intervention (PPCI) may lead to instability or early stent complications. However, CMR in the hyperacute phase of STEMI may improve risk stratification. We investigated feasibility and safety of CMR in the hyperacute phase of STEMI immediately after PPCI. One hundred and twenty eight consecutive patients immediately after PPCI for STEMI. Sixty four underwent CMR <12 h after PPCI versus 64 matched controls. Outcomes were followed over 6 months. CMR in hyperacute STEMI was not associated with in-hospital death, infarct expansion, or urgent revascularization (P = NS). CMR (32 ml gadolinium contrast) immediately after PPCI (180 ml iodine contrast) did not increase nephropathy. CMR did not increase major adverse cardiac events (5 vs. 8%, P = 0.16) or recurrence of angina (6 vs. 8%, P = 0.73) at 6 months. CMR immediately after PPCI is feasible and safe, allowing very early risk stratification in STEMI.
在直接经皮冠状动脉介入治疗（PPCI）后极早期进行心血管磁共振成像（CMR）可能会导致不稳定或早期支架并发症。然而，ST段抬高型心肌梗死（STEMI）超急性期的CMR可能会改善风险分层。我们研究了在PPCI后立即对STEMI超急性期进行CMR检查的可行性和安全性。128例连续的STEMI患者在PPCI后立即接受检查。64例患者在PPCI后<12小时接受CMR检查，与64例匹配的对照组进行对比。对结果进行了6个月的随访。超急性STEMI患者的CMR检查与院内死亡、梗死扩展或紧急血运重建无关（P=无显著性差异）。在PPCI（180毫升碘造影剂）后立即进行的CMR检查（32毫升钆造影剂）并未增加肾病的发生。CMR检查在6个月时并未增加主要不良心脏事件（5%对8%，P=0.16）或心绞痛复发（6%对8%，P=0.73）。PPCI后立即进行CMR检查是可行且安全的，能够在STEMI患者中进行极早期的风险分层。
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