Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Department of Cardiac Care Unit, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Clin Radiol. 2023 Oct;78(10):e724-e731. doi: 10.1016/j.crad.2023.06.010. Epub 2023 Jun 29.
To investigate the predictive value of ischaemic time and cardiac magnetic resonance imaging (CMRI) T1 mapping in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).
A total of 127 patients with STEMI treated by primary PCI were studied. All patients underwent CMRI with native T1 and extracellular volume (ECV) measurement, 61 of whom also had 4-month follow-up data. The total ischaemic (symptom onset to balloon, S2B) time expressed in minutes was recorded. CMRI cine, T1 mapping, and late gadolinium enhancement (LGE) images were analysed to evaluate left ventricular (LV) function, T1 value, ECV, and myocardial infract (MI) scar characteristics, respectively. The correlation between S2B time and T1 mapping was evaluated. The predictive values of S2B time and T1 mapping for large final infarct size were estimated.
The incidence of microvascular obstruction (MVO) increased with the prolongation of ischaemia time. Regardless of MVO or not, ECV in myocardial infarction (ECV) was significantly correlated with S2B time (r=0.61, p<0.001), while native T1 in MI (T1) was not (r=-0.19, p=0.029). In the 4-month follow-up, native T1 was improved (1385.1 ± 90.4 versus 1288.6 ± 74 ms, p<0.001). Furthermore, ECV was independently associated with final larger infarct size (AUC = 0.89, 95% confidence interval [CI] = 0.81-0.98, p<0.001) in multivariable regression analysis.
ECV was correlated with total ischaemic time and was an independent predictor of final larger infarct size.
探讨缺血时间和心脏磁共振成像（CMRI）T1 映射在接受直接经皮冠状动脉介入治疗（PCI）的急性 ST 段抬高型心肌梗死（STEMI）患者中的预测价值。
研究了 127 例接受直接 PCI 治疗的 STEMI 患者。所有患者均行 CMRI 检查，包括原始 T1 和细胞外容积（ECV）测量，其中 61 例患者还具有 4 个月的随访数据。记录以分为单位的总缺血时间（症状发作至球囊，S2B）。分析 CMRI 电影、T1 映射和晚期钆增强（LGE）图像，以分别评估左心室（LV）功能、T1 值、ECV 和心肌梗死（MI）瘢痕特征。评估 S2B 时间与 T1 映射之间的相关性。估计 S2B 时间和 T1 映射对大终末梗死面积的预测价值。
随着缺血时间的延长，微血管阻塞（MVO）的发生率增加。无论是否存在 MVO，MI 的 ECV（ECV）与 S2B 时间显著相关（r=0.61，p<0.001），而 MI 的原始 T1（T1）则不相关（r=-0.19，p=0.029）。在 4 个月的随访中，原始 T1 得到改善（1385.1±90.4 比 1288.6±74 ms，p<0.001）。此外，在多变量回归分析中，ECV 与最终较大的梗死面积独立相关（AUC=0.89，95%置信区间[CI]为 0.81-0.98，p<0.001）。
ECV 与总缺血时间相关，是最终较大梗死面积的独立预测因子。
