European Heart Journal Advance Access originally published online on February 16, 2005
European Heart Journal 2005 26(11):1070-1077; doi:10.1093/eurheartj/ehi131
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Recovery of left ventricular function after primary angioplasty for acute myocardial infarction
1Department of Cardiology (Thoraxcenter), Erasmus MC—University Medical Center Rotterdam, Bd 410, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
2Department of Radiology, Erasmus MC—University Medical Center Rotterdam, Bd 410, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
Received 25 October 2004; revised 24 December 2004; accepted 5 January 2005; online publish-ahead-of-print 16 February 2005.
* Corresponding author. Tel: +31 10 463 5071; fax: +31 10 463 4320. E-mail address: p.j.defeyter{at}erasmusmc.nl
Aims To study recovery of segmental wall thickening (SWT), ejection fraction (EF), and end-systolic volume (ESV) after acute myocardial infarction (AMI) in patients who underwent primary stenting with drug-eluting stents. Additionally, to evaluate the predictive value of magnetic resonance imaging (MRI)-based myocardial perfusion and delayed enhancement (DE) imaging.
Methods and results Twenty-two patients underwent cine-MRI, first-pass perfusion, and DE imaging 5 days after successful placement of a drug-eluting stent in the infarct-related coronary artery. Regional myocardial perfusion and the transmural extent of DE were evaluated. A per patient perfusion score was calculated and consisted of a summation of all segmental scores. Myocardial infarct size was quantified by measuring the volume of DE. At 5 months after AMI, cine-MRI was performed and SWT, EF, and ESV were quantified. EF increased from 48±11 to 55±9% (P<0.01). SWT at 5 months was inversely related to baseline segmental DE scores (P<0.001) and segmental perfusion scores (P<0.001). EF and ESV at 5 months were related to acute infarct size (R2=0.65; P<0.001 and R2=0.78; P<0.001, respectively) and the calculated perfusion score (R2=0.23; P=0.02 and R2=0.14; P=0.09, respectively) at baseline.
Conclusion Marked recovery of left ventricular function was observed in patients receiving a drug-eluting stent for AMI. DE imaging appears to be a better prognosticator than perfusion imaging.
Key Words: Contrast-enhanced magnetic resonance imaging • Acute myocardial infarction • Left ventricular function • Delayed enhancement • Myocardial perfusion
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