Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
PLoS One. 2019 Feb 8;14(2):e0211807. doi: 10.1371/journal.pone.0211807. eCollection 2019.
Little is known about the causality and pathological mechanism underlying the association of seasonal variation with myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI).
We evaluated the association of seasonal effect with myocardial injury using cardiovascular magnetic resonance (CMR) imaging in STEMI patients undergoing primary percutaneous coronary intervention (PCI).
In 279 patients undergoing primary PCI for STEMI, CMR was performed for a median of 3.3 days after the index procedure. Of these, STEMI occurred in 56 patients in the winter (Winter group), 80 patients in the spring (Spring group), 76 patients in the summer (Summer group), and 67 patients in the autumn (Autumn group), respectively. We compared myocardial infarct size, extent of area at risk (AAR), myocardial salvage index (MSI) and microvascular obstruction (MVO) area as assessed by CMR according to the season in which STEMI occurred.
In the CMR analysis, the myocardial infarct size was not significantly different among the Winter group (21.0 ± 10.5%), the Spring group (19.6 ± 11.5%), the Summer group (18.6 ± 10.6%), and the Autumn group (21.1 ± 11.3%) (P = 0.475). The extent of AAR, MSI, and MVO areas were similar among the four groups. In the subgroup analysis, myocardial infarct size, extent of AAR, MSI, and MVO were not significantly different between the Harsh climate (winter + summer) and the Mild climate (spring + autumn) groups.
Seasonal influences may not affect advanced myocardial injury in STEMI patients undergoing primary PCI.
关于季节变化与 ST 段抬高型心肌梗死（STEMI）患者心肌损伤之间的因果关系和病理机制知之甚少。
我们通过对行直接经皮冠状动脉介入治疗（PCI）的 STEMI 患者进行心血管磁共振（CMR）成像，评估季节效应对心肌损伤的影响。
在 279 例行直接 PCI 治疗的 STEMI 患者中，在指数手术后中位数 3.3 天进行 CMR。其中，56 例 STEMI 患者发生在冬季（冬季组），80 例发生在春季（春季组），76 例发生在夏季（夏季组），67 例发生在秋季（秋季组）。我们根据 STEMI 发生的季节比较了 CMR 评估的心肌梗死面积、危险区面积（AAR）、心肌挽救指数（MSI）和微血管阻塞（MVO）面积。
在 CMR 分析中，冬季组（21.0 ± 10.5%）、春季组（19.6 ± 11.5%）、夏季组（18.6 ± 10.6%）和秋季组（21.1 ± 11.3%）的心肌梗死面积无显著差异（P = 0.475）。4 组间 AAR、MSI 和 MVO 面积相似。亚组分析中，冬季+夏季组和春季+秋季组之间心肌梗死面积、AAR 面积、MSI 和 MVO 均无显著差异。
季节变化可能不会影响行直接 PCI 的 STEMI 患者的晚期心肌损伤。
