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Usefulness of a comprehensive cardiovascular magnetic resonance imaging assessment for predicting recovery of left ventricular wall motion in the setting of myocardial stunning.

Abstract：

OBJECTIVES:We sought to evaluate the usefulness of a comprehensive assessment of four cardiovascular magnetic resonance imaging (CMR)-derived myocardial viability indexes in the setting of myocardial stunning. BACKGROUND:Cardiovascular magnetic resonance imaging allows the simultaneous assessment of several viability indexes. METHODS:We studied 40 patients with a first ST-segment elevation myocardial infarction (MI) and an open infarct-related artery. At the first week, using CMR, wall motion (WM), and four viability indexes were determined: wall thickness, WM improvement with low-dose dobutamine, perfusion, and transmural extent of necrosis. We created a comprehensive score based on the presence and the relative power of these viability indexes for predicting normal WM at the sixth month. RESULTS:Of 153 dysfunctional segments at the first week, 59 (39%) exhibited normal WM at the sixth month. According to the odds ratio of viability indexes for predicting normal WM, we developed a five-level predictive score. The proportions of segments showing normal WM at sixth month were as follows; Level 1 (0 indexes): 0 of 13 (0%); Level 2 (normal thickness and/or perfusion): 14 of 82 (17%); Level 3 (dobutamine response): 5 of 11 (45%); Level 4 (non-transmural necrosis): 20 of 26 (77%); Level 5 (non-transmural necrosis and dobutamine response): 20 of 21 (95%), p < 0.0001 for the trend. These proportions were similar in a matched prospective validation group comprising 16 patients (0%, 18%, 62%, 77%, and 90% for levels 1 to 5, respectively, p < 0.0001 for the trend). CONCLUSIONS:A comprehensive analysis of the four more widely used CMR-derived viability indexes is useful for predicting late systolic function after myocardial infarction.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Bodí V,Sanchis J,López-Lereu MP,Losada A,Núñez J,Pellicer M,Bertomeu V,Chorro FJ,Llácer A

doi

10.1016/j.jacc.2005.07.039

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

1747-52

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(05)01786-9

journal_volume

pub_type

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Usefulness of a comprehensive cardiovascular magnetic resonance imaging assessment for predicting recovery of left ventricular wall motion in the setting of myocardial stunning.