Cardiology Department, Hospital Clinico Universitario, INCLIVA, Universidad de Valencia, Blasco Ibanez 17, 46010 Valencia, Spain.
Int J Cardiovasc Imaging. 2012 Dec;28(8):2057-64. doi: 10.1007/s10554-012-0014-8. Epub 2012 Jan 20.
To evaluate remote myocardial function after ST-elevation myocardial infarction (STEMI) and the impact of infarct size (IS) using cardiovascular magnetic resonance (CMR). 161 patients and 15 controls underwent CMR at 1st week and 6th month after STEMI. Using the 17-segments model, segments were categorized into infarcted, adjacent and remote myocardium. Relative systolic wall thickening (SWT, %) was assessed using the centerline method. IS (% of left ventricular mass) was determined in late enhancement imaging. Overall, in remote myocardium, SWT was comparable (83 ± 32) to controls (77 ± 25, P = .5) and did not increase significantly (P = .2) at the 6th month (88 ± 35, P = .3 vs. control). When IS was categorized into tertiles (<13.6%, (n = 49), 13.7-28.2%, (n = 60), >28.2%, (n = 52)), SWT in the remote area at the 1st week was not different from controls, regardless of infarct size (p between .2 and .8 for all tertiles). At 6 months, SWT was larger compared to controls only in small infarctions (98 ± 34 vs. 77 ± 25, P = .03). In medium and large infarctions there was no difference in SWT of the remote area compared to controls (87 ± 33 and 79 ± 34, P = .3 and P = .09) and there was no significant increase at 6 months (P between .2 and .9). In remote myocardium there was no difference in contractility compared to controls after STEMI. After 6 month a slight hypercontractility can only be observed in small infarctions. In medium and large infarctions no difference of SWT in remote myocardium compared to controls can be observed.
评估 ST 段抬高型心肌梗死（STEMI）后远程心肌功能和梗死面积（IS）的影响使用心血管磁共振（CMR）。161 例患者和 15 例对照在 STEMI 后第 1 周和第 6 个月接受 CMR。使用 17 节段模型，将节段分为梗死、相邻和远程心肌。使用中心线法评估相对收缩壁增厚（SWT，%）。在晚期增强成像中确定 IS（左心室质量的%）。总的来说，在远程心肌中，SWT 与对照组相当（83 ± 32）（77 ± 25，P =.5），在第 6 个月时没有显著增加（P =.2）（88 ± 35，P =.3 与对照组）。当 IS 分为三分位数（<13.6%（n = 49），13.7-28.2%（n = 60），>28.2%（n = 52））时，第 1 周远程区域的 SWT 与对照组无差异，与梗死大小无关（所有三分位数的 P 值介于.2 和.8 之间）。在第 6 个月时，与对照组相比，只有在小梗死中 SWT 较大（98 ± 34 与 77 ± 25，P =.03）。在中大和大梗死中，与对照组相比，远程区域的 SWT 没有差异（87 ± 33 和 79 ± 34，P =.3 和 P =.09），并且在第 6 个月时没有显著增加（P 值介于.2 和.9 之间）。在 STEMI 后，与对照组相比，远程心肌的收缩力没有差异。在 6 个月后，仅在小梗死中可以观察到轻微的超收缩性。在中大和大梗死中，与对照组相比，远程心肌的 SWT 没有差异。
