Related Experiment Video
Updated: Jul 5, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Differences in left ventricular myocardial function and infarct size in female patients with ST elevation myocardial
Gordana Krljanac1,2, Svetlana Apostolović3,4, Marija Polovina1,2
1Cardiology Clinic, University Clinical Center of Serbia, Belgrade, Serbia.
Insights
Female patients with spontaneous coronary artery dissection ST-elevation myocardial infarction (SCAD-STEMI) show better left ventricular (LV) systolic function recovery compared to those with type 1 STEMI. This highlights key differences in myocardial recovery post-infarction.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Cardiac Imaging
Background:
- ST-elevation myocardial infarction (STEMI) in women presents unique challenges.
- Distinguishing between spontaneous coronary artery dissection (SCAD-STEMI) and atherothrombotic occlusion (type 1 STEMI) is crucial for understanding outcomes.
- Limited data exists on differences in left ventricular (LV) function and infarct size between SCAD-STEMI and type 1 STEMI in female patients.
Purpose of the Study:
- To compare baseline clinical characteristics, imaging findings, and therapeutic approaches in female patients with SCAD-STEMI versus type 1 STEMI.
- To evaluate and compare echocardiographic findings at baseline and 3-month follow-up in these two patient groups.
Main Methods:
- Prospective, multicenter study involving 32 female patients (18-55 years) diagnosed with either SCAD-STEMI or type 1 STEMI affecting the left anterior descending coronary artery.
- Assessment of clinical data, risk factors, comorbidities, complications, and treatment strategies.
- Echocardiographic evaluation of LV ejection fraction (LVEF) and LV global longitudinal strain at baseline and 3-month follow-up.
Main Results:
- SCAD-STEMI patients more frequently achieved Thrombolysis in Myocardial Infarction (TIMI) 3 flow.
- Type 1 STEMI patients were more likely to receive percutaneous coronary intervention and dual antiplatelet therapy.
- While baseline LVEF was similar, SCAD-STEMI patients demonstrated significantly greater improvement in LVEF at 3-month follow-up (Δ LVEF 10.1% vs. 1.8%, p=0.002) compared to type 1 STEMI patients. LV global longitudinal strain also showed improvement in both groups, but without significant intergroup difference.
Conclusions:
- Female patients experiencing SCAD-STEMI exhibit a higher likelihood of improved LV systolic function recovery compared to those with type 1 STEMI.
- These findings underscore distinct pathophysiological pathways and recovery patterns for different STEMI etiologies in women.
Introduction:
Differences in pathophysiology, clinical presentation, and natural course of ST-elevation myocardial infarction in female patients due to either spontaneous dissection (SCAD-STEMI) or atherothrombotic occlusion (type 1 STEMI) have been discussed. Current knowledge on differences in left ventricular myocardial function and infarct size is limited. The aim of this study was to assess baseline clinical characteristics, imaging findings, and therapeutic approach and to compare differences in echocardiographic findings at baseline and 3-month follow-up in patients with SCAD-STEMI and type 1 STEMI.
Methods:
This was a prospective multicenter study of 32 female patients (18-55 years of age) presenting with either SCAD-STEMI due to left anterior descending coronary artery (LAD) dissection or type 1 STEMI due to atherothrombotic LAD occlusion.
Results:
The two groups were similar in age, risk factors, comorbidities, and complications. SCAD-STEMI patients more often had Thrombolysis in Myocardial Infarction 3 flow, while type 1 STEMI patients were more often treated with percutaneous coronary intervention and dual antiplatelet therapy. Baseline mean left ventricular (LV) ejection fraction (LVEF) was similar in the two groups (48.0% vs. 48.6%, p = 0.881), but there was a significant difference at the 3-month follow-up, driven by an improvement in LVEF in SCAD-STEMI compared to type 1 STEMI patients (Δ LVEF 10.1 ± 5.3% vs. 1.8 ± 5.1%, p = 0.002). LV global longitudinal strain was slightly improved in both groups at follow-up; however, the improvement was not significantly different between groups (-4.6 ± 2.9% vs. -2.0 ± 2.8%, p = 0.055).
Conclusions:
The results suggest that female patients with SCAD-STEMI are more likely to experience improvement in LV systolic function than type 1 STEMI patients.
