title: Early defects identified by computed tomography angiography are associated with left ventricular dysfunction and exercise intolerance following acute myocardial infarction.
abstract: OBJECTIVE
  We evaluated the influence of early defects (EDs) in the infarcted myocardium after reperfusion, detected by computed tomography angiography (CTA), on cardiac function and exercise capacity in the chronic phase.
  
  
  METHODS
  We retrospectively analyzed 48 acute myocardial infarction (AMI) patients who underwent both CTA using 64-slice multidetector CT within 14 ± 6 days and cardiopulmonary exercise testing within 3 months after AMI onset between 2005 and 2007. The patients were divided into 2 groups: the EDs <75 % or EDs ≥75 % group. Brain natriuretic peptide (BNP) levels and ejection fraction (EF) were measured 6 months after AMI onset.
  
  
  RESULTS
  The minute ventilation-carbon dioxide production slope was significantly higher in the EDs ≥75 % group (28.7 ± 4.9) than in the EDs <75 % group (25.1 ± 3.1, P = 0.048). EF at 6 months was significantly lower in the EDs ≥75 % group (48.1 ± 12.0 %) than in the EDs <75 % group (56.8 ± 10.0 %, P = 0.01). Log of BNP levels was higher in the EDs ≥75 % group than in the EDs <75 % group (P < 0.001).
  
  
  CONCLUSIONS
  EDs detected by CTA in the acute phase of AMI influenced myocardial dysfunction and exercise intolerance in the chronic phase.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kongoji
authors.forename: Kihei
authors.initials: K
authors.lastname: Yoneyama
authors.forename: Kohei
authors.initials: K
authors.lastname: Koyama
authors.forename: Takanobu
authors.initials: T
authors.lastname: Mitarai
authors.forename: Ryo
authors.initials: R
authors.lastname: Kamijima
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kida
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Kazuto
authors.initials: K
authors.lastname: Omiya
authors.forename: Yoshihiro J
authors.initials: YJ
authors.lastname: Akashi
mesh_terms: D000208:Acute Disease; D000368:Aged; D003287:Contrast Media; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D013995:Time; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000150:complications*
chemical_list: D003287:Contrast Media; D020097:Natriuretic Peptide, Brain; D007479:Iopamidol