Author + information
- Harmony R. Reynoldsa,b,
- Sivabaskari Pasupathya,b,
- Himali Gandhia,b,
- Rosanna Tavellaa,b,
- Leon Axela,b and
- John Beltramea,b
Background: Cardiac magnetic resonance imaging (CMR) is used in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) to help determine whether the underlying MI cause is vascular or non-vascular. ST segment elevation on the electrocardiogram suggests complete thrombotic coronary occlusion in MI with obstructive CAD. The relationship between ECG and CMR findings has not previously been analyzed in MINOCA patients.
Methods: CMR data were pooled from a prospective registry study from Australia (n=96) and a prospective diagnostic imaging study from the US (n=42), both focused on MINOCA. Patients were included if they met the universal definition of MI, had no ≥50% stenosis on angiography, and if late gadolinium enhanced (LGE) imaging on CMR was interpretable. MI was defined by ischemic LGE pattern (subendocardial/transmural), myocarditis by non-ischemic LGE and takotsubo cardiomyopathy by the typical wall motion pattern in the absence of LGE.
Results: Among 140 patients with MINOCA undergoing CMR, 36 had STEMI and 104 NSTEMI. Findings on CMR in patients with and without ST elevation are shown in the Figure. There was no difference between the STEMI and NSTEMI groups in CMR findings overall (p=0.62) or in the likelihood of CMR findings consistent with MI (p=0.72).
Conclusions: ST elevation on the presenting ECG was not related to CMR diagnosis of myocardial infarction, myocarditis or takotsubo cardiomyopathy or with the presence of any CMR abnormality in patients with MINOCA.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-348
- 2017 American College of Cardiology Foundation