Evaluation of acute ischemia in pre-procedure ECG predicts myocardial salvage after primary PCI in STEMI patients with symptoms &gt;12hours

Fakhri, Yama; Busk, Martin; Schoos, Mikkel Malby; Terkelsen, Christian Juhl; Kristensen, Steen Dalby; Wagner, Galen S.; Sejersten, Maria; Clemmensen, Peter; Kastrup, Jens

doi:10.1016/j.jelectrocard.2016.02.009

Cited by 11 publications

(12 citation statements)

References 29 publications

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“…12 The normal limit approach with cutoff 2.5 SD was prespecified in our protocol and was chosen since it has previously been used to estimate final infarct size in SPECT. 13 However, the optimal cut-off value for follow-up assessments after STEMI remains unknown when using PET. 11 Absolute rest myocardial blood flow (mlÁminÁg) was calculated by applying Lortie's one compartment model 14 and was expressed as global …”

Section: Pet Acquisitionmentioning

confidence: 99%

Early risk stratification using Rubidium-82 positron emission tomography in STEMI patients

Ghotbi

Hasbak

Nepper‐Christensen

et al. 2019

Journal of Nuclear Cardiology

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Background. Assessment of infarct size after myocardial infarction is predictive of subsequent morphological changes and clinical outcome. This study aimed to assess subacute postintervention Rubidium-82 ( 82 Rb)-PET imaging in predicting left ventricle ejection fraction, regional wall motion, and final infarct size by CMR at 3-months after STEMI.Methods. STEMI patients undergoing percutaneous coronary intervention were included prospectively. Rest-only 82 Rb-PET perfusion imaging was performed at median 36 hours [IQR: 22 to 50] after the treatment. The extent of hypoperfusion and absolute blood flow (mLÁminÁg) were estimated on a global and a 17-segment model with dedicated software. At 3-months follow-up patients completed the CMR functional and late gadolinium enhancement imaging.Results. 42 patients were included, but only 35 had follow-up CMR and constituted the study population. Absolute blood flow was significantly lower in the infarct-related territory compared to remote myocardium, P < .005. Extent of hypoperfusion correlated with final infarct size, r 5 0.58, P < .001, while blood flow correlated with ejection fraction, r 5 0.41, P < .05. In linear mixed models, higher subacute absolute blood flow (b 5 4.6, confidence interval [3.5; 5.2], P < .001, R 2 5 0.67) was associated with greater wall motion. Segmental extent of subacute hypoperfusion (b 5 0.43 [0.38; 0.49], P < .001, R 2 5 0.58) was associated with the degree of late gadolinium enhancement at 3-months.Conclusions. Subacute rest-only 82 Rb-PET is feasible following STEMI and seems predictive of myocardial function and infarct size at 3-months. (J Nucl Cardiol 2017) Key Words: Positron emission tomography AE cardiac magnetic resonance AE Rubidium-82 AE myocardial blood flow AE ST-segment elevation myocardial infarction AE final infarct size Electronic supplementary material The online version of this article

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Section: Pet Acquisitionmentioning

confidence: 99%

Early risk stratification using Rubidium-82 positron emission tomography in STEMI patients

Ghotbi

Hasbak

Nepper‐Christensen

et al. 2019

Journal of Nuclear Cardiology

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“…BRAVE-2 menunjukkan bahwa angioplasti primer mengurangi ukuran infark akhir (Final Infarct Size/FIS) bila dibandingkan dengan terapi medikamentosa optimal pada pasien STEMI stabil dengan onset 12-48 jam. 18,[20][21][22] Pada penelitian ini, analisis bivariat yang membandingkan WMSI sebelum dan 72 jam setelah PCI pada kelompok early dengan kelompok late menunjukkan adanya perbaikan WMSI sebanyak 73% pada kelompok early dan 67% pada kelompok late, perburukan WMSI pada 9% pada kelompok early dan 19% pada kelompok late, dan tidak ada perubahan WMSI pada 18% pada kelompok early dan 14% pada kelompok late. Hasil ini memberikan gambaran bahwa lebih banyak pasien yang mengalami perbaikan WMSI pada kelompok early dibandingkan kelompok late.…”

Section: Artikel Asliunclassified

Waktu antara angina dan tindakan percutaneous coronary intervention menyebabkan perubahan wall motion score index pada pasien infark miokard akut

Sari¹

2018

medicina

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Blockage due to thrombus in Acute Myocardial Infarction (AMI) causes complete ischemia and necrosis in areas supplied by blocked arteries. Rapid revascularization with Percutaneous Coronary Intervention (PCI) will decrease myocardial damage. The left ventricle function is an important outcome during PCI. A semi-quantitative assessment of the regional left ventricular contractile function can be obtained through the assessment of the Wall Motion Score Index (WMSI). The time between angina and PCI is most important, since the time lag represents the total ischemic time, so it needs to be reduced to the shortest possible to increase the clinical outcome. This study aimed to know the correlation between WMSI changes between patients who were treated with PCI with shorter total ischemic time compare with longer total ischemic time. This was a cohort prospective study conducted in Sanglah Hospital, Denpasar, Bali, during November 2017 until January 2018. This study included 32 AMI patients who are treated with PCI. WMSI was measured using transthoracic echocardiography before and 72 hours after PCI. From ROC curve analysis, the time cutoff point between angina and PCI action was 313 minutes with 75% sensitivity and 54% specificity and there were 2 groups consist of group with the time integral between angina and PCI less than 313 minute (early group) and group with the time integral between angina and PCI more than equal to 313 minute (late group). By using the Wilcoxon sign rank pair test, there was significant WMSI changes in both early and late groups before and 72 hours after PCI, with the early group showed better improvement compared to the late group. Meanwhile, Wilcoxon Mann Whitney U test result showed that there was no significant difference in WMSI changes in the early group compared to the late group. These result showed the importance of PCI in improving myocardial contractility even in patients who underwent PCI later than 5 hours after the onset of chest pain.

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“…An objective electrocardiographic (ECG) method for quantifying the timing of evolving acute myocardial infarction, the Anderson-Wilkins acuteness score has previously been developed and modified. The acuteness score quantifies the acuteness of myocardial ischemia from the electrocardiogram (ECG) [5,6], and has been shown to be superior to treatment delay (time from pain-to-balloon) in predicting final infarct size (FIS), salvage and mortality in patients with symptom duration within 12 hours [7][8][9] and 12-72 hours [10]. This score represents a more objective and quantitative ECG measure of the time course of ongoing myocardial ischemia compared to subjective patient-reported symptom duration.…”

Section: Introductionmentioning

confidence: 99%

Algorithm for the automatic computation of the modified Anderson–Wilkins acuteness score of ischemia from the pre-hospital ECG in ST-segment elevation myocardial infarction

Fakhri

Sejersten

Schoos

et al. 2017

Journal of Electrocardiology

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In conclusion, we have developed an automated algorithm for measurement of the modified Anderson-Wilkins ECG acuteness score from the pre-hospital ECG in STEMI patients. This automated algorithm is highly reliable, can be applied in daily practice for research purposes and may be implemented in commercial automated ECG analysis programs to achieve practical use for decision support in the acute phase of STEMI.

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Evaluation of acute ischemia in pre-procedure ECG predicts myocardial salvage after primary PCI in STEMI patients with symptoms >12hours

Cited by 11 publications

References 29 publications

Early risk stratification using Rubidium-82 positron emission tomography in STEMI patients

Early risk stratification using Rubidium-82 positron emission tomography in STEMI patients

Waktu antara angina dan tindakan percutaneous coronary intervention menyebabkan perubahan wall motion score index pada pasien infark miokard akut

Algorithm for the automatic computation of the modified Anderson–Wilkins acuteness score of ischemia from the pre-hospital ECG in ST-segment elevation myocardial infarction

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