title: Microvascular obstruction assessed by 3-tesla magnetic resonance imaging in acute myocardial infarction is correlated with plasma troponin I levels.
abstract: BACKGROUND
  Microvascular obstruction (MVO) at the acute phase of myocardial infarction (MI) is associated with poor prognosis. We aimed to evaluate the correlation between plasma cardiac troponin I (cTnI) at the acute phase of MI and extent of no-reflow, as assessed by 3-T cardiac magnetic resonance imaging (MRI). Secondly, we defined a cut-off value for cTnI predictive of no-reflow.
  
  
  METHODS
  51 consecutive patients with no previous history of cardiovascular disease, presenting ST elevation MI within <12 h. Infarct size and extent of no-reflow were evaluated by 3-T MRI at day 5. Extent of no-reflow at 15 minutes (MVO) was correlated with cTnI at admission, 6, 12, 24, 48 and 72 hours. At 6 months, MRI was performed to evaluate the impact of MVO on LV remodeling.
  
  
  RESULTS
  MVO was diagnosed in 29 patients (57%). Extent of MVO was significantly correlated to peak troponin, cTnI (except admission values) and area under the curve. Using Receiver-operating characteristic (ROC) curve analysis, a cut-off cTnI value >89 ng/mL at 12 h seemed to best predict presence of early MVO (sensitivity 63%, specificity 88%). At 6 months, MVO was associated with left ventricular (LV) remodeling, resulting in higher LV volumes.
  
  
  CONCLUSIONS
  There is a relationship between cTnI at the acute phase of AMI and extent of MVO as assessed by 3-T cardiac MRI. A cut-off cTnI value of 89 ng/mL at 12 h seems to best predict presence of MVO, which contributes to LV remodeling.
authors.forename: Karine
authors.initials: K
authors.lastname: Pernet
authors.forename: Fiona
authors.initials: F
authors.lastname: Ecarnot
authors.forename: Romain
authors.initials: R
authors.lastname: Chopard
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Seronde
authors.forename: Philoktimon
authors.initials: P
authors.lastname: Plastaras
authors.forename: Francois
authors.initials: F
authors.lastname: Schiele
authors.affiliation: Department of Cardiology, EA3920, University Hospital Jean Minjoz, Boulevard Fleming, Besançon 25000, France. nicolas.meneveau@univ-fcomte.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meneveau
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D003331:Coronary Vessels / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D055806:Microvessels / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D054318:No-Reflow Phenomenon / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D013997:Time Factors; D019210:Troponin I / Q000097:blood*; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers; D019210:Troponin I