Vargas-Barrón Jesús, González-Pacheco Héctor, Meléndez-Ramírez Gabriela, Roldán Francisco Javier, Damas-De los Sasntos Félix, Meave-González Aloha, Martínez-Sánchez Carlos
Dirección de Investigación. Instituto Nacional de Cardiología Ignacio Chávez.
Rev Invest Clin. 2014 Mar-Apr;66(2):107-12.
OBJECTIVE. The presence of intramyocardial hemorrhage (IMH) is frequent in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PPCI). We aim for the presence IMH using cMRI in patients who presented AMI and did not undergo PPCI or thrombolysis. Cardiac magnetic resonance has proven to be a highly sensitive method for detect its presence in the ischemic damaged tissue. MATERIAL AND METHODS. Patients admitted with diagnosis of ST elevation myocardial infarction > 24 h after initial presentation and without reperfusion therapy were enrolled in the study. All patients underwent cardiac magnetic resonance for detecting edema, microvascular obstruction and intramyocardial hemorrhage, followed by coronary angiography. RESULTS. Seven male patients, with median age of 53 years, were enrolled. Cardiac magnetic resonance showed that all patients had microvascular obstruction and edema. Two of them had intramyocardial hemorrhage in association with spontaneous reperfusion demonstrated by angiography. CONCLUSION. The results of our study show that in patients with acute myocardial infarction, intramyocardial hemorrhage occurs not only after therapeutic, but also after spontaneous reperfusion. This is the first time that its presence is demonstrated by cardiac magnetic resonance.
目的。在接受直接经皮冠状动脉介入治疗（PPCI）的急性心肌梗死（AMI）患者中，心肌内出血（IMH）很常见。我们旨在对出现AMI但未接受PPCI或溶栓治疗的患者使用心脏磁共振成像（cMRI）检测IMH的存在。心脏磁共振已被证明是检测缺血损伤组织中IMH存在的高度敏感方法。材料与方法。纳入初次就诊后超过24小时诊断为ST段抬高型心肌梗死且未接受再灌注治疗的患者。所有患者均接受心脏磁共振检查以检测水肿、微血管阻塞和心肌内出血，随后进行冠状动脉造影。结果。纳入7名男性患者，中位年龄53岁。心脏磁共振显示所有患者均有微血管阻塞和水肿。其中2例患者存在心肌内出血，血管造影显示为自发再灌注。结论。我们的研究结果表明，在急性心肌梗死患者中，心肌内出血不仅发生在治疗后，也发生在自发再灌注后。这是首次通过心脏磁共振证明其存在。
