title: Concordance of angiographic and electrocardiographic indexes of microvascular obstruction: myocardial haemorrhage role.
abstract: BACKGROUND
  Angiographic and electrocardiographic (ECG) indexes of microvascular obstruction (MVO) have been described. We aimed at assessing by cardiac magnetic resonance (CMR) anatomical features underlying concordance between them.
  
  
  METHODS
  Forty-one patients were enrolled. Patients presented with neither angiographic nor ECG indexes of MVO (without MVO) (44%), with either angiographic or ECG indexes of MVO (discordant with MVO) (22%) or with both angiographic and ECG indexes of MVO (concordant with MVO) (34%). All patients underwent in-hospital CMR. Echocardiographic data obtained after 6 months were compared with those obtained in hospital.
  
  
  RESULTS
  Concordant patients with MVO had larger infarct size, lower myocardial salvage index and higher rate of myocardial haemorrhage (all assessed by CMR) [33% (25-41%), 15% (10-29%) and 88%, respectively] as compared with patients without MVO [12% (9-16%), 66% (52-79%) and 0%; Bonferroni-adjusted P < 0.001, Bonferroni-adjusted P < 0.001 and P < 0.001, respectively], or with discordant ones [25% (21-39%), 35% (20-48%) and 7%; Bonferroni-adjusted P = 0.03, Bonferroni-adjusted P = 0.002 and P = 0.04, respectively]. After 6 months, ejection fraction significantly decreased in concordant patients with MVO (P < 0.001) without significant changes in the other groups.
  
  
  CONCLUSIONS
  Concordance of angiographic and ECG indexes of MVO reflects more severe myocardial damage translating into unfavourable left ventricular remodelling.
authors.affiliation: aInstitute of Cardiology, Catholic University of the Sacred Heart bDepartment of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences Sapienza University of Rome cInstitute of Radiology, Department of Bioimaging and Radiological Sciences, Catholic University, Rome, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.forename: Nicola
authors.initials: N
authors.lastname: Cosentino
authors.forename: Cristina
authors.initials: C
authors.lastname: Spaziani
authors.forename: Valentina
authors.initials: V
authors.lastname: Loria
authors.forename: Francesco
authors.initials: F
authors.lastname: Fracassi
authors.forename: Marco
authors.initials: M
authors.lastname: Roberto
authors.forename: Camilla
authors.initials: C
authors.lastname: Calvieri
authors.forename: Antonella
authors.initials: A
authors.lastname: Lombardo
authors.forename: Luigi
authors.initials: L
authors.lastname: Natale
authors.forename: Carmela
authors.initials: C
authors.lastname: Napolitano
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mandurinoa
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Leone
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006470:Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging*; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D016277:Ventricular Function, Left