Cardiology Medical News about left ventricular remodelling;primary percutaneous coronary intervention;infarct healing;microvascular obstruction

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Microvascular obstruction is a major determinant of infarct healing and subsequent left ventricular remodelling following primary percutaneous coronary intervention
European Heart Journal, 06/09/09

Orn S et al. – Microvascular obstruction is an important determinant of infarct healing. The effect of microvascular obstruction (MO) on infarct size translated into distinct patterns of left ventricular (LV) remodeling during long-term follow-up.

Methods

Study of time-dependent relationships between MO, infarct size, and LV remodeling after acute myocardial infarction (MI)
Subjects: 42 consecutive pts with first-time ST-elevation MI, single-vessel disease, successfully treated with primary percutaneous coronary intervention (PCI)
Cardiac magnetic resonance to assess microvascular obstruction, infarct size, and LV remodeling
Cardiac magnetic resonance at: 2 days, 1 wk, 2 mo, and 1 yr following PCI
First-pass perfusion to assess microvascular obstruction
Pts classification by MO presence/absence at 2 days and 1 wk: no detectable MO at any time point (11 pts), MO detectable only at 2 days (16), and MO detectable both at 2 days and 1 wk (15)

Results

On multivariable analysis adjusting for infarct size at 2 days, detectable MO at 1 wk was independent predictor of infarct size at 1 yr follow-up, associated with adverse infarct healing, adverse LV remodeling, increased LV volumes, and lower ejection fractions vsrest of cohort

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