Prognostic value of pulmonary transit time by cardiac magnetic resonance imaging in ST-elevation myocardial infarction.
Humans
Prognosis
ST Elevation Myocardial Infarction
/ complications
Stroke Volume
Ventricular Function, Left
Prospective Studies
Percutaneous Coronary Intervention
/ adverse effects
Magnetic Resonance Imaging
/ methods
Myocardial Infarction
/ etiology
Lung
/ pathology
Magnetic Resonance Imaging, Cine
/ methods
Cardiac magnetic resonance imaging
Prognosis
Pulmonary transit time
ST-segment-elevation myocardial infarction
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
03
06
2022
accepted:
24
07
2022
revised:
04
07
2022
pubmed:
19
8
2022
medline:
3
2
2023
entrez:
18
8
2022
Statut:
ppublish
Résumé
To investigate the prognostic value of pulmonary transit time (pTT) determined by cardiac magnetic resonance (CMR) after acute ST-segment-elevation myocardial infarction (STEMI). Comprehensive CMR examinations were performed in 207 patients 3 days and 4 months after reperfused STEMI. Functional parameters and infarct characteristics were assessed. PTT was defined as the interval between peaks of gadolinium contrast time-intensity curves in the right and left ventricles in first-pass perfusion imaging. Cox regression models were calculated to assess the association between pTT and the occurrence of major adverse cardiac events (MACE), defined as a composite of death, re-infarction, and congestive heart failure. PTT was 8.6 s at baseline and 7.8 s at the 4-month CMR. In Cox regression, baseline pTT (hazard ratio [HR]: 1.58; 95% CI: 1.12 to 2.22; p = 0.009) remained significantly associated with MACE occurrence after adjustment for left ventricular ejection fraction (LVEF) and cardiac index. The association of pTT and MACE remained significant also after adjusting for infarct size and microvascular obstruction size. In Kaplan-Meier analysis, pTT ≥ 9.6 s was associated with MACE (p < 0.001). Addition of pTT to LVEF resulted in a categorical net reclassification improvement of 0.73 (95% CI: 0.27 to 1.20; p = 0.002) and integrated discrimination improvement of 0.07 (95% CI: 0.02 to 0.13; p = 0.007). After reperfused STEMI, CMR-derived pTT was associated with hard clinical events with prognostic information independent of and incremental to infarct size and LV systolic function. • Pulmonary transit time is the duration it takes the heart to pump blood from the right chambers across lung vessels to the left chambers. • This prospective single-centre study showed inferior outcome in patients with prolonged pulmonary transit time after myocardial infarction. • Pulmonary transit time assessed by magnetic resonance imaging added incremental information to established prognostic markers.
Identifiants
pubmed: 35980426
doi: 10.1007/s00330-022-09050-5
pii: 10.1007/s00330-022-09050-5
pmc: PMC9889516
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1219-1228Informations de copyright
© 2022. The Author(s).
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