What question did this study set out to answer?

To assess the clinical relevance of intramyocardial hemorrhage in relation to infarct size, microvascular obstruction, and cardiac function in patients undergoing primary percutaneous coronary intervention.

September 14, 2009International journal of cardiac imagingOpen Access

Intramyocardial hemorrhage and microvascular obstruction after primary percutaneous coronary intervention

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Why the study?

Does intramyocardial hemorrhage predict left ventricular functional changes beyond microvascular obstruction in patients after primary percutaneous coronary intervention?

Population

45 patients after primary stenting for a first acute myocardial infarction

Design

Cohort

Follow-up

4 months

Authors

ABA. M. BeekAmsterdam UMC Location Vrije Universiteit Amsterdam RNRobin NijveldtCardiac Imaging ARAlbert C. van RossumCardiac Imaging

Discussion

Member takes

Implication

IMH lacks independent prognostic value for LV recovery beyond MVO; leaves open whether IMH-targeted strategies could improve outcomes.

Key Points

To assess the clinical relevance of intramyocardial hemorrhage in relation to infarct size, microvascular obstruction, and cardiac function in patients undergoing primary percutaneous coronary intervention.
Prospective cohort of 45 patients evaluated at 1 week and 4 months following primary stenting for a first acute myocardial infarction.
Cardiovascular MR imaging used T2-weighted spin-echo imaging to identify edema and intramyocardial hemorrhage, delayed enhancement for infarct size and microvascular obstruction, and cine CMR for left ventricular volumes and ejection fraction.
Intramyocardial hemorrhage was identified in 22 of 45 patients (49%), who exhibited larger infarct sizes, higher left ventricular volumes, and lower ejection fractions.
T2-weighted contrast-to-noise ratio predicted ejection fraction at baseline (beta = -0.62, P = 0.003) and 4-month follow-up (beta = -0.84, P < 0.001) in univariable analysis, but only baseline ejection fraction and microvascular obstruction remained predictive in multivariable analysis.

Structured PICO

Does intramyocardial hemorrhage predict left ventricular functional changes beyond microvascular obstruction in patients after primary percutaneous coronary intervention?

Population

45 patients after primary stenting for a first acute myocardial infarction

Intervention

Cardiovascular MR imaging (CMR) assessment of intramyocardial hemorrhage (IMH) at 1 week

Outcome

Clinical significance of IMH in relation to infarct size, microvascular obstruction (MVO) and left ventricular function at 4 monthssurrogate

Intramyocardial hemorrhage is common after reperfused myocardial infarction and correlates with infarct size, but does not provide prognostic value for functional recovery beyond microvascular obstruction.

Cite This Study

Beek et al. (2009) studied this question.

synapsesocial.com/papers/69eff9ecbce9831ba4f73907 https://doi.org/10.1007/s10554-009-9499-1

Topics

Cardiac MRI

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Intramyocardial hemorrhage and microvascular obstruction after primary percutaneous coronary intervention

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Intramyocardial hemorrhage and microvascular obstruction after primary percutaneous coronary intervention

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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