Ventricular longitudinal function is associated with microvascular obstruction and intramyocardial haemorrhage

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Myocardial Infarction Research

Background:

• Microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH) are independent predictors of adverse prognosis in reperfused ST-elevation myocardial infarction (STEMI).
• Mitral annular plane systolic excursion (MAPSE) is a key echocardiographic measure of left ventricular (LV) longitudinal function.

Purpose of the Study:

• To evaluate the association between acute MAPSE, assessed via cardiovascular magnetic resonance (CMR), and the presence of MVO and IMH.
• To determine if acute MAPSE can predict subsequent left ventricular (LV) remodeling after STEMI.

Main Methods:

• Cardiovascular magnetic resonance (CMR) imaging including cine, T2-weighted, T2*, and late gadolinium enhancement (LGE) was performed within 3 days of reperfused STEMI in 54 patients.
• Infarct size, MVO, and IMH were quantified using LGE and T2-weighted/T2* imaging.
• Averaged-MAPSE was calculated from four-chamber cine views.

Main Results:

• MVO and IMH were present in 59% and 57% of patients, respectively.
• The presence of MVO and IMH was significantly associated with lower averaged-MAPSE (p<0.001 for both).
• MAPSE demonstrated high sensitivity and specificity for detecting MVO and IMH, with MAPSE ≤10.6 mm being a significant threshold.

Conclusions:

• Acute MAPSE, assessed by CMR, serves as an independent predictor of MVO and IMH in patients with STEMI.
• MAPSE is a valuable tool for assessing myocardial injury and predicting adverse outcomes post-reperfusion therapy.