Reduced right/left ventricular blood pool T2-ratio predicts congestive heart failure after STEMI
Felix Troger1, Mathias Pamminger1, Christina Tiller2
1University Clinic of Radiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
Summary
A lower right ventricular/left ventricular (RV/LV) T2-ratio measured by cardiac magnetic resonance imaging (CMR) predicts new congestive heart failure (CHF) after ST-segment elevation myocardial infarction (STEMI). This ratio is a valuable prognostic tool for CHF development post-STEMI.
Area of Science:
- Cardiovascular Imaging
- Biomarkers
- Heart Failure Research
Background:
- T2-mapping in cardiac magnetic resonance imaging (CMR) assesses blood-oxygenation.
- RV/LV T2-relaxation time differences correlate with exercise capacity in heart failure.
- Prognostic value of RV/LV T2-ratio post-STEMI for congestive heart failure (CHF) is unknown.
Purpose of the Study:
- To investigate the prognostic significance of the RV/LV T2-ratio for predicting new-onset CHF after ST-segment elevation myocardial infarction (STEMI).
Main Methods:
- Six hundred four patients with first-time STEMI underwent CMR within four days post-revascularization.
- RV/LV T2-relaxation times were measured in the blood pool using T2-maps; RV/LV T2-ratio was calculated.
- Patients were followed for a median of 3.0 years to identify new CHF diagnoses.
Main Results:
- A median RV/LV T2-ratio of 73% was observed; a ratio <60% was associated with significantly higher rates and earlier onset of CHF.
- Patients with reduced T2-ratio (<60%) were older, had larger infarcts, higher NT-proBNP, lower ejection fractions, and more microvascular injuries.
- RV/LV T2-ratio <60% independently predicted CHF post-STEMI and improved risk prediction when added to NT-proBNP.
Conclusions:
- CMR-derived RV/LV T2-ratio is a simple and effective tool for assessing CHF prognosis after STEMI.
- This imaging biomarker offers valuable prognostic information for patients recovering from STEMI.
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