Thomas Stiermaier1, Holger Thiele1, Ingo Eitel2. 1. University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology, and Intensive Care Medicine, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany. 2. University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology, and Intensive Care Medicine, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany. Electronic address: ingoeitel@gmx.de.
Abstract
BACKGROUND: Experimental data reported a temporal pattern of myocardial edema following acute myocardial infarction (AMI). Therefore, the aim of this study was to assess the time course of myocardial edema in a large population of patients with ST-segment elevation myocardial infarction (STEMI). METHODS: Myocardium at risk (MAR), infarct size (IS) and myocardial salvage index (MSI) were compared according to the time between infarction and cardiovascular magnetic resonance (CMR) imaging in a large multicenter STEMI cohort (n=795). CMR scans performed >8days (>192h) after AMI were excluded (n=23). Scans performed within 8days were reported at time-points 12-24h, 24-36h, 36-48h, and days 3 to 8 (192h). RESULTS: MAR/MSI and IS could be assessed in 693 and 755 patients, respectively. The extent of MAR over the first week after ischemia/reperfusion showed a slight rise and fall (p=0.029 in one-way analysis of variance). However, analysis of IS demonstrated a similar trend over time (p=0.026). Post-hoc testing did not reveal significant differences between particular time periods for both MAR and IS. A stable edematous reaction was also observed between 12-24h, 24-36h, 36-48h and up to 8days after infarction in a more detailed analysis. MSI did not show statistically significant variations (p=0.147). Multivariate regression analysis did not identify the time of CMR acquisition as a predictor of MAR (p=0.709), IS (p=0.810) or MSI (p=0.916). CONCLUSION: These data do not confirm a temporal pattern of myocardial edema over the first week after AMI in humans.
BACKGROUND: Experimental data reported a temporal pattern of myocardial edema following acute myocardial infarction (AMI). Therefore, the aim of this study was to assess the time course of myocardial edema in a large population of patients with ST-segment elevation myocardial infarction (STEMI). METHODS: Myocardium at risk (MAR), infarct size (IS) and myocardial salvage index (MSI) were compared according to the time between infarction and cardiovascular magnetic resonance (CMR) imaging in a large multicenter STEMI cohort (n=795). CMR scans performed >8days (>192h) after AMI were excluded (n=23). Scans performed within 8days were reported at time-points 12-24h, 24-36h, 36-48h, and days 3 to 8 (192h). RESULTS: MAR/MSI and IS could be assessed in 693 and 755 patients, respectively. The extent of MAR over the first week after ischemia/reperfusion showed a slight rise and fall (p=0.029 in one-way analysis of variance). However, analysis of IS demonstrated a similar trend over time (p=0.026). Post-hoc testing did not reveal significant differences between particular time periods for both MAR and IS. A stable edematous reaction was also observed between 12-24h, 24-36h, 36-48h and up to 8days after infarction in a more detailed analysis. MSI did not show statistically significant variations (p=0.147). Multivariate regression analysis did not identify the time of CMR acquisition as a predictor of MAR (p=0.709), IS (p=0.810) or MSI (p=0.916). CONCLUSION: These data do not confirm a temporal pattern of myocardial edema over the first week after AMI in humans.
Authors: Borja Ibanez; Anthony H Aletras; Andrew E Arai; Hakan Arheden; Jeroen Bax; Colin Berry; Chiara Bucciarelli-Ducci; Pierre Croisille; Erica Dall'Armellina; Rohan Dharmakumar; Ingo Eitel; Rodrigo Fernández-Jiménez; Matthias G Friedrich; David García-Dorado; Derek J Hausenloy; Raymond J Kim; Sebastian Kozerke; Christopher M Kramer; Michael Salerno; Javier Sánchez-González; Javier Sanz; Valentin Fuster Journal: J Am Coll Cardiol Date: 2019-07-16 Impact factor: 24.094
Authors: Martina Bona; Rahel K Wyss; Maria Arnold; Natalia Méndez-Carmona; Maria N Sanz; Dominik Günsch; Lucio Barile; Thierry P Carrel; Sarah L Longnus Journal: J Am Heart Assoc Date: 2021-01-30 Impact factor: 5.501