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Culprit vessel-related myocardial mechanics and prognostic implications following acute myocardial infarction

Sören J Backhaus1,2, Johannes T Kowallick2,3, Thomas Stiermaier4,5

  • 1Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|July 7, 2019
PubMed

Insights

Cardiac magnetic resonance imaging reveals distinct patterns of damage after acute myocardial infarction (AMI) based on the affected artery. These findings offer new insights into prognosis and potential therapeutic targets for AMI patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Prognosis in acute myocardial infarction (AMI) is linked to infarct-related artery (IRA) damage but lacks detailed description.
  • Cardiac magnetic resonance (CMR) can elucidate IRA-associated pathophysiological consequences.

Purpose of the Study:

  • To describe IRA-specific pathophysiological changes following AMI using CMR.
  • To correlate these changes with clinical outcomes and identify prognostic markers.

Main Methods:

  • 1235 AMI patients (STEMI and non-STEMI) underwent CMR post-percutaneous coronary intervention.
  • CMR-feature tracking assessed left ventricular (LV) and left atrial (LA) strains (GLS, GCS, εs).
  • Infarct size (IS) and microvascular obstruction were quantified; outcomes (MACE) tracked for 12 months.

Main Results:

  • LAD and LCx lesions were associated with higher mortality than RCA lesions.
  • LAD lesions showed the largest infarct size and LV/LA impairment.
  • Left atrial strain (εs) for LAD/RCA and GLS for LCx independently predicted MACE.

Conclusions:

  • CMR enables IRA-specific phenotyping of morphologic and functional changes post-AMI.
  • These IRA-specific alterations have prognostic implications.
  • Findings may identify novel diagnostic and therapeutic targets for AMI.
Abstract

Keywords:
Cardiac functionCardiovascular magnetic resonanceFeature trackingInfarct-related arteryPrognosis

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