Author + information
- Takayuki Onishi,
- Yuko Onishi,
- Isshi Kobayashi,
- Shigeo Umezawa and
- Akihiro Niwa
Background: We have demonstrated that the index of microcirculatory resistance (IMR) measured acutely after primary percutaneous coronary intervention correlates with infarct size using cardiac magnetic resonance imaging. However, optimal IMR cut-off values for predicting the presence of microvascular obstruction (MVO) and preserved cardiac function are unknown. This study aims to evaluate further the predictive value of IMR using cardiac magnetic resonance imaging in patients with ST-segment elevation myocardial infarction undergoing primary coronary intervention.
Methods: We measured IMR at the time of primary coronary intervention in 64 patients with ST-segment elevation myocardial infarction using a pressure-temperature sensor guidewire. All patients completed serial cardiac magnetic resonance imaging studies 1 week and 6 months following myocardial infarction.
Results: The mean IMR was 41.4 ± 32.2 (median 30.5, 25th to 75th interquartile range 18.3 to 52.2). Patients with MVO showed significantly higher IMR than those without (58.5 ± 7.2 vs. 27.3 ± 2.6, p = 0.001). Receiver operating characteristic (ROC) analysis revealed an IMR cut-off value of 46.5 for predicting MVO (sensitivity 65.5%, specificity 91.4%) with an area under the curve (AUC) of 0.754. At both 1 week and 6 months, the IMR significantly correlated with infarct size (R = 0.544, p < 0.001; R = 0.485, p < 0.001, respectively) and left ventricular ejection fraction (LVEF) (R = −0.427, p < 0.001; R = −0.346, p = 0.005, respectively). ROC analysis demonstrated a cut-off value of 29.5 for predicting preserved LV function (EF > 40%) at 6 months (sensitivity 56.0%, specificity 85.7%, AUC 0.739).
Conclusions: The IMR measured immediately after primary coronary intervention correlates with severity of myocardial injury and predicts cardiac function after ST-segment elevation myocardial infarction.
Moderated Poster Contributions
Acute and Stable Ischemic Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 12:45 p.m.-12:55 p.m.
Session Title: New Perspectives on CAD Risk Factors
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1319M-05
- 2017 American College of Cardiology Foundation