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Relationship of microvascular obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction

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Chinese Medical Sciences Journal 2023年第1期38卷 11-19页

作者： Ya-Nan Zhao Jia-Ning Cui Xing-Hua Zhang Jin-Feng Li Shi-Min Chen Xiu-Zheng Yue Tao Li Department of Radiology First Medical Center of Chinese People’s Liberation Army General HospitalBeijing 100853China Department of Epidemiology and Statistics graduate school of Chinese People’s Liberation Army General HospitalBeijing 100853China Philips Healthcare Beijing 100600China

Objective To investigate the impact of microvascular obstruction(MVO)on the global and regional myocardial function by cardiac magnetic resonance feature-tracking(CMR-FT)in ST-segment-elevation myocardial infarction(STEMI)patients after percutaneous coronary *** Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1-7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective *** on the presence or absence of MVO on late gadolinium enhancement images,patients were divided into groups with MVO and without *** infarct zone,adjacent zone,and remote zone were determined based on a myocardial 16-segment *** radial strain(RS),circumferential strain(CS),and longitudinal strain(LS)of the global left ventricle(LV)and the infarct,adjacent,and remote zones were measured by CMRFT from cine images and compared between patients with and without MVO using independent-samples *** regression analysis was used to assess the association of MVO with the impaired LV *** A total of 157 STEMI patients(mean age 56.66±11.38 years)were *** was detected in 37.58%(59/157)of STEMI patients,and the mean size of MVO was 3.00±3.76 *** with patients without MVO(n=98),the MVO group had significantly reduced LV global RS(t=-4.30,P<0.001),global CS(t=4.99,P<0.001),and global LS(t=3.51,P=0.001).The RS and CS of the infarct zone in patients with MVO were significantly reduced(t=-3.38,P=0.001;t=2.64,P=0.01;respectively)and the infarct size was significantly larger(t=8.37,P<0.001)than that of patients without *** presence of LV MVO[OR=4.10,95%CI:2.05-8.19,P<0.001]and its size[OR=1.38,95%CI:1.10-1.72,P=0.01],along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis,while only heart rate(OR=1.08,95%CI:1.03-1.13,P=0.001)and LV infarct size(OR=1.10,95%CI:1

关键词： cardiac magnetic resonance feature tracking ST-segment elevation myocardial infarction microvascular obstruction myocardial strain Myocardial function

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A historical literature review of coronary microvascular obstruction and intra-myocardial hemorrhage as functional/structural phenomena

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The Journal of Biomedical Research 2023年第4期37卷 268-289页

作者： Leonid N.Maslov Natalia V.Naryzhnaya Sergey V.Popov Alexandr V.Mukhomedzyanov Ivan A.Derkachev Boris K.Kurbatov Andrey V.Krylatov Feng Fu Jianming Pei Vyacheslav V.Ryabov Evgenii V.Vyshlov Svetlana V.Gusakova Alla A.Boshchenko Akpay Sarybaev Laboratory of Experimental Cardiology Cardiology Research InstituteTomsk National Research Medical Center of the Russian Academy of SciencesTomskTomsk Region 634012Russia Department of Physiology and Pathophysiology National Key Discipline of Cell BiologySchool of Basic Medicinethe Fourth Military Medical UniversityXi'anShaanxi 710032China Siberian State Medical University TomskTomsk Region 634050Russia National Center of Cardiology and Internal Medicine Bishkek 720040Kyrgyzstan.

The analysis of experimental data demonstrates that platelets and neutrophils are involved in the no-reflow phenomenon,also known as microvascular obstruction(MVO).However,studies performed in the isolated perfused hearts subjected to ischemia/reperfusion(I/R)do not suggest the involvement of microembolization and microthrombi in this *** intracoronary administration of alteplase has been found to have no effect on the occurrence of MVO in patients with acute myocardial ***,the major events preceding the appearance of MVO in coronary arteries are independent of microthrombi,platelets,and *** cells appear to be the target where ischemia can disrupt the endothelium-dependent vasodilation of coronary ***,reperfusion triggers more pronounced damage,possibly mediated by *** and intra-myocardial hemorrhage contribute to the adverse post-infarction myocardial ***,pharmacological agents used to treat MVO should prevent endothelial injury and induce relaxation of smooth *** conditioning protocols have been shown to prevent MVO,with L-type Ca2+channel blockers appearing the most effective in treating MVO.

关键词： heart ischemia reperfusion microvascular obstruction intra-myocardial hemorrhage

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