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In Acute ST-Segment Elevation Myocardial Infarction, Coronary Wedge Pressure Is Associated with Infarct Size and Reperfusion Injury as Evaluated by Cardiac Magnetic Resonance Imaging
Joint Authors
Dregoesc, Mihaela Ioana
Dumitru, Raluca Bianca
Bolboacă, Sorana Daniela
Marc, Mădălin Constantin
Manole, Simona
Iancu, Adrian Corneliu
Source
Journal of Interventional Cardiology
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-08-17
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
Coronary collateral flow influences patient prognosis in the setting of acute myocardial infarction.
However, few data exist about the relation between coronary collaterals, infarct size, and reperfusion injury.
The angiographic Rentrop score is prone to subjectivism and to the inherent limitations of angiographic images.
Its prognostic value is controversial in the setting of acute myocardial infarction.
The invasive measurement of coronary wedge pressure (CWP) represents an alternative to Rentrop score for the evaluation of coronary collateralization.
Our study evaluates pre-revascularization CWP as a predictor of infarct size and reperfusion injury as evaluated by cardiac magnetic resonance imaging.
Methods.
Patients with acute ST-elevation myocardial infarction underwent preprocedural CWP measurement and primary percutaneous coronary intervention.
Infarct size, microvascular obstruction, intramyocardial edema, and intramyocardial hemorrhage were evaluated by cardiac magnetic resonance imaging.
Results.
Mean CWP was inversely associated with infarct size p=0.01, microvascular obstruction p=0.02, intramyocardial edema p=0.05, and intramyocardial hemorrhage p=0.01.
An excellent association was found between mean CWP and an infarct size ≥24% of left ventricular mass (AUC = 0.880, p=0.007), with an optimal cutoff value ≤24.5 mmHg.
Both intramyocardial edema p=0.02 and hemorrhage p=0.03 had a larger extent in patients with coronary wedge pressure ≤24.5 mmHg.
Rentrop grade <2 was associated with larger infarct size p=0.03, but not with the extent of edema, microvascular obstruction, or intramyocardial hemorrhage.
Conclusions.
Pre-revascularization CWP was a predictor of infarct size and was significantly associated with a larger extent of intramyocardial edema and intramyocardial hemorrhage.
Rentrop grade <2 was associated with a larger infarct size, but had no influence on reperfusion injury.
The clinical trial is registered with NCT03371784.
American Psychological Association (APA)
Dregoesc, Mihaela Ioana& Dumitru, Raluca Bianca& Bolboacă, Sorana Daniela& Marc, Mădălin Constantin& Manole, Simona& Iancu, Adrian Corneliu. 2020. In Acute ST-Segment Elevation Myocardial Infarction, Coronary Wedge Pressure Is Associated with Infarct Size and Reperfusion Injury as Evaluated by Cardiac Magnetic Resonance Imaging. Journal of Interventional Cardiology،Vol. 2020, no. 2020, pp.1-7.
https://search.emarefa.net/detail/BIM-1187762
Modern Language Association (MLA)
Dregoesc, Mihaela Ioana…[et al.]. In Acute ST-Segment Elevation Myocardial Infarction, Coronary Wedge Pressure Is Associated with Infarct Size and Reperfusion Injury as Evaluated by Cardiac Magnetic Resonance Imaging. Journal of Interventional Cardiology No. 2020 (2020), pp.1-7.
https://search.emarefa.net/detail/BIM-1187762
American Medical Association (AMA)
Dregoesc, Mihaela Ioana& Dumitru, Raluca Bianca& Bolboacă, Sorana Daniela& Marc, Mădălin Constantin& Manole, Simona& Iancu, Adrian Corneliu. In Acute ST-Segment Elevation Myocardial Infarction, Coronary Wedge Pressure Is Associated with Infarct Size and Reperfusion Injury as Evaluated by Cardiac Magnetic Resonance Imaging. Journal of Interventional Cardiology. 2020. Vol. 2020, no. 2020, pp.1-7.
https://search.emarefa.net/detail/BIM-1187762
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1187762