Author + information
- Gianluca Pontone,
- Andrea Igoren Guaricci,
- Patrizia Carità,
- Daniele Andreini,
- Marco Guglielmo,
- Saima Mushtaq,
- Andrea Baggiano and
- Massimo Verdecchia
Background: Myocardial salvage index (MSI) measured by cardiac magnetic resonance (CMR) allows to evaluate the myocardial damage in patients with ST segmentelevation myocardial infarction (STEMI). QT interval corrected for heart rate at ECG (QTc) prolongs in all patients with early transmural ischemia. We sought to evaluate the correlation between QTC time change after STEMI and MSI as detected by CMR in consecutive STEMI patients underwent to successful primary percutenousintervention (PCI).
Methods: Fifty consecutive anterior STEMI patients reperfused by primary PCI underwent quantitative ECG repolarization analysis and CMR protocol. The difference (ΔQTc) between the QTc of ischemic myocardium (maximum QTc in anterior leads) versus remote myocardium (minimum QTc in inferiorleads) over the first week, left ventricle enddiastolic (LVESVCMR) and endsystolic volume (LVESVCMR), numbers of myocardial segments with wall motion abnormalities (WMA index), left ventricle ejection fraction (EFCMR), and myocardial salvage index (MSI) were measured. The endpoint was defined as MSI>0.6.
Results: The QTc in anterior leads was systematically longer than QTc in inferior leads (p<0.0001) over the first week with the highest ΔQTC at 3th day. The Pearson analysis showed a significant correlation between ΔQTc at 6th day after the admission and percentage of LGE (r:0,49, p 0.0007) and MSI (r:0.48; p:0.0012). At univariate analysis peak myocardial enzymes, LVEDVCMR, LVESVCMR, AWM index and ΔQTC at 6th day were all independent predictor of high MSI (>0.6) while at multivariate analysis only WMA index (p:0.05) and ΔQTC at 6thday (p:0.02) still remained as predictors of endpoint. The receiver operative curve of ΔQTC at 6th day showed a AUC of 0.78 to predict a MSI>0.6.
Conclusions: ΔQTC measurement is inversely correlated with MSI and it could represent an easy tool to evaluate the myocardial damage after PCI in STEMI patient.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: MR Structure and Valuvular Heart Disease
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1290-209
- 2017 American College of Cardiology Foundation