title: Regional functional recovery after acute myocardial infarction: a cardiac magnetic resonance long-term study.
abstract: We sought to analyze the trend of functional recovery after successful reperfused ST-elevation myocardial infarction (STEMI) in an optimally treated patient group over a 14 month follow-up in relation to ischemia-time and the presence of microvascular obstruction (MVO). First-pass perfusion-, cine- and late enhancement (LE)- cardiac MR were performed in 40 patients (33 male and 7 female, 54.8 ± 12.3 years) within 6 days as well as 4 and 14 months after successful primary percutaneous coronary intervention for STEMI. Significant recovery of segmental wall thickening (SWT %) occurred exclusively in infarcted segments reperfused within 4 h after symptom onset (group 1 with pain-to-balloon time <2 h: 59 ± 4 to 70 ± 4%; P < 0.02) (group 2 with pain-to-balloon-time 2-4 h: 51 ± 4 to 59 ± 3%, P < 0.05) during the first 4 months, whereas changes thereafter were not significant (P = NS). Infarcted segments with MVO showed lowest regional myocardial function at any time of assessment (all P < 0.001) and a lack of significant recovery during the study period. Significant recovery of regional myocardial function is related to rapid revascularization of the infarct-related artery and the absence of MVO. Improvement of SWT occurred exclusively within the first 4 months after acute myocardial infarction and remained unchanged thereafter.
authors.affiliation: Clinical Department of Radiology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: Agnes
authors.initials: A
authors.lastname: Mayr
authors.forename: Kathrin
authors.initials: K
authors.lastname: Pedarnig
authors.forename: Gert
authors.initials: G
authors.lastname: Klug
authors.forename: Michael
authors.initials: M
authors.lastname: Schocke
authors.forename: Otmar
authors.initials: O
authors.lastname: Pachinger
authors.forename: Werner
authors.initials: W
authors.lastname: Jaschke
authors.forename: Bernhard
authors.initials: B
authors.lastname: Metzler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003287:Contrast Media; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D016015:Logistic Models; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009206:Myocardium / Q000473:pathology; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D020127:Recovery of Function; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D003287:Contrast Media