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心脏病发作的时间趋势ST段升高心肌梗塞的严重性结果:心脏磁共振成像研究

Ivan Lechner¹, Martin Reindl¹, Christina Tiller¹

¹University Clinic of Internal Medicine III, Cardiology and Angiology Medical University of Innsbruck Innsbruck Austria.

Journal of the American Heart Association

|July 25, 2023

概括

尽管ST段升高心肌梗塞 (STEMI) 治疗的进展,心磁共振成像显示心肌梗塞大小或严重程度在15年内没有显著变化. 对新型疗法的进一步研究对于减少心脏组织损伤至关重要.

科学领域:

心脏病学心脏病学
医疗成像医学成像
临床研究临床研究

背景情况:

心肌组织损伤的严重程度显著影响ST段升高心肌梗塞 (STEMI) 的发病率和死亡率.
在组织层面上心肌梗塞特征的时间趋势仍然未被描述.
心脏磁共振成像 (CMR) 提供了心肌组织损伤的全面评估.

研究的目的:

在STEMI后的标准化早期时间点使用CMR评估心脏病发作特征的时间趋势.
为了评估心脏病发作大小的变化,微血管阻塞和心内肌动脉出血随着时间的推移.
研究STEMI患者的长期结果和左心室重塑.

主要方法:

在2005年至2021年期间,对843名STEMI患者进行皮肤冠状动脉干预 (PCI) 治疗的分析.
在STEMI后的第一周内使用了多参数CMR协议.
在三个研究期的第三阶段,比较了心脏病发作特征和临床结果.

主要成果:

在研究期间,心脏病发作大小 (P=0.25),微血管阻塞 (P=0.50) 或心脏内出血 (P=0.34) 没有显著变化.
左心室重塑指数和喷射分数保持不变 (所有P>0.05).
4个月后的主要不良心血管事件在各组中相似 (P=0.36).

结论:

尽管PCI和指导方针推的治疗方法取得了进展,但心肌梗塞的严重程度在过去15年中没有得到改善.
目前的治疗方法可能不足以减少STEMI中心肌组织损伤.
优先考虑临床研究新型治疗策略,以减轻心肌损伤是必不可少的.

关键词:

ST细分升心肌梗塞的心脏病发作心脏磁共振成像 - 心脏磁共振成像心脏病发作的大小心脏病发作的大小预后预后预后时间趋势时间趋势

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