title: Impact of coronary artery collaterals on infarct size assessed by serial cardiac magnetic resonance imaging after primary percutaneous coronary intervention in patients with acute myocardial infarction.
abstract: OBJECTIVE
  Coronary collaterals have been shown to protect ischemic myocardium from necrosis in patients with acute myocardial infarction (AMI). We sought to determine the impact of collateral circulation on infarct size in AMI using serial cardiac magnetic resonance (CMR).
  
  
  METHODS
  A total of 46 anterior AMI patients (age, 58.9+/-10.6 years; male 72.3%) undergoing primary percutaneous coronary intervention (PCI) were investigated. The infarct size was measured on serial CMR performed within 7 days after primary PCI (acute stage) and 3 months later (chronic stage).
  
  
  RESULTS
  Thirty-four patients (73.9%) showed collateral flow before primary PCI. CMR taken at the acute stage showed no significant difference in infarct size between two groups. However, follow-up CMR revealed significantly smaller percentage of infarct thickness (51.8+/-14.0 vs. 62.5+/-11.7%, P = 0.035) and mass (22.3+/-9.9 vs. 30.9+/-11.6%, P = 0.042) in patients with collaterals. There were significant changes from the acute to chronic stage regarding left ventricular end-systolic (-18.2+/-10.0 vs. 0.8+/-2.5 ml, P = 0.022) and end-diastolic volume (-14.8+/-9.2 vs. 2.6+/-13.7 ml, P = 0.031), percentage of infarct mass (-6.1+/-2.8 vs. -0.8+/-1.1%, P = 0.034), and thickness (-8.9+/-3.3 vs. -3.1+/-2.8%, P = 0.029) in collateral group compared with noncollateral group on serial CMR.
  
  
  CONCLUSIONS
  Serial CMR revealed the effect of collaterals in patients with AMI on reduction of infarct size and improvement of myocardial remodeling at the chronic stage.
authors.affiliation: Division of Cardiology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors.forename: Se-Jung
authors.initials: SJ
authors.lastname: Yoon
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Jae-Youn
authors.initials: JY
authors.lastname: Moon
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Ha
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
authors.forename: Won-Heum
authors.initials: WH
authors.lastname: Shim
authors.forename: Seung-Yun
authors.initials: SY
authors.lastname: Cho
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D056988:Anterior Wall Myocardial Infarction / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D003097:Collateral Circulation; D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA