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Predictive value of total ischaemic time and T1 mapping after emergency percutaneous coronary intervention in acute

J Wang1, Y Meng1, S Han1

  • 1Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Clinical Radiology
|July 17, 2023
PubMed

Insights

Extracellular volume (ECV) in myocardial infarction (MI) correlates with ischaemic time and predicts final infarct size. This cardiac magnetic resonance imaging (CMRI) metric aids in assessing STEMI patient outcomes after primary PCI.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Acute ST-segment elevation myocardial infarction (STEMI) requires timely reperfusion.
  • Assessing infarct size and microvascular obstruction (MVO) is crucial for patient prognosis.
  • Cardiac magnetic resonance imaging (CMRI) offers advanced tissue characterization.

Purpose of the Study:

  • To evaluate the predictive value of ischaemic time and CMRI T1 mapping for infarct size in STEMI patients.
  • To determine the correlation between ischaemic time and CMRI-derived metrics like extracellular volume (ECV).
  • To assess ECV as a predictor of final infarct size after primary percutaneous coronary intervention (PCI).

Main Methods:

  • 127 STEMI patients undergoing primary PCI were studied.
  • CMRI with native T1 and ECV measurements was performed.
  • Ischaemic time (symptom onset to balloon, S2B) and CMRI parameters were analyzed for correlation with infarct size.

Main Results:

  • Microvascular obstruction (MVO) incidence increased with ischaemia time.
  • ECV in myocardial infarction (ECVMI) strongly correlated with S2B time (r=0.61, p<0.001).
  • ECVMI was an independent predictor of larger final infarct size (AUC=0.89, p<0.001).

Conclusions:

  • ECVMI is a valuable metric correlating with ischaemic time in STEMI.
  • ECVMI serves as an independent predictor of final infarct size.
  • CMRI ECV mapping aids in quantifying myocardial damage post-STEMI and primary PCI.
Abstract

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