Skip Navigation


European Heart Journal Advance Access originally published online on June 6, 2009
European Heart Journal 2009 30(16):1978-1985; doi:10.1093/eurheartj/ehp219
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
30/16/1978    most recent
ehp219v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Ørn, S.
Right arrow Articles by Dickstein, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ørn, S.
Right arrow Articles by Dickstein, K.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Microvascular obstruction is a major determinant of infarct healing and subsequent left ventricular remodelling following primary percutaneous coronary intervention

Stein Ørn1,2,*, Cord Manhenke1,2, Ole Jacob Greve3, Alf Inge Larsen1,2, Vernon Vijay Singh Bonarjee1,2, Thor Edvardsen4 and Kenneth Dickstein1,2

1 Division of Cardiology, Stavanger University Hospital, PO 8400, 4068 Stavanger, Norway
2 Institute of Internal Medicine, University of Bergen, Bergen, Norway
3 Radiology Department, Stavanger University Hospital, Stavanger, Norway
4 Department of Cardiology, Rikshospitalet, University of Oslo, Oslo, Norway

Received 17 October 2008; revised 1 April 2009; accepted 4 May 2009; online publish-ahead-of-print 6 June 2009.

* Corresponding author. Tel: +47 51 53 90 97, Email: drsteinorn{at}hotmail.com

Aims: We studied the time-dependent relationships between microvascular obstruction (MO), infarct size, and left ventricular (LV) remodelling after acute myocardial infarction (MI).

Methods and results: Forty-two consecutive patients with first-time ST-elevation MI, single-vessel disease, successfully treated with primary percutaneous coronary intervention (PCI) were included. Microvascular obstruction, infarct size, and LV remodelling were assessed by cardiac magnetic resonance. Cardiac magnetic resonance was performed at: 2 days, 1 week, 2 months, and 1 year following PCI. Microvascular obstruction was assessed by first-pass perfusion. Patients were divided into three groups according to the presence or absence of MO at 2 days and 1 week: no detectable MO at any time point (11 patients), MO detectable only at 2 days (16 patients), and MO detectable both at 2 days and 1 week (15 patients). In multivariable analysis adjusting for infarct size at 2 days, detectable MO at 1 week was an independent predictor (P = 0.003) of infarct size at 1 year follow-up, associated with adverse infarct healing, adverse LV remodelling, increased LV volumes, and lower ejection fractions when compared with the rest of the cohort.

Conclusion: Microvascular obstruction is an important determinant of infarct healing. The effect of MO on infarct size translated into distinct patterns of LV remodelling during long-term follow-up.

Clinical study no.: NCT 00465868

Key Words: ST elevation myocardial infarction • Primary percutaneous coronary intervention • Microvascular obstruction • Infarct size infarct healing • Left ventricular remodelling • Cardiac magnetic resonance • Temporal relationships


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.